open access

Vol 69, No 3-4 (2019)
Review articles
Published online: 2019-10-31
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Combined or sequential treatment of advanced melanoma?

Bożena Cybulska-Stopa, Tomasz Świtaj, Hanna Koseła-Paterczyk
DOI: 10.5603/NJO.2019.0024
·
Nowotwory. Journal of Oncology 2019;69(3-4):125-132.

open access

Vol 69, No 3-4 (2019)
Review articles
Published online: 2019-10-31

Abstract

Melanoma is a malignant neoplasm with a very high rate of growth in the number of cases. In Poland, in the years 1980–2010, the number of cases of melanoma increased threefold. Although the incidence rates of melanoma are rising, the mortality rate due to melanoma is falling. In recent years, the treatment of patients with melanoma has changed to a great extent. Thanks to the development of molecular research, the presence of specific mutations in melanoma cells was discovered. The progress in understanding the molecular mechanisms occurring in this neoplastic cells and the interaction between the immune system cells and melanoma cells contributed to the development of new classes of drugs: immunotherapy and targeted therapy. With the use of checkpoint inhibitors, long-term remission of the disease can be achieved, which has been confirmed in many clinical trials that have shown improvements in overall survival (OS) and progression free survival (PSF). However, the predominant problem is the low response rate to checkpoint inhibitors and the time between the initiation of therapy and the response to treatment. This is not the case with targeted therapies, where the response rate is high and the response time is very short. Therefore, a promising treatment strategy can be a combination of these two classes of drugs, so that one can try to achieve a quick and long-term response to the treatment. The paper discusses the current treatment options for melanoma patients in the spreading phase of the disease and analyzes the benefits of combined and sequential treatment.

Abstract

Melanoma is a malignant neoplasm with a very high rate of growth in the number of cases. In Poland, in the years 1980–2010, the number of cases of melanoma increased threefold. Although the incidence rates of melanoma are rising, the mortality rate due to melanoma is falling. In recent years, the treatment of patients with melanoma has changed to a great extent. Thanks to the development of molecular research, the presence of specific mutations in melanoma cells was discovered. The progress in understanding the molecular mechanisms occurring in this neoplastic cells and the interaction between the immune system cells and melanoma cells contributed to the development of new classes of drugs: immunotherapy and targeted therapy. With the use of checkpoint inhibitors, long-term remission of the disease can be achieved, which has been confirmed in many clinical trials that have shown improvements in overall survival (OS) and progression free survival (PSF). However, the predominant problem is the low response rate to checkpoint inhibitors and the time between the initiation of therapy and the response to treatment. This is not the case with targeted therapies, where the response rate is high and the response time is very short. Therefore, a promising treatment strategy can be a combination of these two classes of drugs, so that one can try to achieve a quick and long-term response to the treatment. The paper discusses the current treatment options for melanoma patients in the spreading phase of the disease and analyzes the benefits of combined and sequential treatment.

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Keywords

melanoma; immunotherapy; targeted therapy; sequential treatment

About this article
Title

Combined or sequential treatment of advanced melanoma?

Journal

Nowotwory. Journal of Oncology

Issue

Vol 69, No 3-4 (2019)

Pages

125-132

Published online

2019-10-31

DOI

10.5603/NJO.2019.0024

Bibliographic record

Nowotwory. Journal of Oncology 2019;69(3-4):125-132.

Keywords

melanoma
immunotherapy
targeted therapy
sequential treatment

Authors

Bożena Cybulska-Stopa
Tomasz Świtaj
Hanna Koseła-Paterczyk

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