Novel treatment strategies in advanced melanoma: clinical data analysis with regards to registered indications in Poland

Abstract

An enormous progress can be observed over recent years in the treatment of advanced melanoma. First of all, there are great expectations regarding active immunotherapy, and ipilimumab, registered in Poland in 2011 allows long-term survival in some patients. Another therapeutic strategy involves specific molecularly targeted therapies, such as BRAF kinase inhibitors — vemurafenib and dabrafenib. These two classes of drugs are characterized by different kinetics of response (ipilimumab — late, but frequently long-lasting response, however apparent only in some patients; vemurafenib and dabrafenib — quick, but often only temporary response in most patients). BRAF inhibitors are particularly recommended for patients with rapid disease progression. Particular caution should be exercised when administering ipilimumab, due to its specific profile of side effects (e.g. immune-mediated reactions), which demands an early diagnostic and appropriate patient education, but most of all, the patients should be managed according to predetermined algorithms. A lot of ongoing trials using diverse immunotherapeutics and kinase inhibitors, in monotherapy or in combination therapy, create new possibilities for improvement of the therapeutic effects in patients with advanced melanoma.