What is the role of immunotherapy in the treatment of choroidal melanoma?

Updated: Dec 12, 2018
  • Author: Enrique Garcia-Valenzuela, MD, PhD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Answer

Since 2011, multiple novel systemic therapies for metastatic melanoma (stage IV) have become available. These include immune checkpoint inhibitors and targeted therapy, which have led to durable responses and some improvement in overall survival and quality of life.

Several FDA-approved immunotherapy options are currently available for melanoma. These include the immunomodulator checkpoint inhibitors ipilimumab, nivolumab, and pembrolizumab; the cytokines interferon alpha-2b and peginterferon alpha-2b; and oncolytic virus therapy with T-VEC.

Currently, FDA-approved targeted therapies for melanoma includes the oral BRAF inhibitors dabrafenib (Tafinlar) and vemurafenib (Zelboraf) for melanomas with a mutated or activated BRAF gene and the oral MEK inhibitor trametinib for patients who have melanoma with a BRAF V600E or V600K mutation. BRAF and MEK inhibitors are usually given in combination. Other targeted therapies in clinical trials include KIT inhibitors. Tumor-infiltrating lymphocyte (TIL) immunotherapy is also under investigation for the treatment of metastatic melanoma. [9, 10] This is an area of intense medical research, with ever-increasing degrees of biological sophistication being applied to new clinical trials.


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