Updates in Pharmacotherapy for Melanoma

Angie Amado, PharmD Candidate 2019; Sonia Amin Thomas (Sonia Patel), PharmD, BCOP

Disclosures

US Pharmacist. 2018;43(6):HS2-HS9. 

In This Article

Treatment Overview

Initial treatment for primary melanoma continues to involve surgical excision and may include adjuvant radiation to help reduce the risk of recurrence. For patients with stage III in-transit melanoma in whom resection is not feasible, nonsurgical local approaches may include intralesion injections.[5]

For first-line treatment of unresectable or metastatic disease (Table 1), recommended options include checkpoint immunotherapy, BRAF-targeted therapy (in the case of BRAF-mutated disease), and clinical trials.[5] For disease-free resectable melanoma or advanced disease, recent studies have supported new adjuvant treatments based on their superior efficacy compared with traditional chemotherapy. Two new treatments include biochemotherapy—a combination of high-dose interferon, interleukin-2 (IL-2), and chemotherapy—and immune checkpoint inhibitors.[7,8] For patients with BRAF-mutant metastatic disease, BRAF-targeted treatments may include BRAF/MEK inhibitor combination therapy with dabrafenib/trametinib or vemurafenib/cobimetinib or single-agent BRAF-inhibitor therapy with vemurafenib or dabrafenib.[5] Treatment selection in any stage depends on many factors, including the patient's overall health, comorbidities, and risk of recurrence, and risks and benefits should be assessed before treatment initiation.

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