Skip to content

    Melanoma/Skin Cancer Health Center

    Font Size
    A
    A
    A

    Melanoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Treatment Option Overview for Melanoma

    Table 8. Standard Treatment Options for Melanoma continued...

    BRAFinhibitors

    Vemurafenib

    Vemurafenib, approved by the FDA in 2011, has demonstrated an improvement in PFS and OS in patients with unresectable or advanced disease. Vemurafenib is an orally available, small-molecule, selective BRAF V600E kinase inhibitor, and its indication is limited to patients with a demonstrated BRAF V600E mutation by an FDA-approved test.[11]

    Dabrafenib

    Dabrafenib, an orally available, small-molecule, selective BRAF inhibitor that was approved by the FDA in 2013, showed improvement in PFS when compared with DTIC in an international, multicenter trial (BREAK-3 [NCT01227889]).

    MEK inhibitors

    Trametinib

    Trametinib is an orally available, small-molecule, selective inhibitor of MEK1 and MEK2 that was approved by the FDA in 2013 for patients with unresectable or metastatic melanoma with BRAF V600E or K mutations. Trametinib demonstrated improved PFS over DTIC.

    Combination signal transduction therapy

    In 2014, the combination of dabrafenib and trametinib received accelerated approval from the FDA for patients with unresectable or metastatic melanomas that carry the BRAF V600E or V600 K mutation. The combination demonstrated improved durable response rates over single-agent dabrafenib. Full approval is pending completion of ongoing clinical trials and demonstration of clinical benefit on OS.

    c-KIT inhibitors

    Early data suggest that mucosal or acral melanomas with activating mutations or amplifications in c-KIT may be sensitive to a variety of c-KIT inhibitors.[12,13,14] Phase II and phase III trials are available for patients with unresectable stage III or stage IV melanoma harboring the c-KIT mutation.

    Chemotherapy

    DTIC: DTIC was approved in 1970 on the basis of overall response rates. Phase III trials indicate an overall response rate of 10% to 20%, with rare CRs observed. An impact on OS has not been demonstrated in randomized trials.[15,16,17,18] When used as a control arm for recent registration trials of ipilimumab and vemurafenib in previously untreated patients with metastatic melanoma, DTIC was shown to be inferior for OS.

    Temozolomide: Temozolomide, an oral alkylating agent, appeared to be similar to intravenous DTIC in a randomized phase III trial with a primary endpoint of OS; however, because the trial was designed to demonstrate the superiority of temozolomide, which was not achieved, the trial was left with a sample size that was inadequate to provide statistical proof of noninferiority.[16]

    1 | 2 | 3 | 4
    Next Article:

    Today on WebMD

    Malignant melanoma
    How to spot it early.
    Woman checking out tan lines
    There’s a dark side to that strive for beauty.
     
    sauteed cherry tomatoes
    Fight cancer one plate at a time.
    Lung cancer xray
    See it in pictures, plus read the facts.
     
    12 Ways to Protect Your Skin from Melanoma
    ARTICLE
    precancerous lesions slideshow
    SLIDESHOW
     
    Do You Know Your Melanoma ABCs
    VIDEO
    15 Cancer Symptoms Men Ignore
    ARTICLE
     
    screening tests for men
    SLIDESHOW
    Vitamin D
    SLIDESHOW
     
    Is That Mole Skin Cancer
    VIDEO
    Brilliant sun rays
    Quiz