Immunotherapy for Melanoma – HealthyWomen

How immunotherapy works with the immune system

Immunotherapy helps the body’s immune system better recognize and fight cancer cells. Immunotherapy can work in a few different ways for melanoma:

• Enhancing the overall function of the immune system to destroy cancer cells
• Using a targeted attack on specific types of cancer and immune cells, called immune checkpoint inhibitors;
• With cell therapy, which uses the patient’s own tumor cells to help kick-start the immune system
• With virus therapy, which uses viruses that have been modified in the lab to attack cancer cells

Here’s a closer look at each type of melanoma immunotherapy.

General immunotherapy

In theory, the body’s immune system can recognize and attack cancer cells to prevent their growth. But sometimes cancer cells can grow too fast for the immune system or even the cells to keep up. hide from or attack the immune system. General immunotherapy uses drugs that can help improve the overall function of the immune system. For example, interleukins are proteins that can boost the immune system so it can better recognize and attack melanoma cells. Melanoma treatment uses laboratory versions of the protein, interleukin-2 (IL-2).

IL-2s aren’t used as often as they used to be because they can have serious side effects and usually don’t work as well as immune checkpoint inhibitors.

Immune checkpoint inhibitors

Immune checkpoint inhibitors (ICIs) are a targeted form of immunotherapy. A key way in which immunotherapy works in melanoma is by “turning off” certain proteins in the cells of the immune system that prevent the cells from attacking the cancer.

In a healthy person, the immune system has built-in “checkpoints” that prevent immune cells from destroying healthy cells. Unfortunately, melanoma cells use these checkpoints against the body and it can bind to them to allow cancer to grow. Immune checkpoint inhibitors are drugs that “turn off” these specific checkpoints, allowing immune cells to recognize the melanoma and work to destroy it.

• PD-1 inhibitors: PD-1 inhibitors target an immune cell protein called PD-1. PD-1 normally works to stop immune cells from destroying other cells. Blocking PD-1 frees these immune cells to better fight melanoma cancer cells. The PD-1 inhibitors are called pembrolizumab (brand name: Keytruda) and nivolumab (brand name: Opdivo) and are given as IV infusions. They can only be used for melanoma that has spread and cannot be removed with surgery. They can also be used as secondary treatment (called adjuvant) and preventive treatment to reduce the risk of the cancer coming back.
• PD-L1 inhibitors: PD-L1 inhibitors, atezolizumab (brand name: Tecentriq), work in the same way, by blocking the PD-L1 protein on immune cells that normally stops the cells from attacking. This type of immunotherapy can be used specifically for people who have metastasized melanoma with the BRAF gene mutation. It can be given through an IV or by injection.
• CLTA-4 inhibitors: This type of checkpoint inhibitor targets the CTLA-4 proteins, found on T-cells of the immune system. Used alone, CLTA-4 inhibitors are less effective and have more severe side effects than other immunotherapy drugs, but they can be given alongside a PD-1 inhibitor. Ipilimumab (brand name: Yervoy) is given by IV infusion.
• LAG-3 inhibitors: LAG-3 inhibitors (called relatlimab) block the LAG-3 checkpoint protein. Relatlimab is usually given by infusion in combination with a PD-1 inhibitor called nivolumab. (Together, relatlimab and nivolumab go by the brand name Opdualag.)

Checkpoint inhibitors are a promising development in melanoma treatment. Before ICI treatment, the average survival rate with advanced melanoma it was only six months. Now, however, survival rates have far exceeded the six-month rate.

Infiltrating lymphocyte (TIL) therapy.

T cells are a specific type of immune cell that the body uses to fight cancer. When they move into a tumor, they are called tumor infiltrating lymphocytes (TILs). TIL therapy is a newer cancer treatment that removes TILs from a tumor, multiplies them in the lab, and returns them to the body as an infusion. TIL can be effective for advanced melanoma because the T cells are taken from the cancer cells they have been “taught” to specifically recognize melanoma.

The treatment is complex and is given in several stages in the hospital. In 2024, the US Food and Drug Administration (FDA) approved. lifileucel (brand name: Amtagvi) as the first FDA-approved tumor-derived T-cell immunotherapy.

Oncolytic virus therapy

Oncolytic virus therapy involves “hacking” viruses to target cancer cells. Viruses are notorious for their ability to hide from the immune system and attack healthy cells, so scientists discovered a way to harness this power by altering viruses (called oncolytic viruses) in a lab to attack cancer cells.

In addition to directly destroying cancer cells, oncolytic viruses can also alert the rest of the immune system to attack cancer cells. For melanoma, talimogene laherparepvec (brand name: Imlygic), also known as T-VEC, is an oncolytic virus that can be used to try to shrink tumors that cannot be removed surgically. Currently, the primary goal of oncolytic virus therapy in melanoma is to shrink tumors, and some data show that it may help increase survival rates.

Many of the immunotherapy treatment options for melanoma can be used together, which offers more opportunities for effective treatment. Increased immunotherapy options have offered new hope for a very difficult type of cancer.

The best results from treatment always come with early diagnosis, so knowing the signs of skin cancer and having regular skin checks is very important in the fight against melanoma.