Immunotherapy with melanoma

Immunotherapy with melanoma is a medicamental treatment method aimed at stimulating the immune system and helping it to fight this skin cancer. Melanoma is so aggressive that it is recognized as one of the most immunogenic malignant tumors for the ability to suppress any protective factors of the body.

Currently, immunotherapy in melanoma is considered by oncologists as a way to overcome the immunosuppressive effect of cancer cells on the body.

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Adjuvant immunotherapy for melanoma

The treatment method for melanoma is determined depending on the stage of the disease. Surgical intervention is performed by wide excision of the neoplasm with the capture of part of the surrounding healthy skin. In the presence of atypical cells in the biopsy specimen of sentinel lymph nodes, they are also removed, and the regions of the removed nodes are exposed to irradiation. Chemotherapy courses are prescribed with antitumor drugs-cytostatics.

And in all treatment regimens, at any stage, adjuvant or adjuvant immunotherapy with melanoma is now used. Although it is partially nonspecific, the benefits of immunity-inducing drugs are obvious, since immunomodulatory medications contribute to the activation of cellular immune system factors and enhance the body's resistance. And the main goal of immunotherapy with melanoma is to reduce the risk of metastases and relapse.

The indications of Interleukin-2 (Roncoleukin) are quite extensive, but its use in oncology, including melanoma, is associated with the mechanism of action: this drug (administered intravenously 0.25-2 mg once daily) increases the division of T cells and B-lymphocytes, increases the synthesis of cytotoxic T-lymphocytes and immunoglobulins, and also stimulates the ability of mononuclear phagocytes to utilize tumor antigens. In addition, interleukin-2 slows down the multiplication of cancer cells and their differentiation.

However, in patients who are prescribed immunotherapy for melanoma with interleukin, side effects often occur, manifested by fever, headaches, dyspepsia, arterial hypotension, and severe cardiac arrhythmia. There may also be complications in the form of localized gastrointestinal bleeding, depression and serious mental disorders. In this regard, you may need constant medical supervision and appropriate care for patients.

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Immunotherapy with interferon in melanoma

Effective immunotherapy with interferon in melanoma with the use of drugs whose structurally modified interferon alfa-2b or 2a is effective: Interferon alfa-2a (Intron-A, Realdiron, Alfarekin, Altevir, Reaferon, Laferon, etc.), Pegintron (Alfepeg, Unitrone), Interferon alfa-2a (Roferon-A).

In addition to hypersensitivity to interferon, these drugs have such contraindications: severe heart and vascular diseases, autoimmune pathologies, liver cirrhosis, kidney failure, CNS and psyche problems.

Schemes of application are determined by doctors, depending on the stage of melanoma and the treatment: after removal of the tumor - intravenously drip, per day 20 million IU per day for a month intravenously (as an infusion); the supporting course lasts 11 months (the drug is injected subcutaneously three times a week for 10 million IU). A different dosage and other schedule may be given for intramuscular injections or when combined with cytostatics.

Supportive therapy, as a rule, passes outside the medical institutions, therefore, before its beginning, theoretical and practical training of the patient or guardian is carried out: the rules of antiseptics, the preparation of an injection solution, the technique of hypodermic injections.

The most common side effects of immunotherapy with interferon in melanoma include pyrogenic effects (fever and fever); general weakness; pain in the abdomen, heart, joints and muscles; disorders of stool and appetite. Rare complications include inflammation of the liver parenchyma; kidney failure; tremor, convulsions and paresthesia; change in blood composition (leukopenia and thrombocytopenia); various neuro- and encephalopathies. The irreversible adverse effects of interferon-alpha use include autoimmune disorders.

Advantages and disadvantages of immunotherapy with melanoma

Advantages of immunotherapy with melanoma:

• - there is a slowdown in the progression of the disease;
• - in many patients there is a fairly long remission;
• - the risks of relapse are significantly reduced;
• - the duration of survival can increase.

Disadvantages of immunotherapy with melanoma:

• - immunostimulating drugs act indirectly and can not directly destroy cancer cells;
• - Interleukin-2 in high doses exhibits high multi-organ toxicity;
• - Interferon-alpha preparations should be used for a long time, they require supporting courses (three injections per week), since the termination of immunotherapy leads to a relapse of the disease;
• - the complexity of the biochemical system of regulation of the immune response and the lack of objective data on the genetically determined features of the patient's immunity does not provide an opportunity to predict the outcome of the treatment (in almost 30% of cases there is no positive clinical effect);
• - dosage is determined empirically, the appointment of an optimal dose requires an immunological examination of each patient;
• - prolonged stimulation of immunity often leads to its subsequent oppression.

Immunotherapy with melanoma - using interleukin-2 or interferon - can help some patients even with stage IV disease live longer. Higher doses of these drugs, as clinical practice shows, are more effective, but they can also cause more serious side effects.

Also read - Immunotherapy of cancer

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