Immunotherapy for melanoma

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

Currently, immunotherapy for 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 method of melanoma treatment 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. If there are atypical cells in the sentinel lymph node biopsy, they are also removed, and the areas of the removed nodes are irradiated. Courses of chemotherapy with antitumor cytostatic drugs are prescribed.

And in all treatment regimens at any stage, auxiliary or adjuvant immunotherapy is now used for melanoma. Although it is partly non-specific, the benefit of drugs that stimulate immunity is obvious, since immunomodulatory drugs help activate factors of the cellular immune system and increase the body's resistance. And the main goal of immunotherapy for melanoma is to reduce the risk of metastases and relapses.

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

However, patients who are prescribed immunotherapy for melanoma with interleukin often experience side effects, such as fever, headaches, dyspepsia, arterial hypotension and severe cardiac arrhythmia. Complications in the form of localized gastrointestinal bleeding, depression and serious mental disorders are also possible. In this regard, constant medical supervision and appropriate patient care may be required.

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Interferon Immunotherapy for Melanoma

Interferon immunotherapy for melanoma has been recognized as effective using drugs whose active ingredient is structurally modified interferon alpha-2b or 2a: Interferon alpha-2a (Intron-A, Realdiron, Alpharekin, Altevir, Reaferon, Laferon, etc.), Pegintron (Alfapeg, Unitron), Interferon alpha-2a (Roferon-A).

In addition to hypersensitivity to interferon, these drugs have the following contraindications: severe diseases of the heart and vascular system, autoimmune pathologies, liver cirrhosis, renal failure, problems of the central nervous system and psyche.

The application schemes are determined by doctors, depending on the stage of melanoma and the treatment: after tumor removal - intravenous drip, 20 million IU per day for a month intravenously (as an infusion); the maintenance course lasts 11 months (the drug is administered subcutaneously three times a week at 10 million IU). A different dosage and a different scheme may be prescribed for intramuscular injections or in combination with cytostatics.

Maintenance therapy, as a rule, takes place outside of medical institutions, therefore, before it begins, theoretical and practical preparation of the patient or caregiver is carried out: rules of antisepsis, preparation of injection solution, technique of subcutaneous injections.

The most common side effects of interferon immunotherapy for melanoma include pyrogenic effects (fever and temperature increase); general weakness; pain in the abdomen, heart, joints and muscles; stool and appetite disorders. Rarer complications include inflammation of the liver parenchyma; kidney failure; tremors, seizures and paresthesia; changes in blood composition (leukopenia and thrombocytopenia); various neuro- and encephalopathies. Irreversible negative consequences of interferon-alpha include autoimmune disorders.

Advantages and Disadvantages of Immunotherapy for Melanoma

Benefits of immunotherapy for melanoma:

• - the progression of the disease slows down;
• - many patients experience fairly long-term remissions;
• - the risk of relapse is significantly reduced;
• - survival time may increase.

Disadvantages of immunotherapy for melanoma:

• - immunostimulating drugs act indirectly and cannot directly destroy cancer cells;
• - interleukin-2 in high doses exhibits high multi-organ toxicity;
• - interferon-alpha preparations must be used for a long time and require maintenance courses (three injections per week), since discontinuation of immunotherapy leads to a relapse of the disease;
• - the complexity of the biochemical system regulating the immune response and the lack of objective data on the genetically determined characteristics of patients' immunity makes it impossible to predict the outcome of treatment (in almost 30% of cases there is no positive clinical effect);
• - the dosage is determined empirically; the appointment of the optimal dose requires an immunological examination of each patient;
• - prolonged stimulation of the immune system often leads to its subsequent suppression.

Immunotherapy for melanoma – using interleukin-2 or interferon – can help some patients, even with stage IV disease, survive longer. Higher doses of these drugs have been shown to be more effective, but they can also cause more serious side effects.

Also read – Cancer Immunotherapy

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