Advanced Melanoma, or stage IV melanoma, is a type of skin cancer that has moved (metastasized), via the lymph system, to another area of the body. Commonly, these metastases are found in the lungs, liver, brain or other organs. Before 2011, treatments for advanced stage melanoma were fairly unsuccessful and usually had devastating effects on quality of life for patients. However, a clinical trial which started in 2013 has shown survival rates soaring due to development of immunotherapy.
The two drugs used in this immunotherapy trial were Nivolumab and Ipilimumab. They work to enhance one’s own immune system by altering the body’s own immune ‘checkpoints’. These checkpoints are on each of our cells and tell our immune system whether or not to attack an infection. Cancer cells harness this to survive; telling the immune system that it should not attack and allow the cancer to grow and spread. These immunotherapy drugs block these cancer cells from communicating with the immune system allowing it to attack and kill these cells.
In this trial patients were given either Nivolumab, Ipilimumab or both. Over the course of the trial, which is still ongoing, it has been shown that the 5 year survival rate of those taking the combination treatment is 52%, and 44% with nivolumab alone.
“This treatment not only allowed him to maintain a good quality of life whilst on treatment, but means he will see his children grow up.”
What was this treatment like for patients? My Uncle, Bryan, a 48 year old Dad of two young children, was diagnosed with advanced melanoma in 2017. He was first given the combination dose of Nivolumab and Ipilimumab. The first round resulted in a development of a rash all over his body and, after the second round, developed colitis (inflammation of the colon’s inner lining). It was at this point he was advised to continue only with the Nivolumab therapy, as the side effects were lesser than on the combined treatment. This treatment was successful after 3 months of fortnightly treatments with Nivolumab. However, he remained on a ‘maintenance’ treatment of Nivolumab for 2 years after. Before this trial, the life expectancy of someone with advanced melanoma was not much more than 6 months. This treatment not only allowed him to maintain a good quality of life whilst on treatment, but means he will see his children grow up.
The outcome of this trial has huge implications on the future treatments for melanoma, as well as other cancers such as renal and gynaecological cancers. The safety and effectiveness of these drugs hold incredible potential for people diagnosed with these cancers to survive with a good quality of life.
Last modified: 13th October 2019