Cutaneous melanoma: available therapy for metastatic disease.
Survival of melanoma varies widely by stage, from a potentially highly curable disease when detected in early stages, to a disease with dismal prognosis when it reaches advanced inoperable stages. Stage IV melanoma defines distant metastasis and continues to comprise an ominous prognosis, with a median survival of 6-9 months. Currently, there is no therapeutic agent known to prolong survival in patients with metastatic melanoma. Therapeutic approaches studied in metastatic melanoma include chemotherapy, biochemotherapy, nonspecific immune adjuvants, cancer-specific vaccines, cytokines, monoclonal antibodies, and specific immunostimulants. Chemotherapy with single-agent dacarbazine is the only United States Food and Drug Administration (US-FDA)-approved chemotherapy agent for metastatic melanoma. Immunological approaches have yielded the only newly US-FDA-approved agent for metastatic disease in 30 years, high-dose bolus IL-2, based on durable responses in some patients with metastatic melanoma, but with associated high toxicity rate and cost. A number of novel therapeutic agents are undergoing active clinical investigation.
Tarhini
Ahmad A
AA
Division of Hematology/Oncology, University of Pittsburgh Cancer Institute, UPMC Cancer Pavilion, 5th Floor, 5150 Center Avenue, Pittsburgh, PA 15232, USA. agarwalass@upmc.edu
Agarwala
Sanjiv S
SS
D000970:Antineoplastic Agents / Q000008:administration & dosage; D019496:Cancer Vaccines / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D007376:Interleukin-2 / Q000008:administration & dosage; D008297:Male; D008545:Melanoma / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016879:Salvage Therapy; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000188:drug therapy* / Q000401:mortality* / Q000473:pathology; D016019:Survival Analysis; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D019496:Cancer Vaccines; D007155:Immunologic Factors; D007376:Interleukin-2