[Major therapeutic advances in the treatment of metastatic melanoma].
The treatment of metastatic melanoma is presently in complete revolution. Two molecules have recently been authorized for this indication. These treatments have a very different mechanism of action compared to previous chemotherapies. Vemurafenib is a targeted therapy, which blocks BRAF selectively. This molecule induces objective responses in more than 50 % of the patients with V600E mutated melanoma and a benefit in terms of overall survival. However, many patients relapse after about 6 to 8 months of treatment. Many mechanisms are evoked to explain these secondary resistances to therapy. Ipilimumab is an immunotherapy that blocks CTLA4, a physiological brake of lymphocyte activation. With ipilimumab, the objective responses are less frequent than with vemurafenib but are more prolonged over time. Two phases III have demonstrated that ipilimumab treatment is effective on the overall survival of patients with metastatic melanoma. New combination therapies and additional targeted and immunotherapy agents are exciting perspectives that make us more optimistic for the future of metastatic melanoma treatment.
Institut Gustave-Roussy, service de dermatologie, 39, rue Camille-Desmoulins, 94805 Villejuif, France. christine.mateus@igr.fr
Christine
C
Mateus
Caroline
C
Robert
D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use*; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017322:Clinical Trials, Phase II as Topic; D017326:Clinical Trials, Phase III as Topic; D006801:Humans; D007211:Indoles / Q000009:adverse effects / Q000627:therapeutic use*; D000074324:Ipilimumab; D008545:Melanoma / Q000188:drug therapy* / Q000235:genetics / Q000401:mortality / Q000556:secondary; D009364:Neoplasm Recurrence, Local; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*; D000077484:Vemurafenib
D000911:Antibodies, Monoclonal; D000970:Antineoplastic Agents; D007211:Indoles; D000074324:Ipilimumab; D013449:Sulfonamides; D000077484:Vemurafenib; D048493:Proto-Oncogene Proteins B-raf