title: New treatments for cutaneous metastatic melanoma: MAPK pathway-targeted and immune based therapies.
abstract: Increasing knowledge on cellular biology has permitted rapid changes in the treatment of metastatic melanoma. Until 2011, dacarbazine was the gold standard treatment at our disposal. In 2011 the treatment landscape changed dramatically with the approval by the FDA of ipilimumab and vemurafenib. These drugs use two new therapeutic approaches: immunomodulation and the targeting of mutated cellular pathways in tumor cells. These two drugs, used as single agents have shown important increases in overall survival, unseen before in patients with advanced melanoma, but are limited by their toxicities and the appearance of acquired resistances. In this article, we review new therapeutic options in pathway-targeted -with the arrival of MEK inhibitors - and immune based melanoma therapies -with the arrival of anti-PD1 and anti-PDL1- as well as new therapeutic strategies developed to overcome acquired resistance and diminish drug toxicities.
authors.forename: F
authors.initials: F
authors.lastname: Ranchon
authors.affiliation: Dermatology Unit, Hospices Civils de Lyon, CH Lyon Sud, 165 chemin du Grand Revoyet, 69495 Pierre Benite Cedex, France. amelieboes@gmail.com.
authors.forename: A
authors.initials: A
authors.lastname: Boespflug
authors.forename: C
authors.initials: C
authors.lastname: Rioufol
authors.forename: V
authors.initials: V
authors.lastname: Schwiertz
authors.forename: L
authors.initials: L
authors.lastname: Thomas
authors.forename: S
authors.initials: S
authors.lastname: Dalle
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology / Q000627:therapeutic use; D060890:B7-H1 Antigen / Q000037:antagonists & inhibitors; D017321:Clinical Trials, Phase I as Topic; D003131:Combined Modality Therapy; D006801:Humans; D007167:Immunotherapy; D008545:Melanoma / Q000188:drug therapy* / Q000276:immunology / Q000556:secondary; D020928:Mitogen-Activated Protein Kinases / Q000037:antagonists & inhibitors; D058990:Molecular Targeted Therapy; D061026:Programmed Cell Death 1 Receptor / Q000037:antagonists & inhibitors; D048493:Proto-Oncogene Proteins B-raf / Q000037:antagonists & inhibitors; D012878:Skin Neoplasms / Q000276:immunology / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D060890:B7-H1 Antigen; C423236:CD274 protein, human; C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor; D048493:Proto-Oncogene Proteins B-raf; D020928:Mitogen-Activated Protein Kinases