title: Drug Combinations as the New Standard for Melanoma Treatment.
abstract: Advanced melanoma is related to a very grim prognosis and fast progression. Until recently, there has been no indicated treatment that would affect the disease's outcome. However, the progress in immunotherapy and molecular therapy has significantly changed the unfavourable prognosis of melanoma progression and its short survival rate. Both approaches have improved patients' outcomes and provided renewed hope for successful treatment. Moreover, in order to further enhance patients' outcomes and to avoid mechanisms of tumour resistance, investigators attempted a combined approach. Targeted therapy combinations allowed a better response rate and progression-free survival than monotherapy with one of the agents. Another promising combination, but with limiting toxicities, is a concurrent immuno- and molecular-targeted therapy. It is suspected that complimentary usage of these drugs may lead to synergism, providing robust and quick tumour responses as well as long-lasting effects. Results of currently ongoing clinical trials that investigate combination strategies in melanoma are expected to provide more mature data about the effectiveness and the safety profile of those therapies. Until more robust results of these studies occur, the best management of advanced and metastatic melanoma is immunotherapy with anti-PD1 drugs or targeted therapy with concomitant BRAF and MEK inhibitor. However, which of these two options should be used first is still under discussion.
authors.affiliation: Department of Clinical Pharmacy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Banacha st. 1, 02-097, Warsaw, Poland. mpolkowska@wum.edu.pl.
authors.forename: Marta
authors.initials: M
authors.lastname: Polkowska
authors.affiliation: Department of Clinical Pharmacy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Banacha st. 1, 02-097, Warsaw, Poland.
authors.forename: Edyta
authors.initials: E
authors.lastname: Czepielewska
authors.affiliation: Department of Clinical Pharmacy and Pharmaceutical Care, Faculty of Pharmacy, Medical University of Warsaw, Banacha st. 1, 02-097, Warsaw, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Kozłowska-Wojciechowska
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D018450:Disease Progression; D019008:Drug Resistance, Neoplasm; D006801:Humans; D008545:Melanoma / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D058990:Molecular Targeted Therapy; D009367:Neoplasm Staging; D015513:Oncogene Proteins / Q000037:antagonists & inhibitors; D059039:Standard of Care
chemical_list: D015513:Oncogene Proteins
keywords: Combinations; Immunotherapy; Malignant; Melanoma; Targeted