Immunotherapy in Melanoma: Highlights for the General Practitioner

Praxis (Bern 1994). 2023;112(3):135-142. doi: 10.1024/1661-8157/a003972.

Abstract

Melanoma is the most aggressive skin cancer, and surgery is the standard of care for localised disease. However, a risk of local and distant relapse exists despite tumour removal, particularly with thick or ulcerated tumours or lymph node involvement. Immunotherapy with immune checkpoint inhibitors (ICIs) targeting PD-1, PD-L-1 or CTLA-4 demonstrated improved relapse-free survival and distant metastasis-free survival against placebo after surgery for stage-III and high-risk stage-II melanoma. In unresectable localised and metastatic tumours, the double immunotherapy with ICIs (anti-PD-1+ anti-CTLA-4) allows for long-term survival in more than 50% of the patients. Novel immunotherapies (anti-LAG-3 ICI, adoptive cell therapy, intra-tumoural immunotherapy, cancer vaccines) and new combinations are in development to overcome resistance and improve patients' survival. Therapeutic decisions for each patient should be discussed in a specialised multidisciplinary team.

Keywords: Immun-Checkpoint-Inhibitoren; Krebsimmuntherapie; Melanom; Melanoma; Mélanome; adoptive Zelltherapie; adoptive cell therapy; cancer immunotherapy; immune checkpoint inhibitors; immunothérapie des cancers; inhibiteurs de points de contrôle immunitaire; oncolytic viruses; onkolytische Viren; thérapie cellulaire adoptive; virus oncolytiques.

MeSH terms

  • Humans
  • Immunotherapy*
  • Melanoma* / therapy
  • Skin
  • Skin Neoplasms* / therapy