Melanoma Treatment – Systemic Immunotherapy

There are a number of drug treatments available to manage the spread of melanoma. Prior to beginning a drug treatment your melanoma will be tested to determine its genetic type. This will help determine which drugs are most appropriate in treating your melanoma. Drug therapies vary from taking daily tablets to attending hospital periodically for an intravenous infusion. Your consultant will discuss the different drug therapies available and the specific information associated with the drug i.e. how it is given, side effects and how we expect it to work. Systemic therapy may be given alone, or combined with surgery/radiotherapy. (If you are started on a systemic therapy you will be given an in depth information folder to explain your treatment).

Systemic Immunotherapy: Anti-PD-1 Antibodies

The immune system is your body’s natural defense against disease. The immune system sends certain types of cells called T cells throughout your body to detect and fight infections and diseases—including cancer. Cancer cells may use the PD-1 pathway to hide from T cells.

PD-1 and PD-L1 are types of proteins found on cells in your body. PD-1 protein is found on immune cells called T cells. It normally acts as a type of “off switch” that helps keep the T cells from attacking other cells in the body. PD-1 attaches to PD-L1, a protein found on some normal (and cancer) cells. This interaction basically tells the T cell to leave the other cell alone and not attack it. Some cancer cells have large amounts of PD-L1, which helps them hide from immune attack. This stops T cells from attacking cancer cells and allows cancer cells to grow and spread.

Immunotherapy is a type of cancer treatment that uses your own immune system to help detect and fight cancer. Instead of attacking cancer cells directly, immunotherapy treatments help your body fight cancer. These therapies target either PD-1 or PD-L1 and stop cancer cells from hiding from the patient’s immune system.

Video courtesy of Melanoma Research Alliance

How is immunotherapy given?

Immunotherapy for melanoma is usually given as an infusion via a drip once every six weeks.

What are the sides effects of immunotherapy?

The side effects of immunotherapy are unpredictable. Some patients (about one-third) report no or only trivial effects from the therapy at all. Other patients can present with severe or even life-threatening side effects. The more severe side effects are caused by the treatment stimulating the immune system to attack normal tissue. The image below highlights the most common side effects:

Side Effects Of Immunotherapy | Image Courtesy of Cancer Council NSW


Advantages and Disadvantages of Treatment

Many people are frightened at the idea of having treatment for cancer, because of the side effects that can occur. Some people ask what would happen if they did not have any treatment. Treatment can be given for different reasons and the potential benefits will vary depending upon the individual situation.

You can talk about your treatment options with your medical team and think about what feels right for you. It can be helpful to make a list of any questions you’d like to ask at your appointments. A friend or relative could also come with you for support.

If you have concerns about your treatment plan, you could get a second medical opinion. Ask your GP or specialist about how to do this.