Onkológia 3/2013

Systemic treatment of malignant melanoma

Although the incidence of malignant melanoma is increasing, in most cases it is diagnosed at the early stage. In the majority of patients with stage IV disease a systematic treatment is requried. Most patients with stage IV disease require a systematic treatment. Approaches that have been shown to provide clinically important benefit for patients with metastatic melanoma in appropriately selected patients include immunotherapy with ipilimumab, a monoclonal antibody targeting CTLA-4, and inhibition of the MAK kinasa pathway with vemurafenib in patients whose tumors contain a V600 mutation in the BRAF gene. These drugs improve survival. Some centers use high-dose interleukine -2 (IL-2) as first line therapy. Cytotoxic chemotherapy does not have an established role in the initial managment of patients with advaced melanoma.

Keywords: malignant melanoma, treatment, ipilimumab, vemurafenib, cytotoxic chemotherapy.