Research in melanoma skin cancer

We are always learning more about cancer. Researchers and healthcare professionals use what they learn from research studies to develop better practices that will help prevent, find and treat melanoma skin cancer. They are also looking for ways to improve the quality of life of people with melanoma skin cancer.

The following is a selection of research showing promise for treating melanoma skin cancer.

We’ve included information from the following sources. Each item has an identity number that links to a brief overview (abstract).

• PubMed, US National Library of Medicine (PMID)
• American Society of Clinical Oncology (ASCO)
• Canadian Cancer Trials and ClinicalTrials.gov (NCT)

The following is noteworthy research into surgery for melanoma skin cancer.

Complete lymph node dissection removes all the lymph nodes in a certain area. It may be done for certain cases of melanoma skin cancer when a sentinel lymph node biopsy (SLNB) is positive. This means that the SLNB shows there are cancer cells in the first lymph node in a chain or group of lymph nodes that cancer is most likely to spread to. Some research shows that complete lymph node dissection after a positive SLNB does not improve survival compared to observation only (Lancet Oncology, PMID 27161539; New England Journal of Medicine, PMID 28591523; ASCO, Abstract 9501).

Immunotherapy uses the immune system to help destroy cancer cells. Research is looking at new ways to use immunotherapy as a treatment for melanoma skin cancer, including the following.

Immune checkpoint inhibitors work by stopping cancer cells from affecting immune system cells in our bodies. The immune system normally stops itself from attacking healthy cells in the body by having some cells make specific proteins called checkpoints. Cancer cells sometimes use these checkpoints to avoid being attacked by the immune system. Immune checkpoint inhibitors are monoclonal antibodies that work by blocking checkpoint proteins so T cells (a type of white blood cell) can attack and kill cancer cells. Immune checkpoint inhibitors, such as ipilimumab (Yervoy), nivolumab (Opdivo) and pembrolizumab (Keytruda), are used to treat melanoma skin cancer that has spread to other parts of the body (metastatic cancer) or that can’t be removed with surgery (unresectable cancer). Researchers are looking at using different immune checkpoint inhibitors as adjuvant therapy after surgery to remove melanoma. Results show this results in longer disease-free survival (New England Journal of Medicine, PMID 29658430; Lancet Oncology, PMID 28162999). Nivolumab seems to give longer disease-free survival than ipilimumab when used after surgery to remove stage 3 melanoma that has spread to the lymph nodes (New England Journal of Medicine, PMID 28891423; ASCO, Abstract 9502). Nivolumab and ipilimumab together improved overall survival for advanced melanoma (New England Journal of Medicine, PMID 28889792). Researchers are also trying to find out how long immune checkpoint inhibitor therapy should be given (ASCO, Abstract TPS9600, Abstract 9549).

Talimogene laherparepvec (T-VEC, Imlygic) is a type of therapy that uses viruses to treat cancer (oncolytic viral therapy). Oncolytic viruses can infect and destroy cancer cells without harming normal cells. T-VEC is injected directly into melanoma tumours. It uses a genetically modified herpes simplex virus (HSV) that stimulates melanoma cells to make granulocyte-macrophage colony-stimulating factor (GM-CSF). This helps the body recognize and work against the melanoma cells. Clinical trials show that T-VEC improved overall survival and increased the time that the cancer responds to treatment (called the duration of response). T-VEC was especially effective in people who had never been treated for metastatic melanoma or who had stage 3B, 3C or 4 melanoma skin cancer that had only spread to other areas of the skin or to lymph nodes (Annals of Surgical Oncology, PMID 27342831; Journal of Clinical Oncology, PMID 26014293). In the United States, T-VEC is approved to treat melanoma skin cancer that can’t be removed with surgery or that comes back after treatment (recurrent cancer) (Melanoma Research, PMID 29176501).

Targeted therapy uses drugs to target specific molecules (such as proteins) on or inside cancer cells. These molecules help send signals that tell cells to grow or divide. By targeting these molecules, the drugs stop the growth and spread of cancer cells while limiting harm to normal cells. The following is noteworthy research into targeted therapy for melanoma skin cancer.

Vemurafenib (Zelboraf) combined with cobimetinib (Cotellic) is being studied as a neoadjuvant therapy for melanoma skin cancer with BRAF mutations that has spread to lymph nodes (Canadian Cancer Trials, NCT 02036086).

Dabrafenib (Tafinlar) combined with trametinib (Mekinist) seems to improve overall survival compared to dabrafenib alone in people with untreated stage 3C or stage 4 melanoma skin cancer with BRAF mutations (Lancet, PMID 26037941; ASCO, Abstract 102).

Binimetinib is one MEK inhibitor being studied to treat advanced NRAS-mutant melanoma (Lancet Oncology, PMID 28284557). Other MEK inhibitors are also being studied.

Researchers continue to try to find out more about melanoma skin cancer. Clinical trials are research studies that test new ways to prevent, detect, treat or manage melanoma skin cancer. Clinical trials provide information about the safety and effectiveness of new approaches to see if they should become widely available. Most of the standard treatments for melanoma skin cancer were first shown to be effective through clinical trials.

Find out more about clinical trials.