Interleukin-2 and experimental immunotherapy approaches for advanced melanoma
- Jeffrey A Sosman, MD
Jeffrey A Sosman, MD
- Professor of Medicine
- Robert H. Lurie Comprehensive Cancer Center of Northwestern
Although the incidence of malignant melanoma is increasing, most cases are diagnosed at an early stage. For localized melanomas, surgical excision is curative in most cases, and patients at high risk of developing metastatic disease may benefit from adjuvant therapy. (See "Initial surgical management of melanoma of the skin and unusual sites" and "Adjuvant therapy for cutaneous melanoma".)
High-dose interleukin-2 (IL-2) was the first immunotherapy approach to produce durable remissions in patients with advanced disease. However, these benefits were limited to a small fraction of patients, and treatment was associated with substantial toxicity.
The use of high-dose IL-2 in melanoma has largely been replaced by immunotherapy with checkpoint inhibitors directed against programmed death-1 protein (PD-1) alone or in combination with antibodies targeting cytotoxic T-lymphocyte antigen 4 (CTLA-4). In addition, targeted therapy directed against the mitogen-activated protein (MAP) kinase pathway has provided an additional important treatment option for patients with advanced disease and a V600 mutation of BRAF.
The results with high-dose IL-2 and the potential role of other experimental immunotherapy approaches are reviewed here.
The principles of cancer immunotherapy and an overview of the treatment of metastatic melanoma are presented separately:To continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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