Melanoma: Targeted Therapy
Targeted therapy is the use of medicines that target the parts of cancer cells that
make them unlike normal cells. Targeted medicines for melanoma work on genes and proteins
in melanoma cells. Targeted medicines are different from standard chemotherapy medicines.
They can work when chemotherapy medicines don’t. And they have different side effects.
What targeted therapy medicines are used for melanoma?
BRAF is a gene that’s part of body cells. About 50% of all melanomas have changes
in the BRAF gene. These changes help the melanoma cancer cells grow. Some medicines
can target this gene to help attack melanoma. Before the medicines are used, a sample
of melanoma tissue is tested for change in the BRAF gene. Melanoma cells that don’t
have a change in the BRAF gene would not be helped by these targeted medicines.
Vemurafenib, dabrafenib, and encorafenib are medicines that target the BRAF gene.
These are used to treat advanced melanomas that can’t be removed with surgery. They
can often shrink tumors for at least several months. The medicine is taken daily as
pills or capsules.
The most common side effects of these medicines include:
In some cases, these medicines can cause squamous cell carcinoma. This is a less serious
type of skin cancer that can be easily treated with surgery. Less common but more
serious side effects are also possible. Talk with your doctor about the risks and
benefits of these medicines for you.
A protein in cells called MEK can interact with the BRAF protein to help melanoma
cells grow. There are 3 medicines that target MEK proteins. The medicines are called
MEK inhibitors. They are trametinib, cobimetinib, and binimetinib. MEK inhibitors
are taken daily as a pill to help treat advanced melanomas. They are only helpful
for people whose melanoma cells have BRAF gene changes. When used alone, MEK inhibitors
do not shrink tumors as well as a BRAF inhibitor. But when used with a BRAF inhibitor,
they may work better than either medicine alone. Also, combining a BRAF inhibitor
and a MEK inhibitor may lower the risk of getting other skin cancers that can be caused
by a BRAF inhibitor.
The most common side effects of MEK inhibitors include:
Some other side effects are less common but can be more serious. Talk with your doctor
about the risks and benefits of this medicine for you.
More targeted medicines being tested
Researchers continue to learn more about what makes melanoma cells different from
other cells. They’re working to develop new medicines to target these differences.
New medicines are being tested in clinical trials.
Researchers are also testing existing medicines to use for melanoma. A small number
of melanomas have changes in the C-KIT gene that help them grow. This is most often
the case for melanomas in areas such as the palms, soles of the feet, or inside the
mouth. Several medicines that target C-KIT are already used to treat some other types
of cancers. These medicines are now being tested in clinical trials to see if they
can help treat melanomas.
If you’re interested in a medicine that is part of a clinical trial, talk with your
healthcare provider. They can help you find out if a clinical trial would be right
Working with your healthcare provider
It's important to know which medicines you're taking. Write your medicines down, and
ask your healthcare team how they work, what side effects they might have, and when
they should be reported.
Talk with your healthcare providers about what signs to look for and when to call
them. Make sure you know what number to call with questions. Is there a different
number for evenings and weekends?
It may be helpful to keep a diary of your side effects. A written list will make it
easier for you to remember your questions when you go to your appointments. It will
also make it easier for you to work with your healthcare team to make a plan to manage
your side effects.