The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma

Abstract

| Immunotherapy is associated with durable clinical benefit in patients with melanoma. The goal of this article is to provide evidence-based consensus recommendations for the use of immunotherapy in the clinical management of patients with high-risk and advanced-stage melanoma in the USA. To achieve this goal, the Society for Immunotherapy of Cancer sponsored a panel of melanoma experts-including physicians, nurses, and patient advocates-to develop a consensus for the clinical application of tumour immunotherapy for patients with melanoma. The Institute of Medicine clinical practice guidelines were used as a basis for this consensus development. A systematic literature search was performed for high-impact studies in English between 1992 and 2012 and was supplemented as appropriate by the panel. This consensus report focuses on issues related to patient selection, toxicity management, clinical end points and sequencing or combination of therapy. The literature review and consensus panel voting and discussion were used to generate recommendations for the use of immunotherapy in patients with melanoma, and to assess and rate the strength of the supporting evidence. From the peer-reviewed literature the consensus panel identified a role for interferon-α2b, pegylated-interferon-α2b, interleukin-2 (IL-2) and ipilimumab in the clinical management of melanoma. Expert recommendations for how to incorporate these agents into the therapeutic approach to melanoma are provided in this consensus statement. Tumour immunotherapy is a useful therapeutic strategy in the management of patients with melanoma and evidence-based consensus recommendations for clinical integration are provided and will be updated as warranted.

IL-10: Master Switch from Tumor-Promoting Inflammation to Antitumor Immunity

“…Many approaches have been pursued to improve the arsenal of T-cell-stimulating agents in the fight against cancer, with proinflammatory cytokines such as IFN-a and interleukin (IL)-2 being among the most clinically successful agents for the treatment of melanoma (1). With the discovery of inhibitory molecules, cytotoxic T-lymphocyte antigen 4 (CTLA-4) and programmed death-1 (PD-1) on T cells as "immune checkpoints" and the development of inhibitors for these immune checkpoints, immunotherapy as therapeutic targets in cancer treatment has finally emerged into mainstream oncology.…”

Histone variant H2A.Z.2: A novel driver of melanoma progression

“…Although recent advances in targeted or immune therapies have raised hope for a "melanoma cure", they are only effective in distinct subsets of patients, cause significant toxicity, and/or are overcome by the rapid emergence of drug resistance. 1,2 Thus, investigation of alternative approaches is essential. Although much effort has been expended in characterizing and targeting the genetic alterations in melanoma, 3 studies have only just begun to shed light on the importance of epigenetic regulation in melanoma pathogenesis.…”

The cost-effectiveness of nivolumab monotherapy for the treatment of advanced melanoma patients in England

“…For patients with a BRAF mutation (BRAF +ve), ipilimumab and BRAF inhibitors (dabrafenib or vemurafenib) were standard treatments. Despite more recent therapeutic advances with ipilimumab, the long-term survival of many advanced melanoma patients remains elusive [8], with consequences felt by patients, caregivers, and society.…”