Beating Cancer by Braving Drugs

Melanoma drugs effective but can have serious side effects

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) When it’s the body against cancer, the body has to win at all costs. Getting the better of melanoma may require the immune system taking one for the team.

Researchers may have found a new drug to treat melanoma, but bad reactions have to be closely watched.

"Tell your doctor immediately about any drug reactions!"

Jeffrey S. Weber, MD, PhD, director of Moffitt Cancer Center’s Melanoma Research Center, led an investigation into a new class of melanoma drugs.

In 2011, the US Food and Drug Administration (FDA) approved a new type of drug to treat metastatic (spreading) melanoma classified as anti-CTLA-antibodies.

Dr. Weber said, “Anti-CTLA-4 antibodies have shown patterns of anti-tumor response that are different from responses to conventional chemotherapy.”

Yervoy (ipilimumab) is available on the market now, and tremelimumab is still being tested.

Both drugs work by triggering the immune system to destroy cancer cells.

While these drugs are effective against the cancer, Dr. Weber is concerned about the serious side effects they can cause. These are called immune-related adverse events (irAEs).

Dr. Weber has observed the following irAEs:

• Rashes that can turn into toxic skin problems
• Colitis - inflammation of the colon that causes diarrhea
• Inflammation of the kidneys, pituitary gland, pancreas, eyes, liver and lymph nodes
• Nerve damage

Just because a patient developed a serious side effect did not mean the drug didn’t work against the melanoma.

For this reason, Dr. Weber and his colleagues did not suggest eliminating either drug, but rather closely monitoring and managing the adverse effects.

Researchers found that the melanoma drugs produced one of four outcomes:

• Reduced cancerous lesions by 12 weeks and stopped new ones from forming
• Stabilized the melanoma, then slowly shrank tumors
• Tumors grew at first and then shrank
• After 12 weeks, new lesions appeared, but the total number of tumors shrank

Catching irAEs as early as possible and administering proper treatment is absolutely necessary to manage outcomes.

Researchers recommend a team approach, where all the health professionals monitor for serious side effects and are able to move quickly to resolve them.

Dr. Weber said, “Because responses can occur slowly or be mixed, 12 weeks has been the time to first evaluation with ipilimumab.”

This study was published in May in the Journal of Clinical Oncology. Funding for this study was provided by Bristol-Myers Squibb and StemScientific, no conflicts of interest were found.

Reviewed by: 
Review Date: 
August 30, 2012
Last Updated:
August 30, 2012