The American Journal of Public Health published a study from New York University that showed between 1986 and 2013 new malignant melanoma (MM) cases more than doubled and mortality rates increased by nearly 10%. Not great numbers.
However, from 2013-2016, overall MM mortality decreased by nearly 20% with reduction in deaths seen in every age group. This is the largest and most sustained improvement in mortality ever observed!
Enter the new targeted therapies (-nib’s) and immunotherapies (-mab’s) which became available since 2011 and is credited with the successful results treating metastatic MM.
Immune checkpoint inhibitors encourage the patient’s own immune system to attack the MM cells (eg ipilimumab, pembrolizumab, nivolumab). Targeted therapies are specifically targeted to the patient’s tumour and more specifically at BRAF and MEK proteins known to be part of the cell signalling pathway that drives growth of MM cells. Examples of BRAF inhibitors (vemurafenib, dabrafenib, encorafenib) and MEK inhibitors (trametinib, cobimetinib, binimetinib). In about half of all MM, the BRAF protein is genetically mutated so it can no longer regulate normal cell multiplication and grow out of control. MEK is an enzyme that works with BRAF to regulate cell growth.