Drug treatments for melanoma have evolved in recent years. New drugs are now available; others are under development (in clinical trials) and will be available in the months and years to come.
Currently, several types of drugs are used to treat melanoma of the skin: molecules of immunotherapy, targeted therapies and classical chemotherapy.
These treatments are said to be general or even systemic, because they act throughout the body.
Immunotherapy, targeted therapies and conventional chemotherapy do not have the same mode of action. Immunotherapy is a treatment that aims, for molecules used in melanoma (at the time of printing of this guide) to stimulate the body’s immune defenses against cancer cells. Targeted therapies block the growth or spread of cancer cells, by interfering with the molecular alterations they present or with the mechanisms which are at the origin of their development and dissemination. Conventional chemotherapy drugs destroy cancer cells by acting on their dividing mechanisms.
Before starting treatment with anti-cancer drugs, the doctor who prescribes them will explain the principle and the objectives to you. He also carries out a pre-treatment assessment and informs you about possible side effects and the solutions that exist to anticipate or limit them. Do not hesitate to submit any questions you have about this treatment to him.
In general, you must inform all the healthcare professionals who follow you about the treatment you are receiving for melanoma so that they can assess the risk of interaction with other treatments that you may also be taking for another pathology.
The use of drug treatments is not systematic for melanoma of the skin. They may be prescribed, depending on the case, for certain stage II, III and IV melanomas. The choice of offering a drug treatment and the choice of molecules are discussed, on a case-by-case basis, in a multidisciplinary consultation meeting (RCP).
These treatments aim to control the development of the disease and relieve the symptoms. The expected benefits and side effects should be discussed with the patient.
The course of treatment is carefully planned by the medical team according to your situation. The doctor who takes care of you gives you a calendar which determines the place and days of treatment, as well as the names of the drugs used.
The total duration of treatment is variable. It takes place either continuously, every day for a given period, or by successive cures. Each treatment is followed by a period of rest. An assessment of the response to therapy, that is, how the melanoma responds to treatments, is done after two or three months of treatment. It makes it possible to prolong the treatment if it is effective or to modify it if it is ineffective.
Before each treatment, a clinical examination and a blood test are carried out to check that your state of health allows the treatment to be continued. In the event of abnormalities, such as a significant drop in the number of white blood cells, for example, the treatment may be postponed or modified.
Classical immunotherapy and chemotherapy drugs are usually injected into a vein by infusion. Some medicines can be given in the form of tablets: this is called oral treatment. This is the case, for example, with all the targeted therapy molecules currently available.