FDA Approves Melphalan as a Liver-Directed Treatment for Uveal Melanoma
On August 14, 2023, the U.S. Food and Drug Administration approved melphalan (Hepzato™) for injection or hepatic delivery system (Hepzato Kit) containing melphalan as a liver-directed treatment for adult patients with uveal melanoma with unresectable hepatic metastases affecting less than 50% of the liver and no extrahepatic disease, or extrahepatic disease limited to the bone, lymph nodes, subcutaneous tissues, or lung that is amenable to resection or radiation.
Oncology Drug Reference Sheet: Tebentafusp-Tebn
When the U.S. Food and Drug Administration approved tebentafusp-tebn (Kimmtrak®) in January 2022 as an orphan drug for unresectable or metastatic uveal melanoma in adults, it became the first—and only, at the time of this reference sheet’s publication—drug approved for the indication.
First-Line Combination Immunotherapy Prolongs Survival in BRAF Advanced Melanoma
Initial treatment with two monoclonal antibodies significantly improves survival for patients with BRAF V600-variant advanced melanoma compared to treatment with two targeted agents, researchers reported during the November 2021 ASCO Plenary Series meeting. The initial findings were so conclusive that the study’s data safety and monitoring board stopped the trial early.
Fiber—but Not Probiotics—Boosts Immunotherapy Response for Melanoma
Patients with melanoma who consume a high-fiber diet during treatment with immune checkpoint inhibitors (ICIs) or anti-PD-1 therapy experience longer progression-free survival than those who don’t, researchers reported in Science. And probiotic supplementation, often considered a healthy behavior, reduces immunotherapy response.
FDA Approves Nivolumab and Relatlimab-Rmbw for Unresectable or Metastatic Melanoma
On March 18, 2022, the U.S. Food and Drug Administration (FDA) approved nivolumab and relatlimab-rmbw (Opdualag™) for adult and pediatric patients aged 12 years or older with unresectable or metastatic melanoma. Nivolumab and relatlimab-rmbw is a fixed-dose combination of the LAG-3–blocking antibody relatlimab and the programmed death receptor-1–blocking antibody nivolumab.
Immunotherapy After Surgery May Prevent Early-Stage Melanoma Recurrence
Completing up to a year of pembrolizumab immunotherapy after surgical resection of stage IIB or IIC melanoma decreases patients’ risk for disease recurrence or death by 35%, according to study findings presented at the European Society for Medical Oncology 2021 annual meeting. The new findings led the U.S. Food and Drug Administration to expand its approval of pembrolizumab to use as adjuvant therapy in both adults and children aged 12 and older with early-stage melanoma.
Clinical Full-Body Skin Examination Identifies Twice the Number of Cancers
A dermatologist-performed total-body skin examination (TBSE) identifies more than two times the number of skin cancers than patients or other providers discovered, researchers reported in the International Journal of Women’s Dermatology. The cancers may otherwise have gone undiagnosed, leading to later-stage disease and poorer outcomes.
Combination Immunotherapy May Further Increase Melanoma Survival Length
Using two agents that target two different receptors more than doubles length of survival for advanced melanoma than a single agent alone, researchers reported at the 2021 American Society of Clinical Oncology annual meeting.
Lung, Melanoma, and Overall Cancer Death Rates Decline, According to 2021 Report
Cancer mortality for all racial and ethnic groups in the United States continues to decline, with death rates for lung cancer and melanoma decreasing faster than others, according to findings that the American Cancer Society (ACS), the Centers for Disease Control and Prevention, the National Cancer Institute, and the North American Association of Central Cancer Registries (NAACCR) published in their July 2021 Annual Report to the Nation on the status of cancer.
Long-Term irAEs From Checkpoint Inhibitors Have Considerations for Survivorship
More than 40% of patients with melanoma treated with nivolumab or pembrolizumab experience persistent long-term immune-related adverse events (irAEs) for at least 1.5 years, researchers reported in JAMA Oncology.
Nursing Considerations for Melanoma Survivorship Care
Breast, prostate, colorectal, and melanoma are the most common primary cancer sites among 58% of survivors. Advancements in immunotherapy and targeted therapies have significantly increased treatment options for a disease that once had very limited treatment options, markedly improving overall five-year survival rates for patients with melanoma. Yet survival rates vary depending on extent of disease (local versus metastatic) and ethnic minority disparities. Although the overall (all stages combined) five-year survival rate for White patients with melanoma is 93%, the rate drops to 87% for Hispanics and to just 23% for those with distant melanoma.
Gut Microbiome May Be a Factor With Immunotherapy Resistance in Advanced Melanoma
Altering a patient's gut microbiome through fecal transplant improved response to immune checkpoint inhibitor therapy in 40% of patients with advanced melanoma who initially did not respond to the immunotherapy in a small, single-arm clinical trial. Researchers reported the findings in Science.
FDA Approves Atezolizumab for BRAF V600 Unresectable or Metastatic Melanoma
On July 30, 2020, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq®) in combination with cobimetinib and vemurafenib for patients with BRAF V600 mutation-positive unresectable or metastatic melanoma.
Gut Microbiome Diversity May Improve Response to Melanoma Immunotherapy
A high-fiber diet leading to higher gut microbiome diversity may improve response to anti-PD-1 immunotherapy in patients with melanoma, according to the results of a new study presented at the 2019 American Association for Cancer Research Annual Meeting in Atlanta, GA.
FDA Approves Pembrolizumab for Adjuvant Treatment of Melanoma
On February 15, 2019, the U.S. Food and Drug Administration (FDA) approved pembrolizumab for the adjuvant treatment of patients with melanoma with involvement of lymph node(s) following complete resection.
Older Patients Respond Better to Checkpoint Inhibitors for Melanoma
Patients aged 62 and older are more likely to respond to immune checkpoint inhibitors for melanoma, such as pembrolizumab, according to findings from a study published in Clinical Cancer Research. A follow-up study showed that it may be because of age-related changes in the immune cells in melanoma tumors.
Small Steps Toward Sun Safety Can Make a Big Difference
I haven’t always been convinced of the importance of sun safety. In my younger years, I got more sunburns than I’d like to admit in an attempt to develop a tan. In college, I spent afternoons studying outside on a sunny quad with nothing more than shorts and a tank top for sun protection.
Stay Current on Evolving Therapies in Melanoma
After decades of no new treatment options for advanced melanoma, several drugs for unresectable stage III and IV disease and recurrent melanoma have been approved, including newer classes of drugs such as checkpoint inhibitors (anti-PD-1 and anti-CTLA-4 drugs) and signal transduction inhibitors (BRAF, MEK, and KIT inhibitors). Advanced practice registered nurses (APRNs) must be familiar with these newer agents and classes of drugs, especially the mutations that guide their use.
Manage Adverse Events From Immunotherapy and Targeted Therapy for Melanoma
New targeted and immunotherapy drug approvals have offered improved survival and disease outcomes for patients with melanoma, but the new therapies are also associated with a range of adverse events (AEs) that differ from those associated with chemotherapy. Oncology nurses will need to shift their thinking to best manage those AEs.
Raise Awareness in July for Ultraviolet Safety and Skin Cancer Risk
With summer in full swing, it’s the perfect time to head outdoors and enjoy the sunny weather. But are you protecting yourself from potential risks? The U.S. Department of Health and Human Services has named July as Ultraviolet (UV) Safety Month. The goal is to spread the word about how important it is to protect everyone’s skin from the harmful effects of UV rays. This presents a teaching opportunity for oncology nurses and their patients—not just during July but all year long.
Combination Treatment Improves Survival for Advanced Melanoma
A combination of nivolumab and ipilimumab improved overall survival when compared to either drug alone, according to results from a recent study reported at the American Association for Cancer Research 2017 annual meeting.
Dermascopic Clues Help Identify Seborrheic Keratosis-Like Melanoma
Melanomas that resemble seborrheic keratosis (SK) can be challenging to diagnose correctly. SKs are often removed without being evaluated dermascopically or sent for pathologic analysis, risking the possibility of missing a diagnosis of SK-like melanoma. A new study published in JAMA Dermatology outlined the key dermascopic clues that clinicians can use to identify SK-like melanomas to prevent treatment delays and achieve the best patient outcomes.
Encourage Malignant Melanoma Awareness in May
As Melanoma/Skin Cancer Detection and Prevention Month, May is the perfect time to encourage people to examine their skin and seek medical assistance if they recognize signs of a melanoma. Early detection and prompt treatment is associated with a much higher survival rate for skin cancer diagnoses.
Disease Symptoms Most Likely to Predict Recurrence of Early-Stage Melanoma
Patients and healthcare providers are most likely to detect recurrence of early-stage melanoma based on symptom reports rather than routine imaging tests, according to the results of a study published in the Journal of the American College of Surgeons.