The National Academy of Medicine provides an update on the use of immunotherapy to treat skin cancer (or melanoma).
- The European body fighting cancer places melanoma sixth among the most common cancers in 2023.
- In France, according to the National Cancer Institute, the number of new cases (incidence) is increasing by 2% per year, despite prevention campaigns.
- Immunotherapy is now established as an effective therapy against this type of cancer.
“Therapeutic progress, notably with the arrival of immunotherapy, has made it possible to improve the survival of people suffering from numerous cancers, including melanoma, with an evolution that can be described as dazzling between 2010 and 2015 for the latter”. In a press release, the National Academy of Medicine takes stock of the use of immunotherapy to treat skin cancer (or melanoma).
The history of immunotherapy and melanoma began in 2010 with the first study demonstrating that a monoclonal antibody, anti-CTLA-4, increased the chances of survival of a patient at the metastatic stage, which ‘no treatment had ever been possible before. In 2014, a second monoclonal antibody, anti PD-1, made it possible to obtain response rates of 30 to 40% in metastatic forms, with lasting remissions making it possible to stop treatment.
Immunotherapy to treat melanoma: hopes and side effects
“The hope offered by immunotherapy was, however, offset by the discovery of autoimmune side effects,” explains the National Academy of Medicine. “Linked to the activation of cytotoxic T lymphocytes, these side effects can affect all organs. They are severe in 15% of cases and, above all, some can persist when immunotherapy is stopped”adds the institution.
In the therapeutic race thus engaged, the idea of combining two monoclonal antibodies quickly emerged. With a follow-up of 7 years, dual therapy combining “anti-PD-1 and anti-CTLA4” at the metastatic stage demonstrates greater efficacy than anti-PD-1 alone, but with greater toxicity. Thus, the Checkmate 067 study shows that 77% of living patients treated with both antibodies and 69% of patients treated with anti-PD-1 alone are without treatment after a follow-up of more than 6.5 years.
Melanoma is the sixth most common cancer in 2023
“The therapeutic successes observed at the metastatic stage have had consequences in the management of melanoma at a less advanced stage,” therefore note the doctors.
Faced with the very rapid evolution of the place of immunotherapy in the treatment of melanoma, the National Academy of Medicine finally emphasizes in particular that “the development and promotion of actions to prevent skin melanoma among the widest public remain public health actions of great importance”, and “the benefit/risk ratio must be assessed before any decision on immunotherapy, particularly at an early stage of the disease, due to the possibly permanent nature of autoimmune side effects”.
The European body fighting cancer places melanoma sixth among the most common cancers in 2023. In France, according to the National Cancer Institute, the number of new cases (incidence) is increasing by 2% per year, despite prevention campaigns. The prevalence of cancer in France is currently 28/100,000 for men and 22/100,000 for women.
