Immunotherapy in the management of melanoma: current status

notherapy in the management of melanoma: current status Review (637) Total Article Views Authors: Alston D, Brewer JD Published Date February 2013 Volume 2013:2 Pages 1 - 10 DOI: http://dx.doi.org/10.2147/ITT.S30824 Received: 25 September 2012 Accepted: 24 October 2012 Published: 26 February 2013 Dylan Alston,1 Jerry D Brewer2 1Chicago College of Osteopathic Medicine, Midwestern University, Downers Grove, IL, 2Mayo Clinic, Rochester, MN, USA Abstract: As the rate of melanoma continues to increase, so does the need for more effective and durable therapies. Despite considerable research, the management of advanced disease remains challenging. Numerous therapies are being investigated, many of which aim at upregulating the immune system's innate ability to attack the tumor. Cytotoxic T lymphocyte antigen 4 antibodies are immune stimulants that act as negative regulators of the immune system by modifying an antitumor T-cell response. Ipilimumab, one such cytotoxic T lymphocyte antigen 4 antibody, and vemurafenib, a BRAF competitive inhibitor, were approved as first-line therapies in 2011 due to improved survival rates versus standard chemotherapy. Allovectin-7 is a lipid plasmid that encodes for major histone compatibility complex DNA sequences. It has led to increases in cytotoxic T-cell production, which subsequently attacks the tumor. OncoVEX, an oncolytic herpes virus, and PV-10, a chemoablative agent, have yielded promising results in metastatic lesions and have demonstrated a unique "bystandarder" phenomenon. In this paper we review the basics of melanoma from the pathophysiology, risk factors, signs, diagnostic approaches, and current status of immunologic management of melanoma.