Monitor New Treatment Options Such As BRAF Gene Targeted Therapy

Above is a 3D image of a melanoma cell.  From this view, they don't look so dangerous, do they?

Above is a 3D image of a melanoma cell. From this view, they don’t look so dangerous, do they?

***It is important even after diagnosis to keep abreast of new developments in the fight to significantly increase the survival rate of advanced stage melanoma.  Even if you are now cancer free but have been previously diagnosed with either Stage III or Stage IV melanoma, stay aware of what it happening.***

Keep going to doctor appointments as recommended and read available literature about new and/or developing treatment options.  Recent advancements have been of particular interest to me.

For example . . .

***About half of all melanomas have changes (mutations) in the BRAF gene. These changes cause the gene to make an altered BRAF protein that signals the melanoma cells to grow and divide quickly.  My tumors show these mutations.***

Why is this important?

Look at the impact of the mutation on survival in the chart below.

Patients with tumors that contain the BRAF gene mutation have a much worse rate of survival.

Patients with tumors that contain the BRAF gene mutation have a much worse rate of survival.

Drugs that target this and related proteins are now available.  If you have advanced melanoma (e.g. Stage III or IV), be sure that a biopsy sample of your tumor is tested to see if it contains a BRAF mutation. Drugs that target the BRAF protein (or the MEK proteins) are not likely to work in patients whose melanomas have a normal BRAF gene.

The first set of drugs that fight this type of melanoma are called BRAF inhibitors.  These drugs attack the BRAF protein directly.

Vemurafenib (Zelboraf): 

***This drug causes tumors to shrink in about half of the people whose metastatic melanoma has a BRAF gene change.  It also prolongs the time before the tumors start growing again and helps some patients live longer, although the melanoma typically starts growing again eventually.***

This drug is taken as a pill, twice a day.  The most common side effects are joint pain, fatigue, hair loss, rash, itching, sensitivity to the sun, and nausea. Less common but serious side effects can occur, such as heart rhythm problems, liver problems, severe allergic reactions, and severe skin or eye problems.

Some people treated with this drug develop new skin cancers called squamous cell carcinomas. These cancers are usually less serious than the melanoma they already have and usually can be treated by simply removing them. Still, your doctor will want to check your skin often during treatment and for several months afterward. You should also let your doctor know right away if you notice any new growths or abnormal areas on your skin.

Dabrafenib (Tafinlar): 

***This drug seems to work about as well as vemurafenib in terms of shrinking melanoma tumors when it is used by itself.***

It is taken as a capsule, twice a day.  Common side effects include thickening of the skin (hyperkeratosis), headache, fever, joint pain, non-cancerous skin tumors, hair loss, and hand-foot syndrome (redness, pain, and irritation of the hands and feet). Although it also can cause squamous cell carcinomas of the skin, these may happen less often than with vemurafenib. Some other more serious side effects that can occur with dabrafenib include severe fevers, dehydration, kidney failure, eye problems, and increased blood sugar levels.


***The MEK gene is in the same signaling pathway inside cells as the BRAF gene, so drugs that block MEK proteins can also help treat melanomas with BRAF gene changes.***

 Trametinib (Mekinist):

This drug has been shown to cause some melanomas with BRAF changes to shrink. It is a pill taken once a day. Common side effects include rash, diarrhea, and swelling. Rare but serious side effects can include heart damage, loss of vision, lung problems, and skin infections.

***When used by itself, this drug does not seem to help shrink as many melanomas as the BRAF inhibitors (although it can still help some people).***

Another approach is to combine it with a BRAF inhibitor in the hope of causing tumors to shrink for longer periods of time. Study results combining this drug with dabrafenib have been promising, showing that some side effects (such as the development of other skin cancers) are actually less common with the combination.


***For more information, please visit these sites.***

About mcreyscope

Retired / disabled survivor of Stage IV melanoma and paraneoplastic syndrome. Now in a fight with terminal treatment resistant Stage IV Prostate Cancer.
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