Novel Approaches and Improvements of Immune Checkpoint Inhibitors in Treatment of Melanoma

Background & Objectives: Melanoma along with many other diseases can be treated by programmed cell death protein 1 pathway (PD-1/PD-L1) and immunologic checkpoint blockade consisting of antibodies that target cytotoxic T lymphocyte–associated antigen 4 (CTLA-4). Materials and Methods: In this study, the PubMed database was searched to find English articles related to our topic applying the keywords of target therapy, Anti-PD-1, melanoma, anti-CTLA-4, and immune checkpoint inhibitors.Results: The treatment setting was modified forever by the approval of effectiveness of immune check point inhibitors in melanoma with the performance of clinical trials of PD-L1, PD-1, and CTLA-4 blocking antibodies. During the second and third stages of trials for melanoma patients (advanced grade), a significant enhancement was found in the patients, who experienced a long-term progression-free survival and an objective response when treated with an integrated method of ipilimumab and nivolumab, compared to the independent use of ipilimumab. Generally, nivolumab is not approved for treatment of melanoma prior to ipilimumab by the FDA. However, it has had significant impacts during the third stage of trial, compared to nivolumab to chemotherapy in patients with BRAF– melanoma who were not formerly cured. Therefore, it could be suggested that this drug be consumed prior to ipilimumab due to its better rates of response and less toxicity with nivolumab, compared to ipilimumab.Conclusion: According to the results of the study, the response rates of melanoma patients, who had a lower response rate to single-checkpoint blockade, was higher when a combination of CTLA-4 blockade and checkpoint blockade with PD-1 was applied. Today, many patients with metastatic melanoma can be treated by an immune checkpoint inhibitor. Furthermore, this treatment can provide prolonged survival and perhaps complete cure for patients with this condition.

Novel Approaches and Improvements of Immune Checkpoint Inhibitors in Treatment of Melanoma Keywords:

target therapy , Anti-PD-1 , melanoma , anti-CTLA-4 , immune checkpoint inhibitors