Read about cancer treatment options listed by gene mutation, type of cancer and type of treatment.
Cancer Treatment > By Cancer Type > Melanoma > Biomarkers, targeted and immunotherapies
Biomarkers, targeted and immunotherapies for melanoma
This section covers the following topics:
helps the body’s immune system to fight cancer. Two types of immunotherapies are commonly used to treat advanced melanoma:
- Immune checkpoint inhibitors are a type of used to treat melanoma. These include:
- Keytruda (pembrolizumab)
- Opdivo (nivolumab)
- Yervoy (ipilumumab)
- Sometimes Yervoy is used in combination with Opdivo
- Imlygic (talimogene laherparepvec or T-VEC therapy) is a genetically engineered virus that is used to treat advanced melanoma. The medication is injected directly into the tumor to stimulate an immune response.
testing for treatment selection
tests look at samples of blood, tumor or other tissue for changes or abnormalities caused by cancer. These tests can give doctors clues about the cancer, including:
- how fast the cancer is growing
- which treatments are most likely to work
- whether or not the cancer is responding to treatment or growing
- whether or not the cancer has come back after remission
tests may be used to select treatments, and help patients avoid side effects from treatments that will not work for them. tests used to select a specific treatment are sometimes called companion diagnostic tests. These tests may be done on tumor tissue or on blood. See our Testing section for more information.
Experts recommend that patients with advanced or recurrent melanoma also be tested for the following biomarkers:
- Tumor testing can find a specific mutation in a gene known as BRAF. In melanoma, the most common BRAF mutation is called V600E (may also be V600K/R/M/D/G). Patients with a BRAF V600 mutation may benefit from the addition of targeted therapies known as BRAF inhibitors.
Additional tests that may be used for melanoma:
- Tumor testing can find mutations in genes known as KIT and NRAS.
- testing may help identify people who are eligible for certain clinical trials.
Target therapies for melanoma include:
- BRAF inhibitors
- BRAF inhibitors are oral medications that help slow down tumor growth in patients with advanced or recurrent melanoma that test positive for the tumor called a BRAF V600 mutation.
- About half of all melanomas have a tumor mutation in the BRAF gene.
- If your melanoma has a BRAF mutation often you will get both a BRAF inhibitor and a MEK inhibitor. Combining these drugs often works better than either one alone.
- BRAF inhibitors include:
- Tafinlar (dabrafenib)
- Braftovi (encorafenib)
- Zelboraf (vemurafenib)
- MEK inhibitors
- MEK inhibitors are oral medications that are given alone or in combination with a BRAF inhibitor to treat melanoma in people with a BRAF V600 mutation.
- MEK inhibitors include:
- Mekinist (trametinib)
- Cotellic (cobimetinib)
- Mektovi (binimetinib)
Table of targeted and immunotherapies for melanoma
| Name of drug | Type of agent | Cancer | Indication | |
|---|---|---|---|---|
| Braftovi (encorafenib) |
BRAF inhibitor (type of kinase inhibitor) | Unresectable or melanoma |
Combined with Mektovi (binimetinib), for the treatment of patients with unresectable or melanoma |
BRAF V600E or V600K tumor mutation |
| Cotellic (cobimetinib) |
BRAF inhibitor (type of kinase inhibitor) | Unresectable or melanoma | Combined with Zelboraf (vemurafenib) for the treatment of patients with unresectable or melanoma | BRAF V600E or V600K tumor mutation |
| Mekinist (trametinib) | MEK inhibitor (type of kinase inhibitor) |
Melanoma | Combined with Taflinar (dabrafenib) as treatment of patients with melanoma and involvement of lymph node(s), following complete resection | BRAF V600E or V600K tumor mutation |
| Mekinist (trametinib) | MEK inhibitor (type of kinase inhibitor) |
Unresectable or melanoma | As a single agent and in combination with dabrafenib for the treatment of unresectable or melanoma | BRAF V600E or V600K tumor mutation |
| Mektovi (binimetinib | MEK inhibitor (type of kinase inhibitor) |
Unresectable or melanoma | Combined with Braftovi (encorafenib), for the treatment of patients with unresectable or melanoma | BRAF V600E or V600K tumor mutation |
| Tafinlar (dabrafenib) |
BRAF inhibitor (type of kinase inhibitor) | Unresectable or melanoma | Combined with Mekinist (trametinib) for the treatment of patients with unresectable or melanoma | BRAF V600E or V600K tumor mutation |
| Tafinlar (dabrafenib |
BRAF inhibitor (type of kinase inhibitor) | Unresectable or melanoma | Combined with Mekinist (trametinib) for the treatment of patients with unresectable or melanoma | BRAF V600E or V600K tumor mutation |
| Tafinlar (dabrafenib |
BRAF inhibitor (type of kinase inhibitor) | Melanoma | Combined with Mekinist (trametinib) as treatment of patients with melanoma and involvement of lymph node(s), following complete resection | BRAF V600E or V600K tumor mutation |
| Keytruda (pembrolizumab) | Immune checkpoint inhibitor | or unresectable melanoma | For the treatment of patients with melanoma | No required |
| Keytruda (pembrolizumab) | Immune checkpoint inhibitor | Melanoma | For the treatment of patients with involvement of lymph node(s) following complete resection | No required |
| Opdivo (nivolumab) |
Immune checkpoint inhibitor | or unresectable melanoma | As a single agent or combined with ipilimumab | No required |
| Opdivo (nivolumab) |
Immune checkpoint inhibitor | or lymph node positive melanoma | For the treatment of patients following complete resection | No required |
| Yervoy (ipilumumab) | Immune checkpoint inhibitor | or unresectable melanoma | For the treatment of patients with melanoma | No required |
| Yervoy (ipilumumab) | Immune checkpoint inhibitor | Melanoma | treatment of patients with cutaneous melanoma with pathologic involvement of regional of more than 1 mm who have undergone complete resection, including total lymphadenectomy | No required |
| Imlygic (T-VEC or talimogene laherparepvec) | Cancer vaccine | Unresectable recurrent melanoma | For local treatment of cutaneous, subcutaneous, and nodal lesions in patients with melanoma recurrent after initial surgery | No required |
Paying For Care
The majority of public and private health insurance plans are required to cover cancer diagnosis and treatment; copays, coinsurance and deductibles often apply. Patient costs and coverage for specific doctors, facilities or treatments may vary based on your health plan. Visit our section on Insurance and Paying for Care: Treatment for more information, links to sample appeal letters and other resources.
Some pharmaceutical companies and laboratories have assistance programs that help cover the cost for their medications, tumor testing or genetic testing for an inherited mutation:
- Ambry Genetics Patient Assistance Program
- Astellas Patient Assistance Program
- AstraZeneca Access 360
- Bayer US Patient Assistance Foundation
- Color and Invitae discounted panel testing for inherited mutations
- Bayer US Patient Assistance Foundation
- Bristol-Myers Squibb Patient Assistance Foundation
- Eisai Patient Assistance Program
- Foundation Medicine Billing and Financial Assistance
- Genentech Access Solutions
- GSK for You
- LIlly Cares
- Merck Helps
- Myriad Cares
- Pfizer Oncology Together
- Novartis Patient Assistance
- Sanofi Patient Connection
- Seattle Genetics' SeaGen Secure
- Taiho's Patient Support Program
- Takeda's Help at Hand
Organizations that offer co-pay assistance:
Other resources:
- The American Cancer Society provides information and resources on covering the cost of cancer care. Public assistance, such as Medicaid may be available if you are ineligible for other programs.
- Needy Meds: Assistance programs to help patients with cost of medications and other healthcare.
- Triage Cancer offers tools and resources to help individuals cope with the financial aspects of a cancer diagnosis.