Melanoma

Melanoma

Melanoma is by far the most serious form of skin cancer. For all stages of melanoma combined, five-year survival has increased from 82 percent in the late 1970s to 93 percent in recent years.

Melanoma research has been a pioneer in immunotherapy, using drugs to trigger the body's immune defenses to fight melanoma tumors. In 2010, researchers showed for the first time that a drug targeting the immune system can improve survival among people with advanced melanoma. The following year, a second drug targeting a genetic abnormality in some melanomas achieved a similar result. While investigators continue to study why these treatments don't work in all patients, or yet cure the disease, they signal that progress against melanoma is gaining speed and that therapy will become increasingly personalized in the years ahead.

Expand All +

1998

Second immunotherapy drug approved for melanoma

1996

Interferon approved as first adjuvant treatment

Interferon approved as first adjuvant treatment

Badge indicating that research was paid for using federal funds

Interferon alpha 2b becomes available for patients who have a high risk of melanoma recurrence after their tumors are surgically removed. The FDA approves the immunotherapy treatment based on studies showing that one year of high-dose interferon therapy reduces the risk of melanoma recurrence and modestly improves overall survival. However, physicians still recommend it cautiously, due to its lengthy course of treatment and significant side effects, such as depression and flu-like symptoms.

1992

Sentinel lymph node biopsy introduced to assess the spread of melanoma to nearby lymph nodes

Sentinel lymph node biopsy introduced to assess the spread of melanoma to nearby lymph nodes

Badge indicating that research was paid for using federal funds

A surgical technique called sentinel lymph node biopsy becomes a less invasive way to assess whether early-stage melanoma has spread to surrounding lymph nodes. The procedure involves surgically removing the lymph node(s) that receives lymph drainage from the primary tumor – the "sentinel" node – and then examining it under a microscope for evidence of cancer. If the sentinel node is cancer-free, no further lymph nodes are removed and the patient is spared the previous practice of removing multiple lymph nodes. This more conservative approach is easier on patients and reduces the risk of post-operative side effects such as lymphedema. Later studies show that results of sentinel lymph node biopsy are one of the most important predictors of risk for melanoma recurrence. This information helps doctors determine which patients should be treated more aggressively to prevent their cancer from returning.

1987

Personalized immunotherapy can shrink some melanoma tumors

Personalized immunotherapy can shrink some melanoma tumors

Scientists first develop an experimental procedure called adoptive cell transfer, in which one or more of the patient's tumors are removed and specific anti-tumor white blood cells (called tumor infiltrating lymphocytes) are extracted. These cells are then grown in a laboratory to boost their ability to fight the cancer and returned to the patient, often in combination with chemotherapy. Remarkably, this personalized immunotherapy approach has been shown to shrink melanoma tumors in about half of patients whose tumor infiltrating lymphocytes are successfully treated in the laboratory. In part because of the complexity of the approach, the procedure is only available in a few centers worldwide, and research remains active to determine its appropriate role in treatment.

1984

Less extensive surgery found effective for removing melanoma tumors

Less extensive surgery found effective for removing melanoma tumors

Instead of the traditional practice of surgically removing up to two inches of skin and tissue surrounding a melanoma tumor, clinical trials show that margins of three-quarters of an inch or less around the tumor are sufficient. This refinement makes recovery easier and helps reduce the cosmetic impact of surgery.

1982

Research links sun exposure to melanoma risk

Research links sun exposure to melanoma risk

A growing number of studies in this period suggest that sun exposure plays an important role in the development of some melanomas. Specifically, frequency and duration of exposure, as well as a history of severe sunburn, are found to be associated with a person's risk of the disease. In the 1980s, the public health community and advocacy groups such as the Skin Cancer Foundation begin cautioning the public about the potential risks of sun exposure.

1978

Hereditary syndrome linked to increased melanoma risk

Hereditary syndrome linked to increased melanoma risk

Badge indicating that research was paid for using federal funds

Researchers identify a hereditary syndrome called dysplastic nevus syndrome (also known as B-K mole syndrome or Familial Atypical Multiple Mole and Melanoma, or FAMMM, syndrome) that is associated with an approximately 50 percent risk of developing melanoma by age 50. Patients with the syndrome have an unusually large number of moles, which are often irregular in size and shape and have specific coloring and microscopic features. These individuals need more aggressive screening so cancers can be detected at an early stage.

1961

Innovative technique enables intensive chemotherapy without increased systemic side effects

Innovative technique enables intensive chemotherapy without increased systemic side effects

A new approach known as isolated limb perfusion is introduced to help doctors deliver higher-than-usual doses of chemotherapy to an arm or leg where melanoma tumors have spread, without increasing the risk that the drugs will harm other parts of the body. During this procedure, the doctor temporarily stops the flow of blood to and from the affected limb, essentially isolating it with a tourniquet from the rest of the body, and then intravenously administers and circulates chemotherapy through the affected limb with the help of a special machine. The approach is further refined in the 1990s with the introduction of isolated limb infusion, which cuts procedure time, requires fewer specialized medical personnel and is less costly. Investigations continue to try to find better treatments using this technique.

1957

Key component of future melanoma treatment is discovered

Key component of future melanoma treatment is discovered

Researchers identify interferons – proteins produced in immune cells that help fight viruses, bacteria, and other pathogens. Later, in the 1980s, researchers begin to demonstrate that a specific type of interferon – known as interferon alpha 2b – can help reduce melanoma recurrences after surgery by boosting the immune system to fight cancer. The drug has since become a treatment option for many patients with the disease, although physicians still recommend it cautiously, due it its lengthy course of treatment and significant side effects, such as depression and flu-like symptoms.