What are targeted therapies?

Targeted therapies are substances that target the differences between cancer cells and normal cells. They are sometimes called biological therapies.

There are a number of targeted therapies that may be used to treat advanced melanoma. Your doctor will let you know if there is a suitable treatment for you.

At the moment the main targeted therapies to treat advanced melanoma are:

  • Ipilimumab – This triggers the body’s immune system to attack cancer cells.
  • Vemurafenib – This delays the growth of advanced melanoma in patients who have a specific change in a gene called BRAF.
  • Dabrafenib – This slows or stops the BRAF gene growing.

New treatments for advanced melanoma are currently being researched in clinical trials.

You may experience side effects as part of these therapies. Your doctor will discuss these with you and you should let them know if you have any concerns.

It’s advisable not to become pregnant or father a child while having targeted therapy. You should talk to your doctor or nurse if you are concerned about contraception or your fertility during treatment.

Targeted treatments

Targeted therapies are used to stimulate the immune system or control the growth of cancer cells. They may be called biological therapies.

Different types of targeted therapy may be used to treat advanced melanoma. Some are available on the NHS and others are only used in clinical trials at the moment.

If a drug is not routinely available on the NHS, there may be other ways you can get access to it. Your cancer doctor can give you advice.

We have more information about immunotherapy and cancer growth inhibitors and information about specific therapies.


Ipilimumab

Ipilimumab (Yervoy®) works by attaching itself to normal T-cells. T-cells are part of the immune system. They fight infection and diseases.

In some people, T-cells can recognise and destroy melanoma cells. But a protein on the surface of T-cells, called CTLA-4, stops this happening. Ipilimumab blocks this protein so the T-cells can destroy melanoma cells. It can help to shrink or slow the growth of advanced melanoma.

You have ipilimumab as an infusion (drip) into a vein over about 90 minutes. The infusion is repeated every three weeks. Up to four treatments are given.

Common side effects of ipilimumab include:

Ipilimumab can cause inflammation in different parts of the body, such as the bowel, liver, skin and eyes. This can sometimes cause more serious side effects, including persistent diarrhoea, changes in the way the liver works, skin rashes and blisters affecting several areas of the body, and blurred or double vision.

It is important to report these side effects straight away to your medical team or specialist nurse. If you get these side effects, you will usually be prescribed steroid tablets to help reduce the inflammation caused by the ipilimumab. Depending on the severity of the side effects, treatment may be delayed or sometimes stopped. Your doctor or nurse will give you more detailed information about ipilimumab and its side effects.


Vemurafenib

The change in the BRAF gene leads to the production of a changed (mutated) protein. This protein helps melanoma tumours grow. Vemurafenib (Zelboraf®) blocks (inhibits) the changed BRAF protein, which can stop the melanoma cells from growing and dividing.

Vemurafenib is given as a tablet, which is taken daily by mouth. Your doctor will let you know if vemurafenib is a suitable treatment for you.

Common side effects include:


Dabrafenib

Dabrafenib (Tafinlar®) is another targeted therapy drug used to treat melanomas that have tested positive for the BRAF gene mutation.

Kinases are proteins made by cells. They send important chemical signals to cells telling them when to grow. Dabrafenib blocks a faulty kinase, made by the mutated BRAF gene, that tells the cancer cells to grow and divide in an uncontrolled way.

Dabrafenib is given as a tablet, which is taken twice a day by mouth. You have to take the tablets at least one hour before eating and at least two hours after eating. Your doctor will tell you if dabrafenib is a suitable treatment for you.

Common side effects include:


New therapies

Newer therapies that block some of the enzymes involved in cell growth are being researched as treatments for advanced melanoma.

Research is also looking at using cancer vaccines for advanced melanoma. If there are clinical trials testing these or other drugs, your hospital team will give you more information about them.


Contraception

Condoms should be used if you have sex within the first 48 hours after chemotherapy. This is to protect your partner from any of the drug that may be present in semen or vaginal fluid. It’s not advisable to become pregnant or father a child while having chemotherapy, because the drugs may harm the developing baby. For this reason, your doctor will advise you to use a reliable method of contraception (usually barrier methods such as condoms or the cap) throughout your treatment and for a few months afterwards. You can discuss this with your doctor or nurse.

Back to Targeted therapies explained

Monoclonal antibodies

Monoclonal antibodies can attach themselves to cancer cells to prevent them from growing.