Immunothérapie dans le traitement du mélanome au stade avancé

Immunotherapy, which stimulates the anti-tumor immune response, has significantly modified the prognosis of advanced stage melanoma. Anti-CTLA4 monoclonal antibody, ipilimumab, showed a benefit on survival compared to chemotherapy in 2011. Anti-PD1, nivolumab and pembrolizumab subsequently showed superior clinical benefit including overall survival and tolerance over anti-CTLA4. Currently, the combination of ipilimumab and nivolumab appears as the most effective immunotherapy but the toxicity of this regimen is a limitation. Anti-PD1 antibodies have also been evaluated in the adjuvant setting for patients with stage III or IV resected melanoma where they have shown a significant benefit in term of relapse-free-survival. Studies are underway to evaluate these drugs in stage II resected melanoma and in neo-adjuvant setting with promising results.