Malignant Melanoma: The Tumor That Used to Give Cancer a Bad Name

Malignant melanoma is more than just a skin cancer. It is primarily the result of damage to the melanocytes from intense sun exposure in childhood and adolescence. These transformed melanocytes have the capacity to invade the blood and lymphatic system and spread widely, if not caught early. Unlike many other cancers, once melanoma had spread beyond the skin, standard treatment is usually ineffective.

A number of laboratories have recognized that melanoma cells have the ability to “paralyze” the immune response—particularly the cytotoxic T cell response—via several mechanisms. At the same time, understanding of the molecular events that occur with the initiation and progression of melanoma has led to the development of new molecularly targeted therapies, particularly agents directed against mutated BRAF. Unlike the immune therapies, which have to be given intravenously, these targeted agents can be given by mouth often with dramatic clinical responses. Combinations of targeted and immune therapies are now being investigated in advanced disease.

In the space of 10 years, malignant melanoma has gone from the most dreaded cancer in humans to a model for development of more rational and effective cancer treatment.