A Comparison of Various Monoclonal Antibodies to the Previous Standard of Care Chemotherapy in the Treatment of Advanced-Stage Melanoma

Authors

Kevin Verde, Nova Southeastern UniversityFollow
Lauren Johnson, Nova Southeastern UniversityFollow
Alex Clancy, Nova Southeastern UniversityFollow
Ashley Goldberg, Nova Southeastern UniversityFollow
Aleia Monden, Nova Southeastern UniversityFollow
Priya Philip, Nova Southeastern UniversityFollow

Abstract

In the year 2015, it is estimated that the number of new cases of invasive melanoma will be 42,670 in males and 31,200 in females.¹ Melanoma is treatable with early diagnosis; however, more advanced disease has devastating outcomes. For the past decade, two chemotherapy agents, dacarbazine and temozolomide, have been the treatment of choice for advanced stage III or IV melanoma requiring systemic treatment. Interleukin-2 (IL-2) therapy has been used but with serious side effects. More recently, the focus has shifted to monoclonal antibodies and enzyme inhibitors as the main systemic treatment for advanced cutaneous melanoma. This literature review gathered several studies which looked at the use of monoclonal antibodies, and compared monoclonal antibodies to conventional chemotherapy to assess whether there is a significant difference in tumor response, sustained remissions and side effect profile. An extensive medical literature review was conducted with PubMed and Cochrane databases using the keywords: “monoclonal antibody,” “melanoma,” and “treatment.” This list of articles was further narrowed by specific inclusion and exclusion criteria as well as reviewed for validity and quality using the GRADE system. Seven clinical trials were included in this literature review. One observational study evaluated the overall safety and efficacy of monoclonal antibodies, while another compared monoclonal antibodies versus placebo under the same variables. Three of the research studies were randomized clinical trials evaluating the safety and efficacy of monoclonal antibodies in comparison to chemotherapy. Two retrospective studies assessed patients from expanded access programs who did not meet criteria to participate in a clinical trial. All seven studies had similar inclusion and exclusion criteria and the patients were prognostically similar before starting treatment. Six out of the seven studies demonstrated superiority of monoclonal antibodies advanced-stage melanoma treatment. One study failed to demonstrate a statistically significant survival advantage over traditional chemotherapy. The use of monoclonal antibodies has been demonstrated to be a more specific and effective treatment approach than other therapies tried in the past. While monoclonal antibodies have demonstrated efficacy in first line treatment for advanced stage melanoma, further research is necessary to determine which combination of medications is most beneficial for these patients.

Author Bio(s)

Lauren Johnson, currently a second year Physician Assistant student at Nova Southeastern University, received her Bachelor's in Psychology in 2012 from Geneseo State University where she co-authored a study published in the Journal of Neurotoxicology and Teratology. Lauren grew up in New York and resides in Florida with her family.

Kevin Verde is a second year Physician Assistant student at Nova Southeastern University. He obtained his Bachelor’s in Economics from Florida International University. Kevin worked as a Clinical Research Coordinator at the Holy Cross Orthopedic Institute in Fort Lauderdale, Fl. He is a trumpet player and admirer of the arts.

Alex Clancy is currently in her second year at Nova Southeastern University’s Physician Assistant Program. She was born and raised in Southern California and obtained her Bachelors Degree at the University of San Diego in 2012. She plans to pursue a residency in emergency medicine or work in urgent care.

Aleia Monden is a Physician Assistant Student at Nova Southeastern University. She is interested in Dermatology and Pediatric Orthopedic Surgery. Aleia attended Florida State University when she became an Olympic Trial qualifier, and five-time USA Diving National Finalist for Platform Diving and obtained her Bachelor’s Degree in Exercise Science.

Ashley Goldberg, currently a second year Physician Assistant student at Nova Southeastern University, is interested in pursuing a career in dermatology. She graduated from the University of Maryland with a Bachelor's in Community and Behavioral Health. She hopes to one day pursue her culinary passion and open a restaurant.

Priya Philip, currently a second year Physician Assistant student at Nova Southeastern University, received her Bachelor’s in Biology from the same institution. She holds an Associate Degree in Nuclear Medicine Technology and worked as a Nuclear Medicine Technologist for seven years. She resides in Florida with her husband and son.

Acknowledgements

Many thanks to our faculty adviser J. Keith Williams MPAS, PA-C for his guidance throughout the process of writing this paper.

DOI

10.46743/1540-580X/2016.1598

Recommended Citation

Verde K, Johnson L, Clancy A, Goldberg A, Monden A, Philip P. A Comparison of Various Monoclonal Antibodies to the Previous Standard of Care Chemotherapy in the Treatment of Advanced-Stage Melanoma. The Internet Journal of Allied Health Sciences and Practice. 2016 Jan 01;14(3), Article 14.