Who is a good candidate for adjuvant therapy?
Adjuvant therapy is used for specific patients with advanced melanoma-generally stage III or IV who have had surgery that has completely removed their tumours. Adjuvant therapy may be offered to potentially prevent a recurrence of disease in this higher risk patient group.
What types of adjuvant therapy may be considered?
There are various types of therapy, but the two major ones you’ll likely be considering for adjuvant therapy are immunotherapy and targeted therapy. These therapies stimulate the immune system to destroy cancer cells and are very effective and well tolerated in most patients. These therapies are
not the same as chemotherapy which has very different side effects and which is now rarely used to treat melanoma.
How do we determine which adjuvant therapy to use?
Your oncologist and care team will review the options with you. Currently, these therapies are still very new and some are still pending approval for use as adjuvant treatment. Knowing whether to use targeted therapy or an immunotherapy will depend on the characteristic of your tumour and whether or not is has a specific genetic mutation – called the BRAF mutation. Your oncologist will make the recommendation based on what therapy is currently available and based on your individual health needs, preferences and profile.
What are the side effects of adjuvant therapy?
Knowing the potential side effects are important. Each therapy has its own potential side effects. These should be discussed in detail with your oncologist and your oncology team will guide you in your treatment.
How is the drug administered and how long will I
have to be on treatment?
Your adjuvant therapy will depend on your specific medical situation but for adjuvant therapy you’ll most likely be on treatment for about a year. Ask your oncologist about what type of follow up and monitoring will be required, the frequency of administration of the drug therapy, including
what tests will need to be done, so you know what to expect.
Targeted therapy is usually delivered orally, while immunotherapy drugs are given through an IV. This is useful to know as targeted therapy can be taken at home, and the latter will require regular visits to a hospital or infusion center. Talk to your doctor about medication schedules and also whether side effects or dosage will change during the course of treatment.
How will I know if the adjuvant therapy is working?
Adjuvant therapies for melanoma are used to significantly reduce the risk that melanoma will return, which is different from treating metastatic disease where there is detectable disease present. When it comes to a recurrence of disease, no one can predict with certainty that the disease will return. However, with adjuvant treatment, clinical data from drug trials have shown a significant portion of people have not had a recurrence of melanoma.
The future of treatment for melanoma is looking very positive
and we are hopeful that many will receive treatment that may prevent future recurrence of disease, thus reducing the number of metastatic patients and deaths from melanoma.
By Annette Cyr, Three-time melanoma
survivor, Chair & Founder, Melanoma
Network of Canada