Biological therapies are drugs that change the way that cells work and help the body control the growth of cancer.
Some seek out and destroy cancer cells. Others help the body to attack the cancer.
How you have biological therapies
You can have biological therapies as:
- a drip in your arm
- an injection under the skin
- a tablet
When might you have biological therapy
You usually have biological therapy as a treatment for stage 4 (advanced) melanoma skin cancer that has spread to another part of the body.
You might have biological therapy as part of a clinical trial, if you have stage 3 melanoma. Doctors want to find out whether it helps to prevent melanoma coming back. Biological therapy used in this way is called adjuvant therapy. We don’t know yet whether adjuvant therapy helps, so you have it as part of a clinical trial.
Types of biological therapy for melanoma
The two main types of biological therapy for melanoma are:
- targeted treatments, which target gene changes
- immunotherapy drugs, which help the body's natural defence system (immune system) to find and destroy melanoma cells
If you have stage 4 melanoma, the doctor usually does genetic testing on your melanoma cells. This helps them decide which type of biological treatment might help you.
If you have stage 2C or stage 3 melanoma, you might also have these tests. This information is useful later on if your melanoma spreads further.
Drugs that target gene changes (targeted treatments)
The doctor looks to see if the melanoma cells have changes (mutations) in certain genes, such as the BRAF V600 gene. About 40 to 50 out of every 100 people with skin melanoma (40 to 50%) have this gene change. The change to the gene causes it to make an overactive BRAF protein. This makes cells grow and divide too fast.
Targeted treatments that stop cells producing the BRAF protein and can slow or stop the growth of the cancer include:
- vemurafenib (Zelboraf)
- dabrafenib (Tafinlar)
These drugs are not likely to work in people who don’t have the BRAF gene change.
Deciding about treatment
Research looking at dabrafenib and vemurafenib shows that they work as well as each other. But they cause slightly different side effects. Dabrafenib does not cause as much sensitivity to light (photosensitivity) but is more likely to cause a high temperature (fever).
You can talk to your doctor about which treatment may be best for you.
Drugs that help the body's immune system (immunotherapy)
Immunotherapy is a type of biological therapy that helps the body's natural defence system (immune system) to find and destroy melanoma cells.
The immunotherapy drugs for melanoma are:
Doctors used to use 2 immunotherapy drugs called interferon and interleukin 2 to treat melanoma. They don’t use these drugs very often any more.
Newer biological therapies for melanoma
Doctors are looking at some new biological treatments for melanoma. These include:
- MEK inhibitors, such as trametinib and cobimetinib
- melanoma vaccines, such as TVEC
These drugs have been licensed to treat melanoma. But they have not been approved by the National Institute for Health and Care Excellence (NICE). So they may not be available as treatments on the NHS.