Melanoma is generally recognized as one of the cancers that have an increasing cover percentage, though it is usually diagnosed at early stages. Recently, the ways of melanoma treatment for patients with metastatic disease were so limited that many patients were practically doomed. Fortunately, melanoma therapeutics have developed for the past decade because of the use of immune checkpoint inhibitors. Now, people with stages II and III may easily have a long period of remission. Therefore, modern options for melanoma treatment serve as a source of hope for numerous people.
Indeed, innovations in the sphere of melanoma treatment are connected with the use of checkpoint inhibitors and the so-called adjuvant therapy. According to recent research, “the use of anti–CTLA-4 and anti-PD1 immune checkpoint inhibitors and combination BRAF/MEK inhibitors for patients with BRAF V600 mutations has significantly extended survival and allowed some patients to remain in durable disease remission off therapy” (Poklepovic & Luke, 2019, p. 1166). This means that the so-called “low-risk” patients with stage IIA through IIC melanoma like Mr. B. from the question may have a long remission after receiving a special course.
Still, patients in remission should better keep healthy with adjuvant therapies. A decade ago, such kind of additional treatment was frequently considered of marginal effects for earlier stage melanoma because of interferon-α2b (IFN). It turned out that “the substantial associated toxicity of that interferon and other treatments, such as the anti-CTLA4 antibody ipilimumab” (Jenkins & Fisher, 2021, p. 27). Therefore, it used to be of little trust for many efficient doctors. Moreover, as far as stage II is concerned, the lower incidence of disease progression calls for unprecedented efficacy (Rozeman et al., 2018). However, with time, adjuvant therapies became recognized in the sphere of cancer treatment. The case of Mr. B may be the one where adjuvant therapy could have prevented the biopsy from coming back to stage II melanoma.
References
Jenkins, R.W., & Fisher, D. E. (2021). Treatment of advanced melanoma in 2020 and beyond. Journal of Investigative Dermatology, 141(1), 23-31.
Poklepovic, A. S., & Luke, J. J. (2019). Considering adjuvant therapy for stage II melanoma. Cancer, 126(6), 1166-1174.
Rozeman, E.A., Dekker, T. J. A., Haanen, J. B. A. G., & Blank, C. U. (2018). Advanced melanoma: Current treatment options, biomarkers, and future perspectives. American Journal of Clinical Dermatology, 19, 303–317.