What is the role of medications in the treatment of oral malignant melanoma?

Updated: Jan 31, 2020
  • Author: Elizabeth Ann Bilodeau, DMD, MD, MSEd; Chief Editor: Jeff Burgess, DDS, MSD  more...
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Answer

Answer

Drug therapy (dacarbazine), therapeutic radiation, and immunotherapy are used in the treatment of cutaneous melanoma, but they are of questionable benefit to patients with oral melanoma. Dacarbazine is not effective in the treatment of oral melanoma; however, dacarbazine administration in conjunction with interleukin 2 (IL-2) may have therapeutic value. Ipilimumab, a human monoclonal antibody, has shown encouraging results in therapy for metastatic melanoma. [16] The drug blocks regulation of cytotoxic T-lymphocytes and allows sustained immunologic activity against melanoma and other malignancies. Metastatic melanomas with either amplification of C-KIT-a transmembrane tyrosine kinase, or BRAF oncogene mutation have shown tumor volume reduction with targeted immunotherapy. KIT mutations have been reported in 39% of mucosal melanomas. [17] Imatinib and other inhibitors of C-KIT have resulted in either partial or complete responses in patients harboring C-KIT mutations. [4, 18] Current studies are evaluating many other tyrosine kinase inhibitors in the class of imatinib. [19] Vemurafenib and dabrafenib have been effective in treating melanoma with a BRAF mutation. [20]


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