• Caroline Robert and Christina Mateus.
• B Acad Nat Med Paris. 2014 Feb 1; 198 (2): 297-308.

AbstractManagement of patients with metastatic melanoma has improved radically in recent years with the development of new drugs capable of signifcantly prolonging life expectancy. Two strategies have been implemented: targeted anti-BRAF therapy for BRAF-mutated melanomas, and non specific immunotherapies based on anti-CTLA-4 (ipilimumab) and, more recently, anti-PD-1 monoclonal antibodies. These antibodies, by blocking physiological brakes on immune activation, induce an indirect immune response. Ipilimumab, a drug approved in 2011 is of benefit to 20 % of patients but can also trigger significant immune-mediated toxicity. Anti-PD-1 antibodies presently in development seem to have a better therapeutic index, with higher response rates and less toxicity than ipilimumab. Combination therapy with anti-CTLA-4 and anti-PD-1 v is also giving encouraging preliminary results. In future, these new drugs will probably be used in combination, either concurrently or sequentially.

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