Over the last sixty years the incidence of malignant melanoma has skyrocketed. In 1950 one person in 2000 got melanoma; when last examined a few years ago that number was one in fifty. The graph below shows the harsh reality.
Although still only one-third the incidence of colon cancer, melanoma is a feared adversary because of its lethal reputation. Fortunately the death rate has not kept pace with the incidence because people and their doctors now recognize the early warning signs; the average melanoma is diagnosed much earlier than it used to be. Nonetheless a substantial number of people each year will develop advanced melanoma and eventual metastatic disease. Their prognosis has improved little over that of sixty years ago, despite all the advanced in chemotherapy and, more recently, targeted therapy – where small molecules attach to proteins on cell surfaces, turning off the metabolic engine of the cell.
In 2011 the FDA approved Ipilimumab, to be marketed as Yervoy© by Bristol-Myers Squibb, for the treatment of metastatic melanoma. There was considerable fanfare over this in the oncologic community and the press. Since then this drug has proved to be an indispensable part of the treatment of melanoma. Together with Nivolumab, this double therapy has changed the outcome for thousands of patients with this dreaded cancer.