Dr Mario E. Lacouture on Maintaining Quality of Life While Treating Melanomas

Patients with melanoma have more promising options than ever with the advent of targeted therapies and immunotherapies, said Mario E. Lacouture, MD, director of the Oncodermatology Program at Memorial Sloan Kettering Cancer Center. His research aims to provide patients the best possible quality of life while taking these treatments, which can often have adverse effects.

What are some of the most promising new drugs for treating melanomas?
The most promising drugs to treat melanoma are targeted therapies and immunotherapies. It is important for patients to decide with their doctors based on the mutations in their cancer as well as other features such as the type of infiltrates in their cancer, to decide whether a patient should begin therapy with a targeted therapy or immunotherapy.

How can patients with melanoma maintain or improve their quality of life while on these treatments?
To maintain patients’ quality of life, it is important for patients to be aware of the adverse events that can occur with these therapies. Therefore, it is important to educate patients and to provide frequent follow-up when they are receiving targeted therapies or immunotherapies. In most of these cases, interventions can be conducted, for example, by treating patients’ rashes with topical corticosteroids or antihistamines, or using oral corticosteroids whenever they develop rashes or other toxicities to immunotherapies or targeted therapies.

How has your research helped patients treat their skin-related side effects while not interfering with the effectiveness of the anti-cancer drugs?
Our research focuses on identifying individuals that are at risk for these adverse events, and managing or preventing these adverse events without interfering with the anti-cancer response. So we will usually try to use agents that are administered topically, or that have a different mechanism of action of the anti-cancer drug, so that there is no interference with the anti-tumor benefit. In addition, it’s also important to remember that many studies have shown that the appearance of adverse events appears to correlate with the response to the anti-cancer therapy, so it is precisely patients with adverse events that we should try to treat so that they can stay on therapy and live longer. 
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