As a Board-Certified Plastic and Reconstructive Surgeon in Los Angeles, I devote a large portion of my practice to the treatment and prevention of skin cancers and the reconstruction of skin cancer defects. Although the treatment of patients with late stage melanoma is usually managed by oncologists, I wanted to share my excitement about the recent FDA approval of Yervoy (ipilimumab). Yervoy is the first drug that has been shown to extend the lives of patients who suffer from advanced metastatic melanoma. Overall, melanoma is the most dangerous of all types of skin cancers. For this reason, I am very aggressive in my treatment of early stage melanomas and atypical moles which are headed toward the “pre-melanoma sequence.” For pre-melanomas and very early stage melanomas, surgical resection (removal) is very effective. However, for late stage metastatic disease the options are much more limited.
Yervoy is a monoclonal antibody, which is a molecule that is manufactured in a laboratory, which functions through blockade of cytotoxic T-lymphocyte antigen (CTLA-4). CTLA-4 is a protein that effects the immune system by down-regulating it. By decreasing or eliminating the action of CTLA-4, Yervoy allows a patient’s own immune system to combat the melanoma. The medication is administered intravenously, has potential side effects and must be prescribed under the direction of a medical oncologist.