From the Desk of Sam Guild, President
AIM at Melanoma Foundation
Update on the State of Vaccines for Melanoma
Behavioral Addiction Responsible for Excessive Indoor Tanning
Side Effect Central: Lichen Planus
FROM THE DESK OF Sam Guild
PRESIDENT | AIM AT MELANOMA FOUNDATION
Dear Friends and Supporters,
In my President’s Letters, I usually share the highlights of the newsletter as well as what is new with AIM And, as is appropriate for Spring, there is a lot that is new with AIM to share!
First, though, here’s a rundown of our newsletter The key article is about vaccines and specifically about mRNA vaccines and where researchers are in their quest to find a melanoma vaccine There’s also an article in our series called Side Effect Central, which we created to help patients with melanoma and their caregivers understand common side effects of melanoma treatment and to encourage communication with your health care team about those side effects This issue’s article is about lichen planus, an inflammatory skin condition associated with immunotherapy treatment Finally, there is a summary of an indoor tanning study that was able to demonstrate that some indoor tanners continue the behavior even when they know there are serious health concerns associated with it a key component of addictive behavior. I hope you enjoy this newsletter.
We’ve been incredibly busy this spring at AIM, and there is so much we want to share with you.
As you know, part of our mission is patient education, but we also provide education to healthcare professionals about melanoma, nonmelanoma skin cancers, and immunotherapy (because those treatments began in melanoma) We’re excited to introduce the redesigned AIM with Immunotherapy website created to serve as a reliable, clinician-focused hub for the latest in cancer immunotherapy
As for the AIM at Melanoma website, we’re proud to share that we reached a major milestone last month over 100,000 visits to our website in a single month, our highest ever! This record-breaking traffic shows the growing reach of our mission and the critical need for trusted melanoma information, support, and resources Whether it’s patients, caregivers, advocates, or healthcare professionals, more people than ever are turning to AIM for answers and hope
In the Steps Against Melanoma walk world, we’re proud to report that the 4th Annual Tampa Steps Against Melanoma walk kicked off our spring season with a new record fundraising number for them over $32,000! Thank you to everyone involved in the Tampa walk! And we have a number of milestone celebrations this year: Dallas (May 3 , at Bachman Lake Park) and Milwaukee (May 18 at Milwaukee County Zoom) are celebrating their 20th anniversaries; Pittsburgh May 10 at the North Park Boathouse) is celebrating their 10 anniversary Congratulations to all! Finally, we have a new walk this year in Long Island If you’re reading this letter and you live in or anywhere near Long Island, we invite you to get involved by walking, helping, or donating In fact, please check out the list of cities in which we host walks, and if you live near any of them, we hope you’ll get involved The monies raised go directly to AIM’s Melanoma Tissue Bank Consortium Thank you!
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You might know about AIM’s Peer Connect program, which matches trained volunteer mentors with newly diagnosed patients with melanoma This program has 93 participants and continues to grow What’s new is that we’ve introduced a Peer Connect program to serve TILs patients, whose treatment is relatively new and multifaceted We are training TILs mentors now and will soon open the program to patients currently in treatment
Lastly, I will share that I was proud to speak earlier this month at the 11th World Congress of Melanoma & 21st EADO Congress in Athens, Greece. EADO is the acronym for European Association of Dermato-Oncology. I spoke twice during the international conference. On one of the days, I was a panelist with two physicianresearchers, and we discussed the importance of the patient perspective during the treatment journey and how providers, with the use of various resources, can effectively educate patients and families to encourage shared-decision making The other presentation was on the use of biomarker testing in melanoma and ways to help promote its use during the melanoma treatment journey
Thank you for your continued support of AIM Until next time
UPDATEONTHESTATEOF VACCINESFORMELANOMA
INTRODUCTION
Scientists have recently advanced a strategy to send human cells instructions to generate an immune response against cancer It is not an incredibly sophisticated strategy, but it is extremely logical. It takes advantage of the process cells use to communicate to the immune system about a problem The difference is that we tell them what the problem is cancer If clinical trials continue to go well and show efficacy, we could see a vaccine approval to treat melanoma in a year or two.
BEGINNING WITH COVID-19
When the COVID-19 pandemic hit, a vaccine was desperately needed to stop the spread of the virus and save lives worldwide. Traditional vaccines would take time to produce and a more rapid solution was needed.
Fortunately, scientists, who would later win the Nobel Prize for their work, had been busy developing strategies for vaccine technology using molecules in the cell collectively called mRNA, or messenger ribonucleic acid, a relative to DNA This relative, mRNA, takes the design plans from DNA, and conveys them to the cellular machinery that makes proteins
Serendipitously, the science of mRNA was ideal for rapidly developing an mRNA-based vaccine to protect against COVID-19 In fact, several companies brought products to market Moderna, Novavax, and Pfizer by creating mRNA-based vaccines against the virus
Although there may be ongoing concerns associated with requiring the COVID-19 vaccination, the incredible technology that helped eliminate the threat of dying from COVID has many other applications. Cancer researchers, who were already designing experimental therapies using mRNA, were paying very close attention to the safety and efficacy of these products in the marketplace Now, some of their own ideas are being used in clinical trials against cancer.
VACCINES DESIGNED TO PREVENT DISEASE
Traditional vaccination the kind used to prevent disease works by introducing a threat to your immune system and teaching your immune system to identify and fight that threat if it ever comes into contact with it Many of the vaccines we receive as children are traditional vaccines.
COVID-19 vaccines are an example of this traditional technology combined with mRNA technology. mRNA sequences were used to create pieces of COVID-19 inside the human system, where they didn’t belong The COVID-19 pieces would not be enough to recreate the entire virus so no one would develop COVID-19 as a consequence of taking the vaccine but these pieces would catch the immune system’s attention Upon detection of the foreign COVID-19 pieces, the immune system developed molecules to attack them If someone later encountered COVID-19, the immune system would automatically recognize the foreign pieces and respond by fighting off the disease
VACCINES DESIGNED TO PREVENT CANCER
Similar to traditional vaccination, the idea behind cancer vaccines is to create instructions to teach your immune system to correctly identify a threat like a cancer cell and mount an immune response against it However, teaching your immune system to distinguish a cancer cell from a normal one is challenging. In addition, the pieces of the cancer cell change–these are not the same from person to person, which makes developing these vaccines even more challenging
We have had vaccines for many years that prevent certain cancers, but they are all cancers that are initiated by viral infection Examples include the human papillomavirus (HPV) that causes cervical, anal, oral, penile, and other cancers; and hepatitis B infections that cause liver cancer The vaccines for these cancers aren’t designed to help your immune system detect cancer cells; they’re designed to help your immune system detect and kill the viruses HPV and hepatitis B that can lead to cancer At this time, we do not have any approved vaccines for cancer that enable your body to detect and kill a certain cancer cell.
There are currently no vaccines to prevent melanoma. Your best prevention comes from sun safety practices, especially if you have a light complexion.
CANCER VACCINES DESIGNED TO TREAT CANCER
Cancer vaccines designed to treat cancer are a bit different. The individual already has cancer. The goal is to eliminate the cancer using the immune system.
The major challenge for this type of cancer vaccine is determining what pieces on cancer cells can be identified as unfamiliar what part of a cancer cell will your immune system recognize as foreign and begin to fight? Unfortunately, because cancer cells develop within your body, they don’t generally appear to your immune system as foreign And unlike the above noted cancers that stem from viruses, there is no foreign virus to attack Non-specifically training the immune system to attack your cells could cause a life-threatening immune reaction with long-term consequences
However, using mRNA, scientists can tailor instructions to the immune system to specifically identify a cancer cell If they exist, ideal targets would be anything the cancer cell uniquely expresses on the cancer cell surface or something it has in abundance compared to normal cells In melanoma, several tumor-associated pieces (or “antigens”) are expressed in abundance by the melanoma cells, including Melan-A (melanoma antigen), MAGE-A3 (melanoma associated antigen 3), and NY-ESO-1 (New York esophageal squamous cell carcinoma 1).1
Each person’s cancer is likely to differ from the next mRNA can create instructions for assembling pieces that cancer cells have but not normal cells. These are formally called “tumor-specific antigens.” Once the instructions, such as a cancer vaccine, are provided to the human system, normal cells will begin to make and present the cancer pieces to immune cells If everything goes well, the immune system will respond by mounting an attack against cancer cells with those pieces.
One key difference between current traditional prevention vaccines and a cancer treatment vaccine is that the treatment vaccine can be personalized to help the patient’s immune system recognize the cancer in the patient’s body: The cancer cells can be taken from the own patient’s tumor or blood and then injected back into the patient with mRNA instructions to find and destroy those specific cancer cells
ARE ANY MRNA VACCINES APPROVED FOR MELANOMA?
No mRNA vaccines for melanoma have been approved by the FDA yet However, several ongoing clinical trials are testing the safety and efficacy of vaccines to treat melanoma.
KEYNOTE-942: This active Phase II trial (NCT03897881) assesses mRNA-4157 (V940) plus pembrolizumab (Keytruda) in resected (surgically removed) highrisk Stage IIIB to Stage IV cutaneous melanoma The mRNA used is customdesigned based on the individual’s tumor pieces (antigens) unique to their melanoma
To make a personalized vaccine, a section of the tumor is removed to identify unique pieces or antigens Once the unique pieces are identified, the instructions for 9 to 34 antigens will be created via mRNA. Then, the mRNA is injected back into the patient to train the immune system on what to target
Data from the three-year trial update reported a 49% risk reduction in recurrence with mRNA-4157 plus pembrolizumab Adding the mRNA vaccine also increased the 2.5-year recurrence-free survival rate from 55.6% to 74.8%. There was also a trend for improved overall survival to 96.0% versus 90 2% with pembrolizumab alone 2
A Phase III trial (NCT05933577) is ongoing for high-risk patients with melanoma to assess the safety and efficacy of mRNA-4157 (V940) It has enrolled 1089 patients with Stage IIB to Stage IV melanoma. Primary completion is expected in 2029, and full completion in 2030 The study has 165 locations worldwide.
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BNT111 mRNA Vaccine: This active Phase II trial (NCT04526899) is for “BNT111 and Cemiplimab in Combination or as Single Agents in Patients With Anti-PD-1refractory/Relapsed, Unresectable Stage III or IV Melanoma ” It began in 2024 and is estimated to be completed in July 2026.5
BNT111 is a melanoma vaccine that contains mRNA against four tumor-associated pieces or antigens These include MAGE-A3, NYESO-1, tyrosinase, and TPTE (transmembrane phosphatase with tensin homology). Many of these are expressed in abundance on the surface of melanoma cells but not normal cells. The company also included additional modifications within the mRNA design to enhance the successful identification of cancer cells by the immune cells This vaccine is not personalized to each particular patient, but the mRNA is designed to identify specific antigens associated with melanoma. 6
STX-001 mRNA Vaccine: This Phase I/II trial (NCT06249048) is recruiting patients with advanced melanomas that can be injected, excluding uveal melanoma U S sites included in the study are NextGen Oncology, the University of Pittsburg Medical Center, and the University of Texas M.D. Anderson Cancer Center. Patients included have received an immune checkpoint inhibitor therapy, such as ipilimumab (Yervoy), nivolumab, or pembrolizumab, either alone or in combination They also must have either primary or secondary checkpoint inhibitor resistance 7
The mRNA created by STX-001 is interleukin12 or IL-12. This molecule is displayed on the surface of specific white blood cells, called monocytes, that attract the attention of more effective, killing types of immune cells If you were to have your blood analyzed and your monocytes were high, it could indicate the presence of an infection or cancer in your body.
When IL-12 is expressed by melanoma cells on their cell surface, it increases the presence of effective, killing immune cells In addition, IL12 reduces the expression of checkpoint controls that stop the immune system from fighting cancer This vaccine is not personalized to each patient, but specific to melanoma 8
Multiple clinical trials have previously examined the use of IL-12 in melanoma Results have been mixed but improved outcomes have been shown.
Future clinical trials need to be conducted in combination with other anti-cancer agents since IL-12 reduces the targets of immune checkpoint inhibitors, making these drugs ineffective 8
WHEN WILL MRNA VACCINES BE AVAILABLE FOR
PATIENTS WITH MELANOMA?
Although the technology is exciting, there are no approvals yet, and the approach has limitations. For one, personalizing the anticancer targets that should be included for each patient is challenging The design process is resource-intensive and expensive To adopt such an approach, the vaccine must have a significant benefit in treating the patient to justify these costs
Ironically, the challenge of designing an appropriate mRNA vaccine is also its advantage With flexibility in the design platform, scientists have created a way to vaccinate humans against nearly anything that our cells can build inside the body. The customization allows vaccine changes to fight cancer resistance to drugs and recurrent or indolent tumors.
Even though there are no approvals yet, in February 2025, a Phase II study using autogene cevumeran (RO7198457, RG6180) was completed in patients with previously untreated advanced melanoma (NCT03815058) The agent is an mRNA-based vaccine that creates personalized instructions to target specific pieces or antigens of the patient’s tumor The results have not yet been released for melanoma Still, a similar trial using autogene cevumeran in pancreatic cancer is ongoing and showing success
Researchers in the pancreatic cancer trial used mRNAs targeting up to 20 pieces of antigens on the surface of cancer cells. After a year and a half, 50% of the vaccinated patients showed cells with evidence of the vaccine, and these individuals also had delayed recurrence of their cancer. After three years, the vaccine responders had not reached a measurement for recurrence-free survival (because most of them were doing well). In comparison, non-responders of the vaccine had a recurrence-free survival of 13.4 months 9
More clinical trials are required to determine whether mRNA vaccines are safe and effective for patients with melanoma Sometimes, trials produce unclear results, or they can’t produce enough results For example, a Phase I/II study (NCT03480152) was initiated in 2018 to determine whether the mRNA vaccine, National Cancer Institute (NCI)-4650, was safe and could shrink metastatic melanoma. It was terminated in 2020 due to slow accrual with only five patients enrolled.10
ARE ANY VACCINES APPROVED FOR MELANOMA?
Fortunately, yes. T-VEC (Imlygic) is an oncolytic virus therapy that treats advanced melanoma. This type of treatment vaccine is different, and it is not made up of mRNA personalized to the patient. Instead, oncolytic virotherapy introduces an engineered virus into melanoma cells, causing them to burst open. When this occurs, they spill out more viruses and pieces of the destroyed cancer cell
Both the viruses and the cancer cell particles that came from the burst melanoma cell will be swallowed by other cells, slowly and sequentially ridding the body of the virus and cancer cells, as the process continues The immune cells may also recognize the cancer cell particles on other cells and eliminate the infected cells
CONCLUSION
The mRNA vaccines in active clinical trials for melanoma are specifically designed to treat the disease, rather than prevent it The personalized mRNA vaccines are created after removing and analyzing the DNA expressed by an individual’s melanoma; the other vaccine targets melanoma antigens that many patients with melanoma will express One vaccine for melanoma, T-VEC, is approved for use, although the design is based on using a virus to burst cells and does not rely on mRNA
Although mRNA vaccines for melanoma represent an exciting concept, it may be some time before we know whether these are a breakthrough or a bust. Some preliminary results show promise, whereas some clinical trials for mRNA were terminated due to low accrual.
Nevertheless, the 2023 Nobel Prize winners in medicine were a research team investigating mRNA vaccine strategies. Years earlier, they figured out how to design mRNA for therapeutic benefit by communicating instructions to cells and the immune system. Companies applied their research in 2020 when the COVID-19 pandemic hit and developed vaccines against the virus. Hundreds of millions have been injected with this technology that allows your immune system to recognize and kill COVID-19 essentially, a vaccine with mRNA. We hope the same success can be replicated in melanoma
Patient Resources
Learn MoreAbout OncolyticVirusTherapy
Exploreour“In Plain English” Blog Series
References
1. Yao R, Xie C, & Xia X. Recent progress in mRNA cancer vaccines. Hum Vaccin Immunother. 2024; 20(1):2307187. doi: 10.1080/21645515.2024.2307187.
2. Weber JS, Khattak MA, Carlino MS et al. Individual neoantigen therapy mRNA-4157 (V940) plus pembrolizumab in resected melanoma: 3-year update from the mRNA-4157-P201 (KEYNOTE-942) trial. Presented at the 2024 American Society of Clinical Oncology. Abstract LBA9512.
3. Hieken TJ & Ariyan C. Personalized mRNA Vaccines and Contemporary Melanoma Practice Ann Surg Oncol 2025;32(1):1-2. doi: 10.1245/s10434-024-15731-w
4. Clinicaltrials.gov. A Clinical Study of V940 Plus Pembrolizumab in People With High-Risk Melanoma (V940-001). Accessed 4.4.25. Updated 11.18.24. Available at: https://clinicaltrials.gov/study/NCT05933577.
5. Clinicaltrials.gov. Trial With BNT111 and Cemiplimab in Combination or as Single Agents in Patients With Anti-PD-1-refractory/Relapsed, Unresectable Stage III or IV Melanoma. Accessed 4.3.25. Updated 3.25.25. Available at: https://clinicaltrials.gov/study/NCT04526899.
6. Zak MM & Zangi L. Clinical development of therapeutic mRNA applications. Molecular Therapy 2025. doi: https://doi.org/10.1016/jymthe.2025.03.034
7. Clinicaltrials.gov. Phase 1/2 Study of Intratumoral Injection of STX-001 in Advanced Solid Tumors as Monotherapy or in Combination With Pembrolizumab. Accessed 4.4.25. Updated 2.11.25. Available at: https://clinicaltrials.gov/study/NCT06249048?term=NCT06249048.
8. Gao W, Pan J & Pan J. Antitumor Activities of Interleukin-12 in Melanoma. Cancers (Basel). 2022;14(22):5592. doi: 10.3390/cancers14225592
9. Sethna Z, Guasp P, Reiche C et al. RNA neoantigen vaccines prime long-lived CD8+ T cells in pancreatic cancer Nature 2025 Mar;639(8056):1042-1051. doi: 10.1038/s41586-02408508-4.
10. Clinicaltrials.gov. Messenger RNA (mRNA)-Based, Personalized Cancer Vaccine Against Neoantigens Expressed by the Autologous Cancer. Accessed 4.4.25. Updated 6.2.20. Available at: https://clinicaltrials.gov/study/NCT03480152.
BehavioralAddiction Responsiblefor ExcessiveIndoor Tanning
Most people are aware of the link between indoor tanning and skin cancer – so why do they still do it?
New research in BMC Psychology suggests that excessive tanningislinkedwithbehavioraladdiction.
The data published by Allison Leip and colleagues is consistent with the concept that some individuals experience symptoms of tanning dependence They might neglect their responsibilities in favor of indoor tanning and even continue tanning after receiving a diagnosis of skin cancer
The study is essential for clinicians and the public to understand that methods other than education on skin cancer may be needed to reduce tanning among this group. Behavioral control interventions and education could be implemented when designing tanning cessation methods to prevent skin cancer.
In the study, the authors surveyed 280 non-Hispanic White women from across the U.S. who engaged in at least 10 indoor tanning sessions over the past 12 months
They found that these women worried about getting skin cancer all the time (22.4%) or sometimes (43.1%), yet were unable to control the urge to tan.
A barrier to quitting indoor tanning included needing tanning “to lift me up when I’m feeling down,” which was reported by 60 3% of the group exhibiting tanning addiction symptoms. The majority of this group (71.6%) reported they would not be as confident if they quit indoor tanning
Although 40 5% of the group addicted to indoor tanning wanted to quit, most stated it would be extremely hard (47.0%) or hard (30.4%) to do so, and most (61 2%) did not intend to quit in the next 12 months Half of those addicted to indoor tanning said they had attempted to quit tanning at least once in the past 12 months
REASONSGIVEN
FOR NOT QUITTING
INDOORTANNING
BYTHE GROUPADDICTEDTO THE BEHAVIOR INCLUDED FEELING“TENSE AND IRRITABLE”WITHOUT TANNING (41.4%) VERSUSTHE GROUPTHATDID NOTDISPLAY THE ADDICTION (6.8%).
In addition, more than half of those addicted to tanning were told by a friend or relative that they needed to stop or cut down on their tanning behavior
Even though the number of indoor tanners has declined in the U S with increasing education about cancer risks, the percentage of excessive tanners has grown. These tanners use an indoor tanning device more than 25 times per year and more often than needed to maintain a tanned appearance. This suggests that excessive tanners are driven by needs that are not based on cosmetic reasons
Since the pattern of tanning more often than “necessary” mimics the condition of tolerance, the study’s authors wondered whether there was a link based on psychology. Tolerance applies to a rewarding activity that improves mood, but the feeling diminishes over time, which makes the individual increase the frequency of the activity to achieve the same feeling. It partially explains why people addicted to gambling, smoking, or consuming excess alcohol increase the frequency of their behavior over time.
Reasons given for not quitting indoor tanning by the group addicted to the behavior included feeling “tense and irritable” without tanning (41 4%) versus the group that did not display the addiction (6 8%) Peer pressure did not appear significant since only 34.5% of the excessive tanners agreed it would be “hard to quit because so many others around me are tanning ”
ALTHOUGH 40.5% OFTHE GROUPADDICTEDTO INDOOR TANNINGWANTEDTOQUIT, MOSTSTATED ITWOULD BE EXTREMELY HARD (47.0%) OR HARD (30.4%)TO DOSO, AND MOST(61.2%) DID NOTINTEND TOQUITINTHE NEXT12 MONTHS.
Before this study, the evidence supporting indoor tanning as a behavioral addiction was not enough to justify recognition The authors here were able to demonstrate one key feature of addictive behavior – continuing the behavior even when the individual knows there are serious health concerns about its impact.
The summary was based on the 2025 publication, “Building evidence for indoor tanning as a behavioral addiction: concerns, problems, and change perceptions are associated with addictive symptoms,” published in BMC Psychology by Allison Leip, Carolyn J Heckman and Jerod L Stapleton
sideeffect central
Lichen Planus
Side Effect Central is a new series of articles designed to help patients with melanoma and their caregivers understand the side effects that typically accompany melanoma treatments. Our goal is to explain what side effects to expect during treatment and to encourage communication with your medical team about these side effects
Side effects can range from mild to very serious, and doctors cannot predict who will suffer more side effects than others. Serious side effects can cause patients to interrupt or discontinue treatment, so managing them is a critical piece of melanoma treatment
Lichen planus occurs in <1% of the adult population over 40 years of age, but up to 6% of patients who are receiving immune checkpoint inhibitors, such as ipilimumab (Yervoy), nivolumab (Opdivo), and pembrolizumab (Keytruda).
LichenPlanus
Dark red or purple, flat top bumps
WHAT IS LICHEN PLANUS?
Lichen planus is an inflammatory skin condition that causes a skin rash with dark red or purple bumps that have a flat top The bumps are usually small, starting the size of a pin and increasing to <1 cm. They are associated with a severe itching sensation
The bumps may start out looking light pink in color and emerge on the skin of the ankles, back of the hands, elbows, lower back, lower legs, truck or wrists Sometimes lichen planus affects the oral cavity, nails, and genitals. Here, we will focus more on the skin, not as much on the oral condition associated with lichen planus, which can present differently
Lichen planus occurs in <1% of the adult population over 40 years of age, but up to 6% of patients who are receiving immune checkpoint inhibitors, such as ipilimumab (Yervoy), nivolumab (Opdivo), and pembrolizumab (Keytruda) For the small percentage of patients who develop these rashes, they usually appear six to twelve weeks after beginning immune checkpoint inhibitor therapy
WHAT SHOULD PATIENTS KNOW?
Although skin rashes and intense itching can become an uncomfortable and unbearable distraction, rarely does it become potentially life-threatening. If possible, it is best to avoid scratching the area to prevent opening the skin, which could lead to an infection
Many patients may be able to stay on their drug regimens for melanoma when a mild or moderate inflammation of the skin occurs However, there are long-term consequences of inattention, so seeking treatment is important Patients should promptly communicate with their health care team and seek treatment when observing any of the symptoms listed below.
Mild to moderate symptoms report to your health care team
Rash covering <30% of the body that has either small pink or flat red/purple bumps
Severe itching around or on the rash
Sores in your mouth or genital area that look white in color
Serious symptoms—report to your health care team
Rash covering >30% of the body with flat red/purple bumps
Intense itching that interferes with your daily activities, like sleep
Peeling skin that is sloughing off your body
Blisters in your mouth or genital area
Long-term consequences of avoiding treatment
A small percentage of oral lichen planus and oral lesions (05-25%) undergo malignant transformations to oral cutaneous squamous cell carcinoma within five years. All patients with this complication of immune checkpoint inhibitors should be monitored by their dental practitioner and/or general health clinician for this occurrence
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WHY DOES LICHEN PLANUS OCCUR?
IImmunotherapy is designed to supercharge the immune system In the case of immune checkpoint inhibitors, these remove the brakes put on immune cells by cancer cells When the brakes are removed, the immune system becomes activated
Unfortunately, the skin can become susceptible to an immune system-provoked injury as an unintended consequence. Although immunotherapy is created with targeted properties aimed at the tumor’s environment, sometimes it non-specifically activates too much of the immune system throughout the body
Nearly every organ system in the body is at risk for an unprovoked injury by immune checkpoint inhibitors However, immunotherapy works so well in many patients that the risk of side effects is deemed worthwhile to achieve the possible results. Prompt and thorough communication about side effects by patients with their medical team allows for appropriate clinical support, and these two together allow immunotherapy to be used safely and successfully in many patients. Individual perspectives about treatment ideals should be discussed with your clinician.
WHAT CAN A CLINICIAN DO TO TREAT LICHEN PLANUS ASSOCIATED SKIN RASH AND ITCHING?
Rapid identification and treatment can reduce the discomfort induced from mild itching. Early management of this side effect can avoid drug interruption or discontinuation and allow a patient to remain on therapy Once a definitive diagnosis is made, the treatment depends on how much (%) of the body surface is covered in the rash.
For example, if <10% of the skin has a rash, it is considered a mild condition Immunotherapy will not be withheld from the patient For relief, a topical steroid like clobestasol 0.05%, fluocinonide 0.05%, or tacrolimus 0.1% ointment could be prescribed for application
If more that 30% of the skin has a rash, then the condition is severe. Immunotherapy will be withheld. In addition to the treatments given for a mild condition, oral steroids like prednisone or intravenous methylprednisolone may be prescribed. A clinician could also refer the patient to a dermatologist who may consider acitretin, doxycycline, nicotinamide, or other drugs
Bottom line: Patients should communicate regularly with their medical team about any of the signs of a skin rash and itching, as noted above. Clinicians can then manage and treat the condition to allow the patient to remain on immunotherapy or resume treatment as quickly as possible.
References:
Binnie R, Dobson ML, Chrystal A et al. Oral lichen planus and lichenoid lesions – challenges and pitfalls for the general dental practitioner. Br Dent J. 2024;236(4):285-292. doi: 10.1038/s41415-024-7063-y.
Thompson JA, Schneider BJ, Brahmer J et al. Management of Immunotherapy-Related Toxicities, Version 2.2024. Featured Updates to the NCCN Guidelines. J Natl Compr Canc Netw. 2024;22(9):582-592. doi: 10.6004/jnccn.2024.0057.
AIM’s website is a trusted source for clear, up-to-date melanoma information for patients, families, caregivers, and healthcare professionals.
You Supported Someone Through Melanoma—NowHelp Someone Else Feel Less Alone.
AIM is is looking for caregivers like you to become volunteer mentors for those who are now in the shoes you once filled. By offering a listening ear, emotional support, and insight from your own journey, you can help another caregiver feel seen, heard, and supported.
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We’ll provide training and resources you provide compassion, empathy, and understanding. Your support helped your loved one. Now, your story can help someone else.
Become aPeerConnectCaregiverMentor. Because no caregiver should walkthisroad alone.
AIM: MoreThanaName—It’s OurMissioninAction
