Abstract
Metastatic melanoma is an aggressive tumour associated with high mortality. Before 2011 no drug was available that would make a significant difference in the overall course of the disease.
Advances in melanoma therapy were first recorded with the discovery of key molecules regulating cellular immune reactions. CTLA-4 and PD-1 receptors act as negative regulators of immune reaction that prevents the development of autoimmunity and make tumour tolerance possible.
Development of monoclonal antibodies that block these inhibitory molecules launched a new era in melanoma therapy - a transition from non-specific to specific targeted treatment. Therapeutic use of ipilimumab, a CTLA-4 inhibitor, resulted in long-lasting responses to therapy and extended overall patient survival as confirmed in a number of clinical trials that resulted in its introduction in clinical practice.
Results of studies evaluating nivolumab, a PD-1 inhibitor, suggest similar favourable trend, and the combination of both agents, ipilimumab and nivolumab, might influence the course of the disease even more significantly. Future studies should focus mainly on finding predictive factors for response to treatment.