V.E. Askarov1, K.V. Menshikov1,2, Sh.I. Musin1, A.F. Nasretdinov1, N.I. Sultanbaeva1, I.A. Menshikova2, A.V. Sultanbaev1
1Republican Clinical Oncology Dispensary, Ufa
2Bashkir State Medical University, Ufa
Askarov Vadim E. ― oncologist, head of the anti-tumor drug therapy department of the Republican Clinical Oncology Dispensary (Sterlitamak branch)
73/1 Oktyabrya Ave., Ufa, 450054, Russian Federation, e-mail: ufa.askarov@gmail.com, ORCID ID: 0000-0003-0988-7261
Abstract. Melanoma, an aggressive form of skin cancer, exhibits high mortality rates and rapid progression. Major advancements in understanding the molecular pathogenesis of melanoma have revealed critical genetic and epigenetic alterations that contribute to the development of the disease. In 2020, there were 324 635 new melanoma cases and 57 043 deaths, highlighting the urgent need for effective treatment methods. Traditional treatments included surgery, radiotherapy, and chemotherapy; however, breakthroughs in immunotherapy have offered new perspectives.
Historically significant was the use of interleukin-2 (IL-2), which, despite its effectiveness, was accompanied by severe side effects. The discovery of the role of programmed death-1 (PD-1) in immune regulation led to the development of PD-1 checkpoint inhibitors, significantly improving the prognosis for many melanoma patients. Prolgolimab, the first Russian PD-1 inhibitor, has shown high efficacy and safety in treating inoperable or metastatic melanoma, as well as non-small cell lung cancer.
A clinical case of a patient with stage 4 metastatic melanoma who received prolgolimab at a dosage of 1 mg/kg every 14 days demonstrates positive dynamics and disease stabilization with long-term treatment. The MIRACULUM study results confirmed that prolgolimab provides a median overall survival of 26,1 months and a three-year overall survival rate of 43,1%. Therapy was well-tolerated, with a low incidence of severe adverse events.
This case underscores the importance of a comprehensive approach to diagnosing and treating metastatic melanoma, as well as the efficacy and safety of long-term use of prolgolimab. Prolgolimab confirms its role as a promising and effective drug in the immunotherapy of metastatic melanoma, contributing significantly to domestic oncological practice.
Key words: melanoma, prolgolimab, PD-1, melanoma from an unknown primary site.