New Triple Combination Therapy for Skin Cancer

New Triple Combination Therapy for Skin Cancer

Skin cancer can be difficult to treat once it spreads through the body. Melanoma is the most serious type of skin cancer. Read about the recently approved triple combination treatment option for advanced melanoma - a combination of the three medications atezolizumab, cobimetinib, and vemurafenib. 

Share This Post

We all hear the warnings about skin cancer. Protect yourself from ultraviolet (UV) rays – wear sunscreen, stay in the shade, avoid tanning beds. But what is the big deal? Skin cancer does not seem so scary when all you have to do is get a spot removed from your arm or face, right?

Wrong. Skin cancer can be extremely difficult to treat. Melanoma is the most serious type of skin cancer because it is most likely to spread in the body. Surgery to remove cancer spots can be effective, but medications are also used for treatment, especially if the cancer already spread.

Types of Skin Cancer

There are many types of skin cancer, but the three most common types are listed below. 

  1. Basal cell carcinoma is the most common type of skin cancer and looks like a small growth, bump or off-colored patch of skin. This type is normally found on the head, neck and arms. If this is not caught before it grows, it may damage bones and nerves.
  2. Squamous cell carcinoma is the second most common and usually looks like a red bump, scaly patch or an open sore. This type is normally found in areas of high sun exposure, like the head and face, neck, arms, and back. Catching this type before it grows will prevent damaged skin.
  3. Melanoma is the third most common and usually develops within a mole or appears as a dark spot on the skin. Melanoma is generally considered the most serious skin cancer because it is more likely to spread, causing more deaths than the other types. When melanoma spreads through the body, it is called advanced melanoma. 
YouTube player

New Advanced Melanoma Treatment

Melanoma is usually treated with surgery to remove the skin cancer. Treating advanced melanoma requires medication in addition to surgery. Instead of just one medication, the most effective way to treat advanced melanoma is by using a combination of medications. 

The U.S. Food and Drug Administration (FDA) approved the first triple combination therapy for advanced melanoma in July of 2020 – atezolizumab (Tecentriq), cobimetinib (Cotellic) and vemurafenib (Zelboraf). 

Prior to this approval, advanced melanoma was typically treated with a single medication or a combination of two medications. Cobimetinib and vemurafenib can be used together as a two-drug combination, which was previously FDA-approved for advanced melanoma. 

{static_blocks}blog-newsletter-subscription{/static_blocks}

How It Works

The three medications work in three different ways. Atezolizumab is immunotherapy, or an immune checkpoint inhibitor, given through the veins (IV) once every 2 weeks. It is used for many other types of cancer, but this is its first approval for melanoma. 

Cobimetinib and Vemurafenib are both considered targeted therapy. The melanoma must have a specific target called BRAF V600 in order for these medications to work. About half of patients with melanoma have this target. Cobimetinib is an oral medication given daily for three weeks, then a one-week break. Vemurafenib is an oral medication given twice daily, every day with no break. 

The clinical trial evaluating the three medications showed that adding  atezolizumab to  cobimetinib and vemurafenib increased the amount of time when the cancer is not getting worse by about 4.5 months. The trial is still ongoing, so more results are expected in the future.

Notably, the National Comprehensive Cancer Network (NCCN) recommends using triple combination therapy of atezolizumab plus cobimetinib and vemurafenib as one of the first options for advanced melanoma based on the FDA-approval.  Note: The NCCN makes guidelines for treating all types of cancer. 

Treatment Side Effects

With the addition of atezolizumab to cobimetinib and vemurafenib, more side effects are expected. Based on the clinical trial, no new side effects were found by using the combination. The additional side effects expected are specific to atezolizumab. 

The most common side effects during triple combination therapy include the following:

  • Rash and itching
  • Feeling tired
  • Muscle pain
  • Nausea
  • Sensitivity to the sun
  • Diarrhea
  • Low thyroid levels

Wrap-Up

Skin cancer may sometimes seem easy to treat, but it can actually be very difficult. Once cancer  spreads in the body, there are less options for treatment. Reduce the risk of skin cancer by protecting yourself from harmful UV rays. If you already have skin cancer and you are interested in the new triple combination therapy, please ask your doctor to see if it is an option for you. 

References, Studies and Sources:

Centers for Disease Control and Prevention. Basic Information About Skin Cancer. Available from: https://www.cdc.gov/cancer/skin/basic_info/index.htm. Updated April 2020. Accessed 31 August 2020.

American Academy of Dermatology Association. Skin Cancer Resource Center. Available from: https://www.aad.org/public/diseases/skin-cancer. Updated 2020. Accessed 31 August 2020.

U.S. Food and Drug Administration (FDA). FDA Approves Atezolizumab for BRAF V600 Unresectable or Metastatic Melanoma. Available from: https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-atezolizumab-braf-v600-unresectable-or-metastatic-melanoma. Updated 31 July 2020. Accessed 2 September 2020. 

American Cancer Society. Immune Checkpoint Inhibitors and Their Side Effects. Available from: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/immunotherapy/immune-checkpoint-inhibitors.html. Updated 27 December 2019. Accessed 2 September 2020. 

American Cancer Society. How Targeted Therapies Are Used to Treat Cancer. Available from: https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/targeted-therapy/what-is.html. Updated 27 December 2019. Accessed 2 September 2020.

Pharmaceutical Technology GlobalData Healthcare. Triplet combinations emerging in the first-line treatment of melanoma. Available from: https://www.pharmaceutical-technology.com/comment/melanoma-triplet-combination-therapies/. Updated 30 March 2020. Accessed 2 September 2020. 

Gutzmer R, Stroyakovskiy D, Gogas H, et al. Atezolizumab, vemurafenib, and cobimetinib as first-line treatment for unresectable advanced BRAFV600 mutation-positive melanoma (IMspire150): primary analysis of the randomised, double-blind, placebo-controlled, phase 3 trial [published correction appears in Lancet. 2020 Aug 15;396(10249):466]. Lancet. 2020;395(10240):1835-1844. Abstract available from: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30934-X/fulltext

National Comprehensive Cancer Network (NCCN). Cutaneous Melanoma (Version 4.2020). Available from: https://www.nccn.org/professionals/physician_gls/pdf/cutaneous_melanoma.pdf. Published 1 September 2020. Accessed 2 September 2020.

We are committed to providing our readers with only trusted resources and science-based studies with regards to medication and health information. 

Disclaimer: This general information is not intended to diagnose any medical condition or to replace your healthcare professional. If you suspect medical problems or need medical help or advice, please talk with your healthcare professional.

Share This Post

Pharmacists.org Discount Club

Get Started for $1.

  • Cheapest cash pay option at your retail pharmacy
  • 1,000s of drugs below $10.00 that can beat your co-pay
  • Start for $1 for your first month. Cancel anytime. 
  • Tell us your meds, we tell you the cheapest options.

Popular Destinations

Recent Articles

Stress Acne: Causes, Prevention, and Treatment

Stress Acne: Causes, Prevention, and Treatment

Stress. It's a powerful emotion that can wreak havoc on your body. One way that stress can appear is on your skin in the form of stress acne. Stress causes acne by increasing oil production and clogging pores, which leads to an overgrowth of bacteria. To combat this unwanted side effect of stress, we have created a guide with everything you need to know about stress acne: its causes, prevention strategies, and treatments.

Read More »
Cystic Acne

Cystic Acne: What Is It, And How Do You Treat It?

Cystic acne is a type of acne that causes cysts to form deep in the skin. These cysts are often painful and may take weeks or months to heal. If you have cystic acne, then you may need a dermatologist's help. In this article, we will answer all your questions about cystic acne, what it is, who can get it, how do you diagnose it, how do you treat cystic acne, and more.

Read More »
A Guide to Anti Aging Cream for Men

A Guide to Anti Aging Cream for Men

It is frequently said that men are like fine wine – they get better with age. And while in general, men may seem to age more gracefully than women, having a regular skin care routine can help keep your skin looking revitalized. Below are some active ingredients to look for in your anti-aging creams that have been clinically proven to help reduce the appearance of fine lines and wrinkles. 

Read More »
Fordyce Spots, A Mystery Revealed

Fordyce Spots, A Mystery Revealed

Fordyce spots, also called Fordyce granules, are small yellowish-white bumps that appear on the shaft of the penis, labia majora or labia minora, scrotum, around and inside the mouth, and nipples. These spots can grow to up to 1 to 3 millimeters in diameter and will become slightly bigger when sexually aroused. Fordyce spots are not harmful and do not require treatment but they can be an embarrassing problem for some people causing anxiety, stress, or discomfort when in public areas such as the locker room at the gym.

Read More »

Share On:

More To Explore

Stress Acne: Causes, Prevention, and Treatment

Stress. It's a powerful emotion that can wreak havoc on your body. One way that stress can appear is on your skin in the

Cystic Acne: What Is It, And How Do You Treat It?

Cystic acne is a type of acne that causes cysts to form deep in the skin. These cysts are often painful and may take

A Guide to Anti Aging Cream for Men

It is frequently said that men are like fine wine – they get better with age. And while in general, men may seem to

Is Clindamycin Right for You as an Acne Treatment?

Learn more as we discuss clindamycin for acne, how clindamycin works, the different forms of treatment, and whether it is the right form of

Fordyce Spots, A Mystery Revealed

Fordyce spots, also called Fordyce granules, are small yellowish-white bumps that appear on the shaft of the penis, labia majora or labia minora, scrotum,

Clearing Up Butt Acne: Treatment, Prevention and More

Red bumps that appear like acne on the buttocks can occur in both men and women and is a common skin condition. Continue reading

How Much Does Accutane Cost?

As generic forms of the drug entered the market, the cost of the medication has come down, so how much does Accutane cost today?

Your Comparison Guide of Minocycline vs Doxycycline

Minocycline and Doxycycline are both second-generation tetracycline-class antibiotics. They both are approved by the Food and Drug Administration (FDA) and have been proven effective for the treatment of acne, also known as acne vulgaris, but what else is

How to Diagnose and Treat Tinea Versicolor

Tinea versicolor is a common skin infection that causes red, scaly patches on the chest, back, or neck. You may also see flaky white

10 Best Ways to Help Prevent and Remove Blackheads

Blackheads develop when sebum from oil glands gets trapped in hair follicles or pores. Bacteria build up after time, so removing blackheads is important

What Is Minocycline?

Minocycline is a second-generation antibiotic in the tetracycline class of antibiotics. Second-generation, in this case, means that it is a semi-synthetic compound; first-generation tetracyclines are naturally

What is Accutane?

What is Accutane and can it really be used to treat acne? Read our latest blog for more details!

The Difference Between Tretinoin, Retinol, and Retinoids

Topical treatments like tretinoin, retinol, and retinoids for acne and wrinkles can be a little confusing to understand what each one is and what

What is Melasma and How Do You Treat It?

Melasma, sometimes referred to as chloasma, is a skin disorder characterized by darker spots on the skin. The patches can vary in color

A Comprehensive Guide to Minocycline for Acne

If you suffer from acne, there is a targeted medication for treating acne–minocycline. Minocycline is a prescription drug used to treat infections by preventing

Tretinoin Strengths and How They Work With Acne

Tretinoin is a topical medication that is used for the treatment of acne, also called acne vulgaris, and the most common brand in the

How to Get Rid of Hyperpigmentation

Hyperpigmentation, or dark spots on the skin, can be tricky to get rid of. If you are dealing with this condition, you are not

How to Deal with Blood Blisters

Blood blisters are a medical condition where fluid-filled bubbles grow out of blood vessels in the skin. They form under the skin and can

Geologie Review: Does This Personalized Men’s Skincare Work?

Geologie offers personalized skin care products tailored to each male customer they have. The personal touch is certainly nice, but do their products really

Understanding Melasma Treatments

Melasma is a skin conition that is characterized by hyperpigmented spots on the skin. Melasma is sometimes referred to as chloasma. The spots are most

Everyday Tips for Anti-Aging Skin Care

With so many anti-aging products available on the market, it is overwhelming to find which products actually work and are worth spending money on

Body Acne 101: Prevention and Treatment

Body acne is a common condition that affects many people, especially during puberty. It can appear anywhere on your body and can be unsightly

Paronychia: What You Need to Know

Many people are unaware that paronychia is a nail infection. Paronychia usually affects one or more of your fingers, but can also affect your

The ABCs of Skin Lesions

Skin lesions can be a source of anxiety for many people. Whether they're due to an infection, injury, or disease, skin lesions are often

Perioral Dermatitis: Causes, Treatment, and Prevention

Perioral dermatitis is a common skin condition that occurs around the mouth. It often starts with red, inflamed patches and may then progress to

Niacinamide and Vitamin C: Benefits for Your Skin

Niacinamide and Vitamin C are two popular ingredients that you can use to improve the health of your skin. Niacinamide is a form of

Hyperpigmentation and Acne

Acne is the most common skin condition that affects people of all ages. In fact, roughly 80 percent of people ages 11 to 30 have

What is Clindamycin Phosphate?

Clindamycin phosphate is a salt form of the antibiotic medicine clindamycin. Clindamycin phosphate provides coverage for bacteria that are resistant to erythromycin, methicillin, or penicillin. Clindamycin is used to treat acne, also known as acne vulgaris,

15 of the Most Common Types of Skin Lesions and Prevention Strategies

Skin lesions are common skin conditions that appear as an abnormal growth. There are many skin lesions, each of which is caused by a

Collagen Supplements: Does the Research Support the Hype?

The use of collagen supplements is becoming a popular health trend. Collagen is an important protein in your body, and collagen supplements may have