Immunotherapy for melanoma in Germany
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- Role of immunotherapy in the complex treatment of melanoma
- Types of immunotherapy for melanoma
- How immunotherapy for melanoma is carried out
- Benefits of immunotherapy for melanoma
- Organizing Treatment in Top Clinics for Melanoma Immunotherapy in Germany
Melanoma immunotherapy is an innovative method of systemic therapy that complements the conventional protocol at all stages of the disease and can significantly increase treatment success rates, survival rates, and life expectancy. In German hospitals, doctors actively use this type of treatment in the early stages of melanoma to prevent a recurrence, and immunotherapy for metastatic melanoma makes it possible to restrain the progression of the disease and prolong the life of patients with advanced stages of the pathology. In Germany, more than five groups of immunotherapeutic drugs are used, each of which is prescribed strictly individually, taking into account the genetic characteristics of the tumor and the patient's condition. Among these approaches, dendritic cell vaccines stand out as particularly promising, a groundbreaking discovery that earned scientist Ralph Steinman the 2011 Nobel Prize in Medicine for revolutionizing our understanding of immune system cancer treatment.
Role of immunotherapy in the complex treatment of melanoma
Immunotherapy treatment for melanoma is part of the complex therapy of this type of oncology. At stages I and II, the tumor is removed surgically with the capture of 0.5 to 2.0 cm of healthy tissue. If the fingers or auricle are affected, then German surgeons perform modified operations in order to preserve the function of the hand or organ of hearing. After complete healing of the postoperative wound, a course of immunotherapy is prescribed. It is crucial to start treatment no later than nine weeks after surgery. The goal of immunotherapy in this clinical situation is to minimize the risk of cancer recurrence.
When given in the early stages of melanoma, immunotherapy (most often, this is a dendritic cell vaccine) forms a long-term anti-cancer memory. The human immune system stores information about the tumor; if a similar malignant neoplasm reappears in the body, it is quickly destroyed due to the activation of specific anti-cancer immunity.
In the III stage of melanoma, with the involvement of the lymph nodes, doctors additionally remove the lymph nodes, and immunotherapy begins no later than three months after that. The goal of treatment is to destroy the remaining microscopic metastases and ensure complete recovery. Many patients at this stage achieve sustained remission when immunotherapy is combined with standard treatment protocols.
If the tumor is unresectable (this may be in stage III or IV), then melanoma immunotherapy can slow down the further progression of the disease, i.e., the spread of metastases and the destruction of the primary tumor. In this case, the patient receives immunotherapeutic drugs continuously, and this is the primary type of treatment. In advanced cases, dendritic cell vaccines have proven to be a valuable therapeutic option, offering patients new hope for treatment. Previously, doctors could offer such patients only chemotherapy, which had severe side effects.
Types of immunotherapy for melanoma
The overall goal of immunotherapy for melanoma is to make the human immune system learn to recognize and destroy malignant cells. In general, melanoma is a highly immunogenic tumor. This means that it has several unique surface antigens that can be a target for immune attacks. In medical practice, there are cases when small neoplasms disappear on their own, without surgery or other types of treatment, only due to the work of natural antitumor immunity. If this does not happen, then doctors use drugs for such groups:
- Dendritic cell vaccines, that harness the body's natural immune mechanisms to fight cancer at any stage. These personalized vaccines are developed from the patient's own immune cells and can be effectively used both in early stages to prevent recurrence and in advanced stages to combat existing tumors.
- Cytokines, such as Interleukin-2 and Interferon alpha. In melanoma, Interleukin-2 preparations are mainly used since Interferon alpha is deactivated too quickly.
- Tyrosine kinase inhibitors. Such drugs are used in the detection of one of the mutations in the BRAF gene, namely the V600E mutation. Overall, mutations in the BRAF gene cause more than 80% of melanoma cases. Tyrosine kinase inhibitors suppress the activity of this gene.
- Monoclonal antibodies, such as immune checkpoint inhibitors. These are the most common drugs that are highly effective in people with advanced melanoma. Immune checkpoint inhibitors block the CTLA-4 and PD-1 receptors on the surface of lymphocytes and thereby remove the ability of the tumor to hide from anti-cancer immunity.
- Adaptive cellular immunotherapy: TIL-therapy and CAR T-cell therapy. In the first case, lymphocytes are isolated from the affected by melanoma tissues. Such lymphocytes have high anticancer activity. They are cultivated in the laboratory and reinfused in the patient. In the second case, doctors insert artificially synthesized receptors into the patient's lymphocytes, which will allow the cells of the immune system to see the tumor better. The method is extremely effective, but its application is limited by the high average cost of treatment.
Modern medicines for all groups are available in German clinics, and doctors have vast experience in their administration. It is imperative to choose the most effective immunotherapy regimen with minimal side effects.
How immunotherapy for melanoma is carried out
The main type of immunotherapy in melanoma treatment is vaccination with dendritic cells. The treatment program consists of two main steps:
- During the first visit, patients undergo a comprehensive evaluation including clinical examination and necessary laboratory tests. At this stage, blood samples are collected for manufacturing the individual vaccine. This initial step is completed in one day on an outpatient basis.
- The second step takes place after a 7-day period required for manufacturing the personalized DC vaccine. During this visit, the patient receives dendritic cell immunotherapy along with any necessary symptomatic treatment and specialist consultations. This vaccination is also administered on an outpatient basis and takes one day. A single injection is enough to boost anticancer immunity.
The choice of other immunotherapeutic drugs and schemes begins with an examination for mutations. In this case, the accuracy of the diagnostic stage significantly affects the treatment outcome since tumors with different mutations are sensitive to different drugs. The most clinically significant mutations are:
- V600E mutation in the BRAF gene
- Mutation in the KIT gene
Depending on the results of the genetic examination, German oncologists recommend using a drug from the group of tyrosine kinase inhibitors, immune response checkpoint inhibitors, or a combination of both. Therapy can be continued for up to 2 years. It is canceled in case of the complete regression of the primary tumor and all metastases according to the results of MRI, MSCT, or PET/CT with 18F-FDG. During immunotherapy, the patient undergoes regular examinations in order to assess the general condition and the progression of the disease.
Comparing the effectiveness and treatment costs
| Treatment | Response Rate* | Duration of treatment | Cost of treatment, €** |
| Dendritic cell therapy | up to 90% | 1 week | 20,000 - 38,000 |
| Checkpoint inhibitors | up to 45% | about 1 year | 375,000 - 420,000 for the full course |
| CAR T-cell therapy | up to 40% | about 5 weeks | 450,000 - 550,000 |
*Booking Health data. Response rate is the number of patients who show improvement after treatment.
**The cost of treatment depends on the type of tumor, stage of cancer, and other factors.
Benefits of immunotherapy for melanoma
Melanoma is a highly immunogenic tumor. Therefore, immune therapy is more effective in its treatment than in most other types of cancer.
At a very early stage, the advantage of localized immunotherapy with creams is that it enables a complete cure of the cancer without surgery. This is especially important when the tumor is located in aesthetically and functionally significant areas. At later stages, the advantages of the technique are in the effective and non-invasive suppression of intradermal metastases.
The benefits of systemic immunotherapy for melanoma are as follows:
- A variety of available techniques, with dendritic cell vaccines leading the way due to their unique ability to activate the body's natural immune response at any stage of the disease. Other options include cytokines, TIL therapy, oncolytic viruses, immune checkpoint inhibitors, and CAR T-cell immunotherapy
- High efficacy at all stages
- Personalized approach, particularly with dendritic cell vaccines that are created individually for each patient using their own immune cells
- Response to immunotherapy is observed in the majority of patients with melanoma
- The technique is more effective than targeted therapy and chemotherapy
- Most immunotherapy drugs have low toxicity and are well-tolerated
Recent studies show that innovative immunotherapy options allow patients with even the advanced stage of melanoma to expect not only long-term survival with complete remission but also a complete cure. Cases have been described where, after all tumors have disappeared as a result of immunotherapy, melanoma has not returned for many years of follow-up.
Latest Research and Breakthroughs in Melanoma Immunotherapy
Leading immunotherapy expert Prof. Frank Gansauge brings over two decades of groundbreaking experience in dendritic cell therapy, a revolutionary approach that has transformed melanoma treatment outcomes. As one of the pioneers of dendritic cell immunotherapy since 2001, Prof. Gansauge has demonstrated remarkable success rates with this innovative method. His research has been particularly significant in establishing immunotherapy as a cornerstone of modern melanoma treatment, showing how it can extend life expectancy and lead to complete recovery in some cases. With documented cases of patients achieving full remission and remaining cancer-free for over 5 years, Prof. Gansauge's work represents a crucial advancement in melanoma treatment protocols.
Leading Immunotherapy Expert Prof. Frank Gansauge: "Revolutionizing Cancer Treatment with Dendritic Cell Therapy"
Organizing Treatment in Top Clinics for Melanoma Immunotherapy in Germany
If the doctors in your country do not have sufficient experience in carrying out immunotherapy for melanoma, or if they do not have access to the necessary drugs yet, then you can visit one of the specialized oncology centers in Germany. You can come here both for a full course of melanoma treatment and for a separate procedure – immunotherapy. The personalized nature of dendritic cell vaccines makes them particularly convenient for international patients, as the treatment requires just two short outpatient visits.
On the Booking Health website, you will find a complete list of clinics that offer this type of treatment, as well as current prices for medical services. You can choose a healthcare facility and make an appointment yourself or ask for the assistance of a Booking Health medical advisor.
Booking Health experts will help you:
- Select a clinic with proven expertise in innovative immunotherapy approaches and consistently high success rates in melanoma treatment
- Arrange a comprehensive consultation with leading German specialists to develop your personalized treatment plan
- Schedule your treatment at optimal timing, considering both medical requirements and your personal preferences
- Receive a detailed treatment program with transparent cost estimation before your arrival
- Access premium medical services at reduced costs through our exclusive direct contracts with German hospitals (saving up to 50%)
- Ensure continuous medical care with assistance in obtaining necessary medications for ongoing treatment in your home country
- Benefit from long-term medical support with direct communication channels to your treating physicians
- Have complete financial transparency with professional invoice verification and deposit management
- Receive comprehensive travel support including visa assistance, flight and hotel bookings, and reliable transfers
- Get professional medical document translation services for accurate communication with German doctors
- Have access to qualified medical interpreters for clear communication during your treatment
Booking Health has been helping melanoma patients undergo treatment in Germany for over 12 years. You can contact Booking Health with any questions regarding the treatment of melanoma in Germany via the phone number on the website or by using the "Need help" form.
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Authors:
The article was edited by medical experts, board certified doctors Dr. Nadezhda Ivanisova and Dr. Vadim Zhiliuk. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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