Table 1.

Summary of the use and results of therapy with immunomodulating agents available in melanoma

Drug name	Registration	Efficacy in melanoma	Side effects
Ipilimumab (anti-CTLA-4)	Advanced melanoma (unresectable or metastatic) in adults, adjuvant therapy in stage III (in US)	Median OS:  10.1 months (pretreated patients)  11.2 (first line) ORR:  11% (pretreated patients)  15% (first line) 2-year survival rate: 24% (second line) 28.5% (first line) Noted 10-year survival rate – 20% (plateau)	Adverse effects of 3–4 grade in 15–56% of cases (abdominal pain, severe diarrhoea or significant change in the number of stools, blood in stool, Severe elevations in LFT, life threatening skin rash, nephritis, pneumonitis, pancreatitis, non-infectious myocarditis)
Nivolumab
(anti-PD-1)	Advanced melanoma (unresectable or metastatic) in adults as monotherapy or in combination with ipilimumab (only in patients with low tumor PD-L1 expression) Non-small cell lung cancer Renal cell carcinoma Classical Hodgkin lymphoma Squamous cell cancer of the head and neck urothelial carcinoma	ORR: 40–41% (60% in combination with ipilimumab) 2-year survival rate: 57.7% (64% in combination with ipilimumab) 3-year survival rate: 52% (58% in combination with ipilimumab)	Adverse effects of 3–4 grade in 12–14% of patients (mainly autoimmune response). In combination with ipilimumab grade 3–4 side effects occur in 54–55%
Pembrolizumab (anti-PD-1)	Advanced melanoma (unresectable or metastatic) in adults Non-small cell lung cancer classical Hodgkin lymphoma	ORR: 33–45% 2-year survival rate: 55%	Adverse effects of 3–4 grade in 13–18% of patients (mainly autoimmune response)
T-VEC (talimogene laherparepvec)	Local treatment of melanoma with unresectable metastases to skin, subcutaneous tissue and lymph nodes	Median OS: 23.3 months ORR: 26.4%	Mainly flu-like symptoms