Immunotherapy in cutaneous melanoma and biologics in psoriatic disease: similarities and differences from a clinical multidisciplinary perspective

ABSTRACT

Introduction

Immunomodulating therapies harness the power of the immune system to combat disease. In advanced melanoma, immune checkpoint inhibitors have significantly improved survival outcomes by activating the immune system to recognize and eliminate cancer cells. In psoriasis, interleukin inhibitors effectively suppress inflammation and improve disease symptoms.

Areas covered

We provide a meta-opinion-based consensus paper on the analogies and differences in treatment mechanisms, duration, frequency between immunotherapy for advanced melanoma and biologics for psoriasis. Combining the current scientific evidence with expert insights, we provide valuable guidance for future research and decision-making processes.

Expert opinion

The development of immunological treatments in melanoma and psoriasis has revolutionized dermatology, but the quest for tailored therapies that maximize efficacy continues. Managing cutaneous exacerbations during melanoma immunotherapy in psoriatic patients remains challenging. Similarly, treating oncologic psoriasis patients resistant to traditional therapies requires individualized approaches. Research is needed to identify response predictors in both conditions and address the sustainability of healthcare systems due to the high cost of biologics. Drug delay studies for psoriasis and longer follow-up evaluations after immunotherapy discontinuation in melanoma are essential for optimizing treatment outcomes and resource allocation.

KEYWORDS:

• Melanoma
• psoriasis
• biologics
• immunotherapy
• drug delay

Article highlights

• Response to both Immunotherapy for advanced melanoma and biologics for psoriasis can be influenced by prior drug exposure

• Distinctions in drug administration exist, with melanoma immunotherapy often offered as a frontline combination, while biologics for psoriasis are approved as single agents, with potential consideration for combination therapy in resistant cases.

• Response assessment varies, with immunotherapy in melanoma utilizing objective tools like iRECIST criteria, whereas psoriasis management relies on physician-reported measures focusing on disease severity.

• Prognostic biomarkers play a crucial role in melanoma, with TMB and PD-L1 expression being key factors, while limited evidence supports the use of biological markers in psoriasis, where clinical assessment remains central.

• Immunotherapy for melanoma may have higher upfront costs but potential long-term savings. Psoriasis biologics incur lower yearly costs but may require long-term therapy, leading to higher cumulative costs, with disparities in therapy access reported.

Declarations of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.