The worst part of being treated for advanced skin cancer is the flu-like aftershock from chemotherapy that lays out Mary Cayer in front of her four young children.
"It kills me for them to see me laying in bed," she said.
The interferon chemotherapy was one of a few options for advanced melanoma, none of them particularly good, said Dr. Amanda May, a medical oncologist with Medical College of Georgia Cancer Center.
"That's been our constant thing is, what else can we do for melanoma because it is so difficult to treat once you're in advanced disease," she said.
Interferon "works for some. It doesn't work for others," May said. "It's absolutely miserable treatment."
That changed recently when the Food and Drug Administration approved ipilimumab. It is the first drug for melanoma approved in 13 years and the first to show a significant increase in survival for advanced melanoma patients, according to the Skin Cancer Foundation.
Ipilimumab is a monoclonal antibody, a drug designed to target a specific molecule called CTLA-4 that acts to dampen down T-cell response, according to an article last year in the New England Journal of Medicine .
"It works to recruit the immune system," May said, which can then attack the tumor.
In the study, those who got the drug had a 20 percent greater survival rate at one year and 10 percent higher at two years than those who got another immunotherapy.
"This is certainly a drug that offers us more than what we've had in the past, which is very minimal responses," May said. "This is something in the advanced melanoma that is actually showing us a response. It is extending life."
After so many disappointing drug studies in the past, when those results were announced last year at the American Society of Clinical Oncology meeting, "all of a sudden, everybody stopped and listened and said, 'Really?' " May said.
Because it revs up the immune system, the drug can also cause significant side effects. Diarrhea and fatigue were the most common among the study participants and patients need to be closely monitored on the drug, May said.
MCG Cancer Center just began a clinical trial of the drug earlier this year, and is studying it in combination with an immune-stimulating agent, May said.
"There are side effects and they're real, and patients have to be aware of that. But I think they are manageable," she said.
The new drug is likely just a first step and might end up being part of a combination therapy, May said.
"But it certainly shows a response, more response than we've ever had," she said. "It's the first little bright light at the end of the tunnel in the treatment of melanoma. And I think it is going to open the gateway for some newer and better things even. And this is certainly a step."
Because she has already been through seven months of interferon therapy, Cayer said she will likely stick with it through the whole year-long course. All things considered, she feels she is doing well and is optimistic after seeing her mother beat breast cancer 15 years ago.
"She's still doing good," Cayer said. "If she can get through breast cancer, I believe I can fight hard through skin cancer."
Although she doesn't need it right now, Cayer said she is glad there is another drug available.
"That's good news for the future," she said.