Skin / Melanoma SACT Regimens

The information contained in these regimens is a statement of consensus of NCCP and ISMO or IHS professionals regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult these documents is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient's care or treatment. The treatment regimen to be used should take into account factors such as histology, molecular pathology, age, performance status, co-morbidities and the patient’s preference. Each treatment regimen has advantages and disadvantages, and there may be more than one good option. In addition, treatment choices can change over time as more evidence becomes available. Use of these documents is the responsibility of the prescribing clinician and is subject to HSE’s terms of use.

Please email any comments or feedback on these regimens to oncologydrugs@cancercontrol.ie

For information on open clinical trials please refer to the Cancer Trials Ireland website here and also to basket trials here.

Skin/Melanoma Chemotherapy Regimens

Regimen Name	Indication
Avelumab Monotherapy Regimen	00535a Treatment of adult patients with metastatic Merkel cell carcinoma who have received 1 or more lines of chemotherapy for metastatic disease
Cemiplimab Therapy Regimen	00812b As monotherapy is indicated for the treatment of adult patients with metastatic or locally advanced cutaneous squamous cell carcinoma (mCSCC or laCSCC) who are not candidates for curative surgery or curative radiation
Cobimetinib and Vemurafenib Therapy Regimen	00373a Cobimetinib in combination with vemurafenib is indicated for the treatment of adult patients with unresectable or metastatic melanoma with a BRAF V600 mutation
Dabrafenib Monotherapy Regimen	00237a Treatment of adult patients with unresectable or metastatic melanoma with a BRAF V600 mutation
Dacarbazine Therapy Regimen	00464a Treatment of metastatic malignant melanoma.
Encorafenib and Binimetinib Therapy Regimen	00563a Treatment of adult patients with advanced (unresectable or metastatic) melanoma with a BRAF V600 mutation
Ipilimumab monotherapy Regimen	00105a Treatment of adults with advanced (unresectable or metastatic) malignant melanoma.
Nivolumab 240mg Monotherapy - 14 Day Regimen	00483a As monotherapy for the treatment of advanced (unresectable or metastatic) melanoma in adults. 00483f As monotherapy for the adjuvant treatment of adults with melanoma with involvement of lymph nodes or metastatic disease who have undergone complete resection
Nivolumab 480mg Monotherapy - 28 Day Regimen	00484a As monotherapy for the treatment of advanced (unresectable or metastatic) melanoma in adults. 00484c As monotherapy for the adjuvant treatment of adults with melanoma with involvement of lymph nodes or metastatic disease who have undergone complete resection
Nivolumab 1mg/kg Ipilimumab 3mg/kg Therapy Regimen	00431a Nivolumab in combination with ipilimumab is indicated for the treatment of advanced (unresectable or metastatic) melanoma in adults
Nivolumab 3mg/kg Ipilimumab 1mg/kg Therapy Regimen	00551b Nivolumab in combination with ipilimumab is indicated for the treatment of advanced (unresectable or metastatic) melanoma in adults
Pembrolizumab 200mg Monotherapy Regimen	00455b As monotherapy for the treatment of adults with unresectable or advanced melanoma. 00455c For the treatment of ipilimumab-refractory patients with unresectable or advanced metastatic melanoma. 00455g As monotherapy is indicated for the adjuvant treatment of adults with Stage III melanoma and lymph node involvement who have undergone complete resection. 00455l As monotherapy for the adjuvant treatment of adults with Stage IIB or IIC melanoma and who have undergone complete resection.
Pembrolizumab 400 mg Monotherapy Regimen	00558b As monotherapy for the treatment of adults with unresectable or advanced melanoma. 00558c For the treatment of ipilimumab-refractory patients with unresectable or advanced metastatic melanoma 00558g Adjuvant treatment of adults with stage III melanoma and lymph node involvement who have undergone complete resection 00558l As monotherapy for the adjuvant treatment of adults with Stage IIB or IIC melanoma and who have undergone complete resection.
Trametinib and Dabrafenib Therapy Regimen	00415a< Trametinib in combination with dabrafenib is indicated for the treatment of adult patients with unresectable or metastatic melanoma with a BRAF V600 mutation 00415b Trametinib in combination with dabrafenib is indicated for the adjuvant treatment of adult patients with Stage III melanoma with a BRAF V600 mutation, following complete resection
Vemurafenib Monotherapy Regimen	00102a Treatment of adult patients with BRAF V600 mutation-positive unresectable or metastatic melanoma
Vismodegib Monotherapy Regimen	00236a Treatment of adult patients with symptomatic metastatic basal cell carcinoma (MBCC) 00236b Treatment of adult patients with local advanced basal cell carcinoma inappropriate for surgery or radiotherapy.

Regimen Name

Indication

Avelumab Monotherapy