New drug may treat advanced melanoma

HOW COMMON IS SKIN CANCER?

Skin cancer is the most common type of cancer. Among the various types of skin cancer, melanoma is the most severe. Melanoma develops in the cells of the skin that produce melanin, which is the pigment that gives skin its color. It accounts for over 76 percent of cancer deaths each year. The American Cancer Society estimates that in 2015, about 73,870 new cases of melanoma will be diagnosed in the United States.

New Drug Treatment for Advanced Melanoma

Those with advanced melanoma tend to have very low life expectancies but a new drug called nivolumab more than doubled time to disease compared to other drug treatments such as Yervoy.  The findings were presented at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago; they were published simultaneously in the New England Journal of Medicine.

This drug harnesses the patient's immune system to fight their cancer. We explored a milestone in the fight against melanoma in the study from Utah last month and now it appears this drug has furthered research.

Immunotherapy is a new approach to cancer that researchers have only discovered in the last few years or so. Melanoma has been the cancer much of this research is being focused on being that it's so prevalent in our society and very aggressive. 

IMMUNE SYSTEM'S ROLE IN DEALING WITH CANCER

For many years, researchers have been testing immunotherapy treatments as a way to cure cancer. The biggest challenge they have faced is teaching the body that the cancer cells are foreign. Before, cancer cells hid in the body and melanoma was not being attacked by the immune system. By taking the herpes virus and altering it to be recognized by melanoma, the immune system uses its memory to destroy the cancer. Now, the virus and the immune system is killing the cancer. So far, 25 percent of patients have been completely cured.

With this type of treatment, the immune system is able to memorize the virus and fight it at the tumor site, as well as other distant sites it may attack within the body. Patients are also able to avoid having chemotherapy and other surgery related to the cancer.

“The new treatment teaches the body to heal itself and 60 percent of the patients are seeing dramatic results,” Dr. Robert Andtbacka, a surgeon oncologist at the Huntsman Cancer Institute said in a press release.  

Melanoma Drug Treatment: Nivolumab

The drug, nivolumab slowed cancer progression in melanoma patients by more than double, compared with an earlier immunotherapy drug called ipilimumab (Yervoy).

When combined however, the cancer progression nearly quadrupled but came with greater side effects. This could limit treatment in older and most weak patients. No deaths occurred during this large-scale international clinical trial.

"This treatment can be safely applied in a global setting. The trial was conducted at 137 sites globally, and the safety guidelines that were in place clearly were able to handle these side effects," said study author Dr. Jedd Wolchok, chief of the Melanoma and Immunotherapeutics Service at Memorial Sloan Kettering Cancer Center in New York City. 

Both of these drugs belong to a new class called immune checkpoint inhibitors. They work to boost the immune system and help it attack and destroy cancer cells while avoiding good cells like T cells. 

Nivolumab belongs to a second-generation set of immune checkpoint inhibitors that target a more cancer-specific "switch" called PD1. Another study presented earlier at the ASCO meeting showed that nivolumab is effective in treating lung cancer as well.

The drug is FDA approved.

MELANOMA RISK FACTORS

The following factors are the risk factors for melanoma that people should be aware of, according to the Mayo Clinic:

  • Fair skin
  • History of sunburn
  • Family history of melanoma
  • Excessive exposure to ultraviolet light
  • Living close to the equator or at a higher elevation
  • Having many moles or unusual moles
  • Weak immune system

The Mayo Clinic also says melanoma can be prevented by taking responsible precautions like:

  • Avoid midday sunlight – sun is strongest between 10 a.m. and 4 p.m.
  • Always wear sunscreen, even in winter –at least SPF 15.
  • Wear protective clothing.
  • Avoid tanning beds.
  • Know your skin – examine your skin regularly to look out for any changes or growths.

More on the study

To compare the effectiveness of the two drugs, the researchers randomly assigned 945 patients with previously untreated, advanced melanoma to receive ipilimumab, nivolumab or a combination of the two.

They found that nivolumab alone more than doubled the average time to disease progression, compared to ipilimumab -- almost 7 months versus almost 3 months.

Nivolumab also did a better job of shrinking patients' tumors. The average patient experienced a 52 percent reduction in cancerous tissue with the combination therapy and a 34 percent reduction with nivolumab alone.