Patients with advanced melanoma may live longer with Ipilimumab, and have a better likelihood of surviving longer on Vemurafenib than chemotherapy, scientists revealed in the Annual Meeting of the American Society of Clinical Oncology (ASCO).

In a phase three clinical trial, Vemurafenib was tested on 675 participants, all with advanced melanoma. 84% of those on Vemurafenib pills taken twice daily were alive six months later, compared to 64% of those on standard chemotherapy.

48% of those on Vemurafenib had significant tumor shrinkage.

Half of all advanced skin cancer patients have a faulty gene – BRAF. Vemurafenib works on this faulty gene by targeting and blocking this protein at the cellular level. Those running the study were so impressed with the results that it was stopped early, so that the participants on chemotherapy could switch to Vemurafenib.

Compared to those on chemotherapy, Vemurafenib was also found to lower the risk of worsening disease by 74%.

Vemurafenib is being developed by Genentech (Roche) and Plexxikon Inc.

Study leader, Dr. Paul Chapman, of the Memorial Sloan-Kettering Cancer Center’s Melanoma and Sarcoma service, said:

“This is the beginning of personalized medicine in melanoma,” said Dr. Chapman. We have seen tumors shrink rapidly, and in some patients, quality of life improved dramatically. It has been a very exciting year.”

Trials are currently underway to determine whether Vemurafenib might help patients with other types of cancers.

Another clinical trial demonstrated that Ipilimumab (Yervoy) can help patients with advanced melanoma live longer (extends survival time).

502 patients were involved in a double-blind, randomized clinical trial which examined the response of patients who had just been diagnosed and had not had prior treatment for their disease. Half of them were on dacarbazine (standard chemotherapy treatment), while the other half were on ipilimumab plus standard chemotherapy.

A considerable number of patients who would usually have been expected to have died within a few months lived for years, the researchers explained. Researchers said that Yervoy almost doubled the number of patients who survived three years or more.

Study leader, Jedd Wolchok MD, PhD, also of the Memorial Sloan-Kettering Cancer Center’s Melanoma and Sarcoma service, said:

“Ipilimumab blocks a very critical brake that the immune system uses to hold itself back from attacking normal tissues. By temporarily blocking this brake, ipilimumab allows the immune system to become more robustly activated than it otherwise would and, therefore, in some people causes the production of antibodies and T-cells that can recognize melanoma leading to control of the disease.”

Yervoy was created by Bristol-Myers Squibb Co.

National regulatory bodies, such as NICE (National Institute for Clinical Excellence) in the UK, EMA (European Medicines Agency) and the FDA are currently assessing both treatments. UK media believes they could become available in the UK by the end of this year. In March 2011 the FDA (Food and Drug Administration) approved ipilimumab as a treatment for advanced melanoma.

Dr. Allen Lichter, chief executive of the American Society of Clinical Oncology, said:

“Melanoma has just seen a
renaissance of new agents.”

68,000 patients in the USA were diagnosed with melanoma in 2010. There were 8,700 deaths caused by melanoma last year in the USA in the same year.

Written by Christian Nordqvist