Approximately 76,100 Americans will be diagnosed with melanoma this year, and around 9,710 people are expected to die from the skin cancer. But new research, recently presented at the 2014 American Society of Clinical Oncology annual conference in Chicago, IL, reveals a promising new treatment for advanced melanoma.
Melanoma rates have been rising for at least the past 3 decades. Advanced melanoma – where the skin cancer has spread to other organs in the body – is notoriously difficult to treat. In the US, 5-year survival rates for the most advanced stage of melanoma stands at 15-20%.
But in this latest study, researchers report “encouraging” follow-up results from a phase 1b immunotherapy trial, revealing how a combination therapy may improve long-term survival for patients with advanced melanoma.
For the study, the researchers tested the drugs nivolumab and ipilimumab (brand name Yervoy) on 127 patients with advanced melanoma who experienced disease progression after initial cancer treatment.
Some of the patients received a combination of nivolumab and ipilimumab, while other patients received each drug alone.
The researchers found that after 1 year, the overall survival rate in patients who received the combination therapy was 94%, and the 2-year survival rate stood at 88%.
According to the researchers, the CTLA-4 and PD-1 pathways in the body effectively hide tumors from the immune system, meaning the immune system does not recognize them as a threat and fails to attack them.
Nivolumab and ipilimumab are antibodies that block the CTLA-4 and PD-1 pathways, allowing the immune system to react strongly against cancer. Nivolumab specifically targets PD-1 receptors on the surface of T cells, and ipilimumab targets the CTLA-4 receptors.
Commenting on the team’s findings, first author Dr. Mario Sznol, professor of medical oncology at Yale Cancer Center in New Haven, CT, says:
“The treatment of advanced melanoma has changed dramatically in the last few years, but there continues to be a need to increase the number of patients who experience a long-term survival benefit.”
“While these are phase 1b data, the duration of response and 1- and 2-year survival rates observed with the combination regimen of nivolumab and Yervoy are very encouraging and support the rationale for the ongoing, late-stage trials of this combination regimen.”
The research team says they plan to conduct phase 2 and 3 trials to confirm these findings.
This is not the only study to report encouraging results for advanced melanoma treatment.
Another phase 1b trial, conducted by global healthcare company Merck Sharp and Dohme Limited (MSD), assessed a drug called pembrolizumab (MK-3475) in 411 patients with advanced melanoma.
- Melanoma accounts for less that 2% of skin cancer cases but causes a large majority of skin cancer deaths
- The lifetime risk of getting melanoma is 1 in 50 for white people, 1 in 200 for Hispanics and 1 in 1,000 for black people
- Frequent exposure to ultraviolet (UV) rays – from the sun or tanning beds and lamps – greatly increases the risk of skin cancer, including melanoma.
After 1 year, the overall survival rate for patients was 69%, while overall survival at 18 months was 62%. The drug works the same way as nivolumab and ipilimumab – effectively blocking pathways that prevent the immune system from attacking cancers.
According to the BBC, one patient in the UK has already reported successful treatment with pembrolizumab.
Warwick Steele, aged 64, had advanced melanoma that spread to one of his lungs. After three doses of pembrolizumab, scans show that the cancer in his lungs has completely disappeared. He has continued treatment with pembrolizumab since October last year.
Steele’s consultant oncologist, Dr. David Chao of the Royal Free London NHS Trust in the UK, believes the findings are promising. “Pembrolizumab looks like it has potential to be a paradigm shift for cancer therapy,” he says.
Earlier this year, Medical News Today reported on a study published in The International Journal of Cancer, which detailed how starving melanoma cells may slow tumor growth.