Advanced Melanoma Patients See Potential to Extend
Life with Drug Combination
The first long-term follow-up results from a phase 1b
immunotherapy trial combining drugs for advanced melanoma patients
suggests longer term survival
June 2, 2014 - The first long term follow-up
results from a phase 1b immunotherapy trial combining drugs for advanced
melanoma patients has shown encouraging results — long-lasting with high
survival rates — researchers report. The one-year overall survival rate
was 94% and the two-year rate was 88%. It is particularly good news for
senior citizens, who are the most likely victims of this most aggressive
First author Mario Sznol, M.D., professor of
medical oncology at Yale Cancer Center, is presenting the updated data
at the 2014 annual conference of the American Society of Clinical
Oncology (ASCO) in Chicago.
Sznol, clinical research leader of the melanoma
research program at Yale Cancer Center, was the senior author on the
original study of combination immunotherapy that was first published in
the New England Journal of Medicine and presented at ASCO in 2013. Jedd
Wolchok, M.D., of Memorial Sloan Kettering Cancer Center was first
author of the earlier study, and senior author of this updated research.
The trial evaluated the safety and activity of the
combination regimen of nivolumab (anti-PD-1), an investigational PD-1
immune checkpoint inhibitor, and ipilimumab (anti-CTLA-4; Yervoy), given
either concurrently or sequentially, to patients with advanced melanoma
whose disease progressed after prior treatment.
"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," Sznol said.
"While these are phase 1b data, the duration of
response and one- and two-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
CTLA-4 and PD-1 are targets for cancer
immunotherapy because they are shut down the immune system's ability to
respond to attack tumors. Antibodies blocking CTLA-4 and PD-1 enable a
strong immune response against cancer by removing the brakes from the
Nivolumab targets the PD-1 receptor on the surface
of T-cells, and ipilimumab targets CTLA-4 receptors. Both are
manufactured by Bristol-Myers Squibb, which sponsored the study with Ono
Pharmaceutical Company, Ltd.
Other authors include Harriet Kluger, M.D.,
Kathleen Reed, Matthew Burke, and Anne Caldwell of Yale School of
Medicine and Yale Cancer Center; Margaret Callahan. M.D., Michael Postow,
M.D., Naiyer Rizvi, M.D., Alexander Lesokhin, M.D., Neil Segal, M.D.,
Charlotte Ariyan, M.D., Ruth-Ann Gordon, Stephanie Kronenberg, and
Blessing Agunwamba of Memorial Sloan-Kettering Cancer Center; Xiaoling
Zhang of Dako North America; Israel Lowy, M.D., Hector David Inzunza,
M.D., William Feely, Christine Horak, Quan Hong, Alan Korman, John
Wiggington, M.D., and Ashok Gupta, M.D., of Bristol-Myers Squibb;
Michael Atkins of Georgetown-Lombardi Comprehensive Cancer Center; and
John Kirkwood of the University of Pittsburgh Medical Center.
What are the key statistics about
melanoma skin cancer?
Cancer of the skin is by far the
most common of all cancers. Melanoma accounts for less than 2% of skin
cancer cases but causes a large majority of skin cancer deaths.
Here are the American Cancer
Society’s estimates for melanoma in the United States for 2014:
ØAbout 76,100 new melanomas will be
diagnosed (about 43,890 in men and 32,210 in women).
ØAbout 9,710 people are expected to die of
melanoma (about 6,470 men and 3,240 women).
The rates of melanoma have been
rising for at least 30 years.
Melanoma is more than 20 times more
common in whites than in African Americans. Overall, the lifetime risk
of getting melanoma is about 2% (1 in 50) for whites, 0.1% (1 in 1,000)
for blacks, and 0.5% (1 in 200) for Hispanics. The risk for each person
can be affected by a number of different factors, which are described in
the section “What
are the risk factors for melanoma skin cancer?”
The risk of melanoma increases with
age – the average age at the time it is found is 61. But melanoma is not
uncommon even among those younger than 30. In fact, it is one of the
most common cancers in young adults (especially young women).
American Academy of
Dermatology Statement on Drinkable Sunscreen
Recently, there has been media coverage
about “drinkable sunscreen” that claims to provide sun
protection through the ingestion of water that allegedly has
been infused with electromagnetic waves.
The American Academy of Dermatology
(Academy) wants to alert consumers that this drink should not be
used as a replacement for sunscreen or sun-protective clothing.
There is currently no scientific evidence that this “drinkable
sunscreen” product provides any protection from the sun’s
damaging UV rays.
Sunscreen is the only form of sun
protection that is regulated by the U.S. Food & Drug
Administration (FDA). Broad-spectrum sunscreen with an SPF of
at least 15 has been scientifically proven to prevent sunburn
and reduce the risk of skin cancer and early skin aging caused
by the sun.
The Academy continues to recommends that
you still seek shade, wear sun-protective clothing and
wide-brimmed hat, and apply a broad-spectrum, water-resistant
sunscreen with an SPF of 30 or higher. For more sun protection
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