There is a lot of interesting research going on with melanoma (and cancer in general) these days. Scientists have made BIG leaps and bounds toward finding treatments with durable remissions, that will have the least damaging side effects for patients. Below is a collection of articles that I have run across in the past five years while attempting to learn all that I can about my diagnosis.
Some you’ll find very helpful… and others… well… they just HAD to be shared!
Risk-adjusted survival for melanoma brain metastases in the era of checkpoint blockade immunotherapies: Results from a national cohort. (June 2018)
The recent successes of checkpoint blockade immunotherapy (CBI) and BRAFV600–targeted therapy trials have generated exciting promise for revolutionizing the management of patients with advanced melanoma. However, because early clinical trials of CBIs and BRAFV600–targeted therapy either excluded or included disproportionately fewer cases of melanoma brain metastases (MBM), the survival benefit of these novel therapies for MBM remains unknown.
Impact of the influenza vaccination on cancer patients undergoing therapy with immune checkpoint inhibitors (ICI). (June 2018)
Immune checkpoint inhibitors (ICI) are standard of care for many cancer patients (pts). There have been conflicting reports on the effect of the influenza (flu) vaccines (flu-V) on pts being treated with ICI, and some suggest that flu-V may impact survival outcomes in ICI treated pts.
The growing importance of lesion volume as a prognostic factor in patients with multiple brain metastases treated with stereotactic radiosurgery (Feb 2018)
Brain metastases (BM) develop in up to 20–40% of patients diagnosed with cancer, and the incidence is increasing as cancer patients are living longer with improving systemic therapy Radiation therapy (RT) is an integral component of the treatment of BM to improve local control, and in certain instances, overall survival (OS). Whole‐brain radiation therapy (WBRT) has traditionally been the standard for patients with multiple BM. However, there has been a trend toward increased use of stereotactic radiosurgery (SRS) for management of patients with single or <4 BM
The efficacy and toxicity of WBRT in comparison with and in addition to SRS have been evaluated in a randomized fashion and in a meta‐analysis 5. Recent trials have shown the addition of WBRT to SRS does not improve survival outcomes, and WBRT causes significant declines in neurocognition and overall quality of life (QOL) for patients with 1–3 BM
Targeted therapy before surgery inhibits stage 3 melanoma (Jan 17, 2018)
First-of-its-kind study — A pair of targeted therapies given before and after surgery for melanoma produced at least a six-fold increase in time to progression compared to standard-of-care surgery for patients with stage 3 disease, researchers at The University of Texas MD Anderson Cancer Center report in Lancet Oncology.
Making cancer immunotherapy a surer bet. Researchers are seeking biological cues that can more accurately predict treatment outcomes. (December 2017)
Researchers led by Luis Diaz Jr at the Memorial Sloan Kettering Cancer Center in New York City have uncovered compelling evidence to support a correlation between mutational load and checkpoint-inhibitor response. In 2017, Diaz and his team showed that tumours with defects in certain proteins that repair gene mutations are more likely to respond to treatment with pembrolizumab, even in tumour types with an otherwise poor record of responding to checkpoint inhibition2. More than half of people with such tumours, which included a range of cancer types, responded to treatment, and more than 90% of people who had the strongest responses were alive three years later. “These are patients who were looking at death,” Diaz says.
Cancer immunotherapy research round-up…. Highlights from clinical trials. (December 2017)
Personalized vaccines and viruses that infect and destroy cancer cells can help the immune system to build up a strong and specific attack against skin cancers.
Melanoma cells typically carry many mutations, which results in the production of altered proteins not present in healthy cells. Vaccines against such tumour-specific proteins stimulate the immune system to target and destroy the malignant cells.
The Benefits of Immunotherapy Combonations (December 2017)
When a patient of Adil Daud started to take an experimental combination of immunotherapy drugs for melanoma in 2015, he had a grapefruit-sized growth bulging under his armpit. The tumour was inoperable, and Daud suspected that the cancer had spread to the 69-year-old man’s lungs.
But the two immunotherapeutic agents — the antibodies nivolumab and ipilimumab — had a remarkable effect. “The tumour just melted away,” says Daud, an oncologist at the University of California, San Francisco Medical Center. “Within a few weeks, it had vanished.”
Cancer Immunotherapy — clinical trials are unleashing the power of the body’s own defences against tumors (December 2017)
Our bodies are constantly generating cancer cells, which the immune system is constantly destroying. The cells that escape and grow into tumours are now the target of treatments that stoke the immune assault against them — often with dramatic success.
Cancer immunotherapy-induced rheumatic diseases emerge as new clinical entities (September 2016)
“Patients with rheumatic IRAE differ from patients with traditional rheumatic disease in several important ways. First, it appears that their IRAEs do not behave identically to the corresponding classic rheumatic disease. Observations to date show a lack of the traditional autoantibodies associated with RA and Sjogren’s syndrome in most patients with ICI-induced inflammatory arthritis and sicca syndrome, respectively.13 Also, the steroid requirements of therapy for control may be much higher than typically required to manage ‘classic’ inflammatory arthritis.13 Importantly, all patients with rheumatic IRAE have or recently had advanced stage cancer, so there would be concerns about using immunosuppression in them.”
‘Moles don’t belong in the sun’: Genetic tests show how moles turn into melanoma November 2015)
Using a genetic test, researchers have found a new way to tell if a suspicious-looking mole is about to turn malignant.
And they’ve confirmed that people who have moles should not let the sun get on them. Ultraviolet radiation from the sun directly causes the genetic mutations that finally tip a mole over into becoming melanoma, they report in the New England Journal of Medicine.
“Ultraviolet radiation turns moles into melanoma,” said Dr. Boris Bastian of the University of California San Francisco, a pathologist who helped lead the study.
“Moles don’t belong in the sun.”
Diamonds could help detect cancer early (October 2015)
Published in the journal Nature Communications, the study details how a nanoscale, synthetic version of diamonds – called nanodiamonds – can highlight the presence of early-stage cancers in magnetic resonance imaging (MRI) scans.
Numerous studies have investigated the use of nanodiamonds for targeted cancer treatment. In 2011, for example, Medical News Today reported on how nanodiamonds may be effective in the treatment of chemotherapy-resistant liver and breast cancers.
Ranging around 4-5 nanometers in diameter, nanodiamonds are broadly nontoxic, nonreactive and can carry a wide range of drug compounds, making them an ideal candidate for targeted drug delivery.
However, coauthor Prof. David Reilly, from the School of Physics at the University of Sydney in Australia, and colleagues set out to investigate whether nanodiamonds may also be useful for diagnosis of early-stage cancers.
“We thought we could build on these nontoxic properties realizing that diamonds have magnetic characteristics enabling them to act as beacons in MRIs,” explains Prof. Reilly.
New Clue to How Cancer Causes Organ Failure (August 2015)
“…the presence of a tumor in the body can trick these immune cells to fight an infection that does not exist. This is caused by substances secreted by the tumor that activates neutrophils to form “NETs”
Arm yourself to be part of your own team with Patient Power (patientpower.info)
“There’s an old saying that, you know, in a dark room better to light a candle than to curse the darkness,” says Dr. Michael Wong. He discusses with us how he chased the light all the way from Canada to the United States to further his knowledge through postdoctoral studies. He couldn’t live a life that accepted death from cancer so easily.
Does Traditional Chinese Medicine Have a Role in Treating Melanoma?
Dr. Michael Wong remembered his grandmother using many things to treat ailments. He describes how his great grandmother passed down the Chinese touch to his grandmother, and now as a doctor, his grandmother has passed it down to him. He talks about how Chinese medicine has a place, and it is not meant to interfere with drugs that have a stronger potency to truly fight the cancer. Dr. Wong has traveled all the way to China to go straight to the source and check for practices himself. He wants to be able to look a patient in the eye and tell them, “This is the medicinal path you should take.” He wants to accompany his patients on their voyage of cancer, while he continues his voyage of medicinal discovery—because after all, without them, not of this would be possible. His patients are the light in a dark room.
Sponsored by the Patient Empowerment Network through educational grants from Genentech and Novartis.
Amgen tests T-Vec’s combo potential in trial with Merck’s Keytruda (December 2014)
Amgen’s ($AMGN) cancer vaccine candidate may be awaiting FDA and EMA approval as a melanoma monotherapy, but the company isn’t stopping there. Like many of its peers, it’s looking to explore its prospect’s potential as part of an immunotherapy duo, and now it’s kicked off a trial combining its treatment with Merck’s ($MRK) anti-PD-1 therapy that should help it do just that.
On Monday, the California company announced it had initiated a study of its oncolytic immunotherapy talimogene laherparepvec–T-Vec for short–in combination with Merck’s newly approved checkpoint inhibitor Keytruda in metastatic melanoma patients. After enrolling its first participant, the safety and efficacy study will recruit about 109 more across 35 sites in the U.S., Australia and Europe, the biotech announced.
Using polio to kill cancer: A producers’ notebook (March 2015)
A conversation with Jeff Fager and Michael Radutzky about the 60 Minutes story that followed cancer patients treated with polio
Every once in a while, a story comes through 60 Minutes that has the potential to change lives. This week, Scott Pelley’s report on a new medical treatment using the polio virus to kill cancer is that kind of story.
Most people remember polio as the scourge that paralyzed millions of children until a vaccine was developed in the 1950s. Now, researchers at Duke University are injecting a modified polio virus directly into deadly brain tumors. The research is still in early stages and Duke doctors warn that it’s impossible to predict how effective the polio treatment will be in a wider population, but they’ve seen some stunning results in their Phase 1 trial.
Cancer’s Super-Survivors (2014)
This is a great article from The Wall Street Journal about the fabulous things happening with immunotherapy research.
“His family doctor told him he had lost two pints of blood. Further tests revealed a tumor the size of a quarter on his small intestine. He had surgery at Memorial Sloan Kettering Cancer Center, followed by months of chemotherapy. But the disease spread to his liver and kidneys. The diagnosis: Stage 4 melanoma, a skin cancer typically fatal within a year.
“Death is not an option,” he told his doctor.
Nine years later, against all odds, Mr. Telford is still alive. What saved him was an experimental immunotherapy drug—a medication that unleashes the body’s own immune system to attack cancer.”
Scientists Find Cancer Weak Spots for New Targeted Drugs (February 2015)
Scientists have identified weak spots in cancer cells that could be targeted and attacked by new precision drugs.
A major computational analysis by scientists at the University of Sussex and The Institute of Cancer Research, London, has found a number of potential targets for drugs that exploit the inherent weaknesses of cancer cells.
The findings could lead to personalised medicine that ‘reads’ a cancer patient’s DNA and only attacks defective cells – in contrast to the scattergun approach of conventional chemotherapy, which attacks all dividing cells, including healthy ones.
Fighting Cancer with Nanomedicine (April 2014)
Nanotechnology-based therapeutics will revolutionize cancer treatment.
Short drug circulation times and difficulty localizing therapy to tumor sites are but two of the challenges associated with existing cancer treatments. More troubling are the issues of drug toxicity and tumor resistance. Toxicity can cause major complications, such as low white-blood-cell counts or heart failure, that necessitate cessation of treatment. The tissue damage inflicted by some therapies can even be fatal. And evolution of drug resistance by tumors accounts for the vast majority of cases in which treatment fails. Given these and other issues associated with treatment safety and efficacy, scientists are applying tremendous effort toward the utilization of nanomedicine in the fight against cancer.
Nanotechnology-based therapeutics have exhibited clear benefits when compared with unmodified drugs, including improved half-lives, retention, and targeting efficiency, and fewer patient side effects. Researchers have already made progress with chemotherapeutic nanomedicines in the clinic.
Coffee May Reduce Risk For Deadly Skin Cancer (January 2015)
For the study, published Tuesday in JNCI: Journal of the National Cancer Institute, researchers analyzed data from the NIH-AARP Diet and Health Study on more than 447,000 non-Hispanic whites, who are at higher risk of skin cancer. Study subjects filled out questionnaires about their eating habits, including coffee drinking, and were followed-up after about 10 years.
The researchers found that frequent coffee drinkers — those who consumed four cups or more per day — had a 20 percent lower risk for developing malignant melanoma than those who drank less coffee.
From the “Why didn’t I study this sh** in college?” files (November 2014)…….
It’s not a pleasant sight; ticks having their saliva extracted. But according to researchers at the Butantan Institute in Brazil, the arachnid’s spit could be extremely valuable in fighting cancer. Project coordinator, Ana Marisa Chudzinski-Tavassi, says her team originally explored the anti blood-clotting properties of tick saliva. But they soon found that one particular molecule, Ambyomin-X, also kills malignant cells.