German Health Institute Says Ipilimumab Benefits Melanoma Patients

Melanoma patients live longer when treated with ipilimumab than with an experimental tumor vaccine called gp100, according to a study by the German Institute for Quality and Efficiency in Health Care. People treated with ipilimumab lived 10 months, while those who were not lived 6.5 months. In addition, ipilimumab did not make people’s quality of life worse. People had the same symptoms—nausea, vomiting, digestive disorders, fatigue, and pain—whether they were treated with the drug or with a placebo.

Primary source: https://www.iqwig.de/considerable-added-benefit-of-ipilimumab-in.1454.en.html?random=b17062


Blood Test Could Predict When Melanomas Will Come Back

A new blood test could show whether melanomas are likely to return in patients who are clinically free of the disease, according to a study in the Journal of Clinical Oncology. Cancer cells that break off tumors can enter blood vessels; this test identifies three tumor cell biomarkers in blood. The researchers periodically tested blood samples of 322 patients and found those with up to one cancer biomarker were more likely to be melanoma-free compared to those with two or more cancer biomarkers (73% vs 59%). This test could show which patients would benefit from aggressive treatments.

Primary source: http://jco.ascopubs.org/content/30/31/3819.abstract?sid=85400172-d445-4d85-958c-f7bda75450b6


SMURF2 Inhibitors Increase Effectiveness of MEK Inhibitors

Treatments that target a protein called MEK could work better when combined with drugs that inhibit a protein called SMURF2, according to research in the British Journal of the National Cancer Institute. MEK is involved in cell division and can be activated by BRAF and NRAS mutations. However, melanomas often resist MEK inhibitors. The researchers found that MEK inhibitors made melanoma cells grown in the laboratory produce too much of a protein called SMURF2. This in turn led to overproduction of another protein called MITF, which protects melanomas against MEK inhibitors. When treated with both a MEK inhibitor called selumetinib and a SMURF2 inhibitor, tumor growth was suppressed by 98% in mice.

Primary source: http://jnci.oxfordjournals.org/content/105/1/33.abstract?sid=76bd523d-0853-4b55-abe1-b7781898c5a3


Cost-Benefit Analysis Questions Treating Medicaid Patients with Vemurafenib

The impressive, but still short-term, benefits of vemurafenib for melanoma patients may not justify the hefty cost to a Massachusetts Medicaid program, according to an analysis presented at an American Society of Health-System Pharmacists meeting. Vemurafenib targets the most common mutation of BRAF, which is one of the genes that is most often abnormal in melanomas. The analysis noted that vemurafenib boosted 6-month survival rates over those of the conventional chemotherapy drug dacarbazine (84% and 64%, respectively). However, vemurafenib is also more expensive than dacarbazine, with relative per patient costs estimated at $9,995 and $1,811 per month, respectively.


Testing Lymph Nodes Near Melanomas May Not Help

A British Medical Journal report questions an invasive, expensive standard practice for melanoma patients in the U.S. Called sentinel node biopsy, the approach involves testing lymph nodes near tumors for cancer cells and removing nodes that test positive. The report cites a 2006 study showing that sentinel node biopsy did not increase 5-year survival rates and calls for further analysis of the practice’s effectiveness. Sentinel node biopsies are not standard in the UK.


Treatment Breaks May Delay or Prevent Vemurafenib Resistance

Giving melanoma patients a break from vemurafenib could make this treatment more effective. Research in Nature shows that vemurafenib-resistant tumors keep growing during treatment because they produce high levels of mutated BRAF proteins, which are involved in cell division. Moreover, these tumors actually depend on the drug to grow. In contrast, an on-and-off treatment schedule can help keep melanomas from becoming resistant to vemurafenib in mice.

Primary source: http://www.nature.com/nature/journal/vaop/ncurrent/full/nature11814.html


Researchers Write New Guide to Optimal Treatments for Melanomas with BRAF Mutations

Based on current data, researchers have developed a new treatment guide for melanomas with the most common mutations (BRAF V600). While these melanomas can be targeted with vemurafenib and dabrafenib, challenges remain. Not all tumors respond, some become resistant, and side effects can include another type of skin cancer called squamous cell carcinoma. Other treatment options include trametinib, which targets a protein called MEK, as well as immunotherapies such as high-dose interleukin 2 and ipilimumab, both of which can control tumors completely.


Melanoma Apps No Substitute for Doctors

A JAMA Dermatology study shows the dangers of using smartphone apps to self-diagnose melanomas. The researchers compared diagnoses of 60 melanomas and 128 benign lesions by a board-certified dermatopathologist to those of four apps. Three of the apps incorrectly said that 30% or more of the melanomas were harmless. The fourth app, which sent images to board-certified dermatologists, was better, but still misdiagnosed one of the melanomas as benign. These apps are not subject to regulatory oversight.

Primary source: http://archderm.jamanetwork.com/article.aspx?articleid=1557488#qundefined


Avastin-Containing Chemotherapy May Be Safe in Lung Cancer Patients with Brain Metastases

Bevacizumab (Avastin), which is approved for treatment of a number of advanced-stage cancer types, is commonly avoided in patients with brain metastases (cancer that has spread to the brain) because of fear of brain hemorrhages (bleeding in the brain). A retrospective study of 52 patients with advanced non-small cell lung cancer (NSCLC) who had received chemotherapy containing Avastin found no cases of serious bleeding events and no significant differences in survival or treatment side effects between patients with or without brain metastases. Avastin may therefore be a safe treatment option in NSCLC with brain metastases.

Research paper: https://www.jstage.jst.go.jp/article/acrt/20/2/20_47/_pdf