Myriad myPath(TM) Melanoma Improves Diagnosis and Treatment Plans

The gist: It can be difficult for doctors to tell whether a patient has malignant melanoma or simply a benign mole. A test called myPath Melanoma uses molecular testing to help clarify whether or not a person has melanoma. Researchers recently finished a study to look at the effectiveness of the test. They found that doctors who used MyPath Melanoma had 43% fewer cases of indecision, and changed their mind about treatment recommendations 49% of the time.

“Myriad Genetics, Inc. (Nasdaq:MYGN) today presented results from a prospective clinical utility study of its Myriad myPath Melanoma test at the 2014 American Society of Dermatopathology (ASDP) annual meeting in Chicago, Ill. Myriad myPath Melanoma is a genetic test that differentiates malignant melanoma from benign skin lesions across all major melanoma subtypes. Key findings of this clinical utility study included a 43 percent reduction in indeterminate diagnoses and a 49 percent change in physicians’ treatment recommendations for patients.

” ‘These findings demonstrate the power of Myriad myPath Melanoma to improve patient care through more definitive diagnoses of skin lesions, particularly in these difficult-to-call cases,’ said Loren Clarke, M.D., vice president of Medical Affairs at Myriad Genetic Laboratories. ‘Importantly, the number of indeterminate cases was significantly reduced, which means less uncertainty for more patients and physicians, and may lead to less overtreatment in these cases.’ ”

“The study evaluated the impact of the Myriad myPath Melanoma diagnostic test on dermatopathologists’ diagnoses and intended treatment recommendations for 218 patients with pigmented skin lesions that were considered difficult to diagnose. The dermatopathologists recorded their diagnoses and treatment plans before and after receiving the myPath Melanoma test results.”

T-Rays Could Reveal Nascent Melanomas

The same imaging technology used at airport security checkpoints could also help us find melanomas that we can’t see yet, according to research presented at the American Chemical Society’s fall 2013 meeting. The technology uses terahertz rays (T-rays), which are the wavelengths between microwaves and the infrared rays that we feel as heat. In contrast to X-rays, T-rays are not ionizing and so are much safer, penetrating only a few millimeters into the skin. Melanomas start in the deepest part of the skin’s outer layer, long before they appear on the surface as mole-like growths. Early results suggest that dermatologists could use T-rays to diagnose melanomas that are just beginning to form.

Controversy over FDA-Approved Device to Detect Melanomas

Many dermatologists worry about missing melanomas, and in 2011 the FDA approved a tool that could help them catch more of these aggressive skin cancers. But the word is still out on whether it works. Called MelaFind, the device can ‘see’ 2.5 mm deep into the skin, makes images of different layers, and uses pattern-recognition algorithms to assess the likelihood of melanoma. Drawbacks include that MelaFind can only be used on small pigmented spots and that it gives a lot of false positives, which could lead to unnecessary biopsies. But dermatologists who use this tool say that they use their own judgment to make the final call and that MelaFind makes them more confident in their diagnoses.

Watchdog approves skin cancer drugs ipilimumab and vemurafenib

Patients with an advanced form of skin cancer were given new hope today after the health watchdog recommended that two life-extending treatments should be available on the NHS.

Progression of RAS-Mutant Leukemia during RAF Inhibitor Treatment

Vemurafenib, a selective RAF inhibitor, extends survival among patients with BRAF V600E–mutant melanoma. Vemurafenib inhibits ERK signaling in BRAF V600E–mutant cells but activates ERK signaling in BRAF wild-type cells. This paradoxical activation of ERK signaling is the mechanistic basis for the development of RAS-mutant squamous-cell skin cancers in patients treated with RAF inhibitors. This study reports the accelerated growth of a previously unsuspected RAS-mutant leukemia in a patient with melanoma who was receiving vemurafenib. Exposure to vemurafenib induced hyperactivation of ERK signaling and proliferation of the leukemic cell population, an effect that was reversed on drug withdrawal.

New melanoma trial initiated at Moffitt Cancer Center to investigate utility of immunotherapy biomarkers

Phase I melanoma patient trial will test whether the drug PV-10 works better in patients with a distinct immune biomarker signature in both blood and tumor tissue.

Circulating tumor cells may be predictive for recurrence and survival in melanoma patients

Circulating tumor cells detected in the blood of stage III melanoma patients may be a predictive blood biomarker helpful for deciding which patients could benefit from aggressive adjuvant therapy.

‘‘Intermittent dosing’ strategy for BRAF inhibitor treatment holds promise for advanced melanoma

In an industry-academia collaboration, researchers have found an intermittent dose of vemurafenib, an oral BRAF inhibitor used to treat metastatic melanoma can help delay resistance in a mouse model. The results have implications for patients taking the drug.

Mutation Linked to Better Outcomes For Uveal Melanoma Patients

Researchers at Washington University found mutations in the gene SF3B1 are associated with a type of uveal melanoma that has better outcomes and is less likely to spread to other parts of the body.