“A single dose of a programmed cell death protein 1 (PD-1) inhibitor before resection for melanoma may predict clinical outcomes for patients. Researchers from the Abramson Cancer Center at the University of Pennsylvania—who documented this finding in the largest cohort of patients to be treated with anti–PD-1 drugs before surgery—also showed that immune responses brought on by this therapy can peak as early as 7 days after treatment—much earlier than previous studies have shown. These findings were published by Huang et al in Nature Medicine.”
“People with a type of skin cancer who consumed a high-fiber diet responded better to immunotherapy treatment than those with poorer diets, according to data presented at a media preview of the American Association for Cancer Research (AACR) annual meeting.
“Melanoma is a type of skin cancer which although very treatable if caught early, still kills approximately 9,000 Americans a year, mainly people who are diagnosed a more advanced stage of disease where the cancer has spread to other parts of the body.”
It has been over a year since I last wrote about new developments in treatment of melanoma, and it is time for an update. There is certainly some good news for melanoma patients!
Neoadjuvant (before surgery) treatments for resectable melanoma
Stage III—and more rarely, stage IV—melanoma tumors that have not spread widely can be sometimes treated surgically. Last year a small clinical trial showed that, in BRAF-mutant melanoma, treatment with the BRAF/MEK inhibitors dabrafenib and trametinib (D/T) before and after surgery provides a significant improvement over just post-surgery treatment, by preventing later recurrence.
Later in 2018, researchers reported that using the immune checkpoint drugsnivolumab and ipilimumab prior to surgery led to tumor reduction in 73% of patients treated in a clinical trial. After surgery, they remained disease-free for 2 years (the reported time of observation). Treatment with nivolumab alone was not nearly as active in this randomized trial, with only 25% of patients responding to neoadjuvant nivolumab; still, 75% were disease-free within the 2-year observation period.
An interesting trial tested a single dose of the drug pembrolizumab given three weeks prior to surgery. Of 27 patients who received this single infusion, eight (29%) had a complete or major pathological response, meaning that their tumors were reduced by 90% or more. These eight patients continued on pembrolizumab after surgery and were disease-free for over 2 years. Continue reading…
“More than 1,500 cancer care professionals are meeting in Orlando, Florida, March 21-23, for the NCCN 2019 Annual Conference, presented by the National Comprehensive Cancer Network® (NCCN®)—an alliance of 28 leading cancer centers. The conference offers more than 25 sessions presenting the latest treatment recommendations for lung, breast, prostate, colon, and other cancers, including new and emerging therapies. Other key topics include coordination of care, pain management during an opioid crisis, biosimilars, cancer-associated distress, biomarkers, genetic testing, and appropriate transition to end-of-life care. The keynote session highlights the benefits and challenges of treatment with new and innovative therapies (e.g. CAR T-cell) from the perspective of the patient and the clinicians caring for them.”
“A new meta-analysis led by Dr. Joseph Unger of Fred Hutchinson Cancer Research Center has revealed that structural and clinical barriers prevent more than 3 out of 4 cancer patients from participating in clinical trials.
“The study is part of an ongoing effort to understand why patient participation is so low in cancer clinical trials. Unger, a health services researcher and biostatistician who focuses on disparities in cancer research, published his findings today in JNCI, the Journal of the National Cancer Institute.”
“In a new study by Yale Cancer Center, scientists suggest that as the number of clinical trials in cancer immunotherapy grows exponentially, some caution should be exercised as we continue to better understand the biology of these new therapeutic targets. The findings are published today in the journal Cell.
“Researchers around the world have been racing to create therapies that unleash the power of our immune systems against cancer. The most successful of these immunotherapies, which target a molecular pathway known as PD-1/PD-L1, have brightened the landscape for many people suffering with lung cancer and other types of tumors.”
“ASCO and Friends of Cancer Research (Friends) applaud the National Cancer Institute’s (NCI) recent revision of its clinical trial protocol template to broaden eligibility criteria for cancer clinical trials. The protocol template was expanded to help increase the opportunity for participation in NCI-funded clinical trials for patients with certain health-care conditions, as well as to provide an opportunity for patients younger than age 18 to participate in adult clinical trials in certain circumstances.”
“Cancer has an insidious talent for evading the natural defenses that should destroy it. What if we could find ways to help the immune system fight back?
“It has begun to happen. The growing field of immunotherapy is profoundly changing cancer treatment and has rescued many people with advanced malignancies that not long ago would have been a death sentence.”
“In recent years, many Americans have embraced vitamin D and fish oil pills, their enthusiasm fueled by a steady trickle of suggestive research studies linking higher levels of vitamin D with lower rates of cancer and other ills, and fish consumption with reduced heart disease.
“Now a large and rigorous government-funded randomized trial — the only such study of omega-3 fish oils ever carried out in healthy adults, and the largest trial ever done of high-dose vitamin D — has found the supplements do not lower cancer rates in healthy adults. Nor do they reduce the rate of major cardiovascular events, a composite of heart attacks, strokes and deaths from cardiovascular disease. The trial is of the kind considered the gold standard in medicine.”