The National Institute for Health and Clinical Excellence (NICE) recommends giving people in England and Wales access to vemurafenib and ipilimumab via the National Health Service (NHS). The FDA has already approved these drugs for treating metastatic melanoma in the U.S. Initially, the cost of these treatments was a stumbling block in the UK and the watchdog institute’s recommendation comes with the caveat that manufacturers must provide a discount to the NHS.
- metastatic melanoma
An ongoing clinical trial found that 26% of melanoma patients treated with vemurafenib (Zelboraf®) were alive at 3 years—far longer than the average survival time of 9 months with conventional chemotherapy. Vemurafenib is a BRAF inhibitor and this trial includes 32 people with the most common BRAF mutation (V600E). In addition, five people survived at 3 years and 4 months; three of them had no evidence of disease.
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.
A new drug combination could treat melanomas that resist therapy with a single drug, suggests research that appeared in Cancer Discovery on melanoma cells grown in the laboratory. The researchers tested melanoma cells that had BRAF mutations and resisted treatment with the BRAF inhibitor vemurafenib, and that had NRAS mutations, which resist many treatments. The most effective combination treatment was statins, which are commonly used to treat high cholesterol, but can also kill melanoma cells, and drugs that inhibit proteins called cyclin-dependent kinases, which are involved in cell division.
Despite promising results from small trials, a large clinical trial found that combining sorafenib with chemotherapy was no better than chemotherapy alone for melanoma patients. Sorafenib is FDA-approved for kidney and liver cancer that targets tumors by inhibiting the new blood vessels that help them grow and spread. However, this Journal of Clinical Oncology study also showed that the carboplatin/paclitaxel chemotherapy was surprisingly effective. This chemotherapy combination is now listed as a standard melanoma treatment by the National Comprehensive Cancer Network guidelines.
The experimental drug PV-10, which is injected directly into melanoma tumors, may work partly by boosting the immune system. To find out, researchers are launching a clinical trial to see if patients treated with PV-10 have immune biomarkers in their tumors and blood. The study will enroll up to 15 patients.
A genetic abnormality may help predict which melanomas in the eye are unlikely to spread, according to a study in Nature Genetics. The researchers found that nearly 20% of 102 people with eye melanomas had a mutation in a gene called SF3B1. These people were usually younger when diagnosed and their tumors were less likely to spread and become deadly.
Primary source: http://www.nature.com/ng/journal/vaop/ncurrent/full/ng.2523.html