First Drug that Treats Melanomas in the Eyes

About half of melanomas that start in the eye spread to other parts of the body, usually killing people within a year. But while there are a variety of therapies for melanomas in the skin, those in the eyes are biologically distinct and there has been no good way to treat them—until now. A clinical trial of 157 people showed that a drug called selumetinib can shrink melanomas of the eye, which form in a layer called uvea that includes the iris. Selumetinib is a MEK inhibitor that targets the most common uveal mutations (GNAQ and GNA11). The researchers found that tumors shrank in in half of those treated with selumetinib and did not grow again for twice as long compared to those treated with standard chemotherapy (an average of 16 vs 7 weeks). This work was presented at the American Society of Clinical Oncology’s 2013 meeting.


Clinical Trial Reveals Patients' Willingness to Undergo Genetic Testing for Personalized Cancer Treatment

A recently completed clinical trial examining the use of genetic testing to direct cancer treatment was able to exceed its enrollment goal of 600 participants in less than 2 years instead of the expected 5 years. Patients were willing to participate even though they had to undergo an additional biopsy, revealing considerable interest in personalized treatment based on genetic tests. The trial confirmed that erlotinib (Tarceva) is highly effective in non-small cell lung cancer (NSCLC) patients with a mutation in the EGFR gene. It also found that NSCLC patients with mutations in the KRAS gene did not benefit from the novel cancer drug selumetinib. In contrast, not enough small cell lung cancer (SCLC) patients had any of the investigated mutations to properly test how they responded to treatments. Such mutations will require trials involving thousands of patients to draw reliable conclusions.


Clinical Trial Reveals Patients' Willingness to Undergo Genetic Testing for Personalized Cancer Treatment

A recently completed clinical trial examining the use of genetic testing to direct cancer treatment was able to exceed its enrollment goal of 600 participants in less than 2 years instead of the expected 5 years. Patients were willing to participate even though they had to undergo an additional biopsy, revealing considerable interest in personalized treatment based on genetic tests. The trial confirmed that erlotinib (Tarceva) is highly effective in non-small cell lung cancer (NSCLC) patients with a mutation in the EGFR gene. It also found that NSCLC patients with mutations in the KRAS gene did not benefit from the novel cancer drug selumetinib. In contrast, not enough small cell lung cancer (SCLC) patients had any of the investigated mutations to properly test how they responded to treatments. Such mutations will require trials involving thousands of patients to draw reliable conclusions.


Clinical Trial Reveals Patients' Willingness to Undergo Genetic Testing for Personalized Cancer Treatment

A recently completed clinical trial examining the use of genetic testing to direct cancer treatment was able to exceed its enrollment goal of 600 participants in less than 2 years instead of the expected 5 years. Patients were willing to participate even though they had to undergo an additional biopsy, revealing considerable interest in personalized treatment based on genetic tests. The trial confirmed that erlotinib (Tarceva) is highly effective in non-small cell lung cancer (NSCLC) patients with a mutation in the EGFR gene. It also found that NSCLC patients with mutations in the KRAS gene did not benefit from the novel cancer drug selumetinib. In contrast, not enough small cell lung cancer (SCLC) patients had any of the investigated mutations to properly test how they responded to treatments. Such mutations will require trials involving thousands of patients to draw reliable conclusions.


Dabrafenib Bests Chemotherapy and May be Safer than Vemurafenib

A clinical trial found that dabrafenib, a BRAF inhibitor, was far more effective in treating melanomas that have BRAF mutations than the chemotherapy drug dacarbazine, according to a report at an American Society of Clinical Oncology meeting. Patients treated with this drug lived without getting worse for 70% longer than those treated with dacarbazine (5.1 vs. 2.7 months, respectively). Moreover, compared to those treated with vemurafenib in other studies, dabrafenib-treated patients had less risk of another kind of skin cancer called squamous cell carcinoma. This suggests that dabrafenib, which is experimental, could be safer than vemurafenib, which is FDA approved.


Vemurafenib Benefits People Previously Treated for Melanoma

A New England Journal of Medicine study found that vemurafenib, which was approved by the FDA in 2011, controlled melanomas in about half of people who had been previously treated for this disease. The trial included 132 repeat patients; tumors shrank in 47% of the patients and were not evident in 6% during the course of the trial. Vemurafenib is a BRAF inhibitor and about half of melanoma patients have BRAF mutations. While 26% of patients developed another kind of skin cancer called squamous cell carcinoma, these lesions were successfully removed surgically.

Primary source: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1112302


Scans May Reveal Early Drug Resistance in Melanomas

Preliminary results suggest that an imaging technique can give early signs of drug resistance in melanomas. A Journal of Clinical Oncology study found that positron-emission tomography (PET)/computed tomography (CT) scans correlated with standard measures of tumor response in seven melanoma patients treated with vemurafenib. The scans also showed that during the third and fourth weeks of treatment, tumors in three patients began to take up and metabolize more of a sugar. This is a sign of cell activity, suggesting that these tumors were starting to resist the drug.


Vemurafenib Boosts Immunotherapy Against Melanoma in Mice

Vemurafenib increases the effectiveness of a treatment that uses immune system cells modified to target cancer cells, according to a study in Cancer Research. When combined with vemurafenib, which targets melanomas with the most common BRAF mutations (V600), this immunotherapy treatment killed more melanoma cells in mice. The combination treatment was also more successful than vemurafenib alone. The researchers conclude that their work supports testing this combination treatment in people with melanomas that have BRAF V600 mutations.


Combining Dabrafenib and Trametinib Increases Melanoma Patient Survival

People with melanoma lived longer when treated with a combination of dabrafenib (a BRAF inhibitor) and trametinib (a MEK inhibitor) than with dabrafenib alone, according to research in The New England Journal of Medicine. The study included 247 people with melanomas that had BRAF V600E mutations. Treatment with both drugs increased survival to 9.4 months, compared to 5.8 months with dabrafenib alone. In addition, tumors were not evident or shrank considerably in 76% of people treated with both drugs compared to 54% of those treated with dabrafenib alone.

Primary source: http://www.nejm.org/doi/full/10.1056/NEJMoa1210093