Scientific Asia: Experts applaud “remarkable” trial findings for treating a type of skin cancer for which there was previously little hope.
A double dose of immunotherapy medications has been proven to prolong survival for over half of patients with advanced melanoma for at least ten years, according to a trial.
With the combined treatment, survival rates for a previously terminal kind of skin cancer have improved, and some patients are now alive long enough to pass away from other causes.
Only one in twenty patients with metastatic melanoma lived for five years, fifteen years ago; many passed away six to nine months after the diagnosis was made.
According to James Larkin, a professor at the Institute of Cancer Research and a consultant medical oncologist at the Royal Marsden NHS Foundation Trust, “the definition of cure is to return someone to their normal life expectancy for their age and state of health.” “After treating many of these patients over the last ten years, it appears that some have recovered and are returning to their regular lives.”
This year in the UK, over 20,000 instances of melanoma are predicted to be diagnosed, marking a record high mostly due to an increase in cases among the elderly. The great majority of illnesses are avoidable and result from excessive UV light exposure.
The trial looked at two immune checkpoint inhibitors, ipilimumab, and nivolumab, in 945 patients with stage 3 or stage 4 melanoma, where the tumors had spread. The medications function by turning off the immune system’s “brakes,” which stop it from activating healthy tissues. Release the brakes so that the cancer cells can be identified and attacked by the immune system.
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The strategy works quite well. The New England Journal of Medicine published results that were presented on Sunday at the European Society for Medical Oncology in Barcelona. These results indicate that the survival rate for patients with melanoma in the trial was higher than the overall survival rate, indicating that they were beginning to live long enough to die from other causes. Patients treated with both medications had a 52% melanoma-specific survival rate after ten years.
The outcomes were deemed “remarkable” by Larkin. While the effects of many harmful anti-cancer medications that kill tumor cells eventually wear off, immune checkpoint inhibitors produce long-lasting effects.
This trial represents the longest follow-up of patients treated with the medications for advanced melanoma so far, providing physicians with vital information about side effects, overall survival rates, and the duration of treatment effectiveness. Even if some people had adverse effects at first, no new issues developed afterward. The combo therapy continued to benefit the patients even after they discontinued treatment early due to severe adverse effects because the medications had already started to affect their immune systems.
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Lucy Davis, 47, was diagnosed with stage 3 melanoma in 2011 and enrolled in the experiment, which was sponsored by the medicine company, Bristol-Myers Squibb. After the cancer and surrounding lymph nodes were surgically removed, she was informed two years later that the disease had advanced to stage 4 and she only had a few months to live.
Before I began the experiment, Davis said, she was quite ill, had trouble eating, was losing weight, and was in a lot of discomfort. However, three months later, she felt entirely different, had her appetite back, and scans proved that the treatment was effective. “When I was told I only had a few months to live, my kids were five and seven years old; they are now sixteen and eighteen. Incredibly, I got to watch them finish their tests and head off to college.
Despite the encouraging outcomes, efforts are currently concentrated on the sizable percentage of patients who do not respond to immunotherapies. There may be more than one factor at play, including the patient’s immune system and the biology of their tumor, which contribute to the reason why the medications don’t work for many individuals.
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“It’s great to see these data from a disease where the average life expectancy was six to nine months 15 years ago,” Larkin said. However, a sizable portion of the clinic’s patient population continues to not improve with this course of treatment. In the case of melanoma and other malignancies, our field’s concentration is on trying to figure out why these patients aren’t responding.
“Over the last ten years, there have been significant improvements in survival for people with advanced melanoma skin cancer, partially due to the introduction of a class of immunotherapy drugs called checkpoint inhibitors,” stated Dr. Sam Godfrey, Cancer Research UK’s science engagement lead.
According to this study, more patients were able to live with their condition for ten years or longer when two of these checkpoint inhibitors were combined. Positive outcomes like these demonstrate how important it is to continue researching cancer to provide people with longer, better lives.
