Researchers trialling treatment combinations stop spread of melanoma.
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Melanoma is the deadliest form of skin cancer. In the UK, melanoma is the fifth most common cancer, with around 13,500 new cases diagnosed every year.
According to Melanoma UK, of those diagnosed with melanoma in England and Wales, around 86 out of 100 people will live for at least five years, with 83 out of 100 diagnosed living for at least 10 years.
However, researchers believe they have found a treatment combination that can stop the disease from spreading.
Two international studies conducted by researchers at Melanoma Institute Australia have successfully prevented the disease from spreading in stage III patients who had had their tumour surgically removed. These patients had, until now, been at a high risk (40-70%) of their disease progressing to advanced and fatal melanoma.
Study author and conjoint medical director of the Melanoma Institute Australia and chair of Melanoma Medical Oncology and Translational Research at the University of Sydney, Professor Georgina Long, commented: "These results will change the way we treat melanoma patients as well as their quality of life.
"Until now, Stage III melanoma patients who have had their tumours surgically removed have simply had to play the waiting game, to see if their melanoma would metastasise or spread. Living with such fear severely affected them and their loved ones.
"Results from these clinical trials suggest we can stop the disease in its tracks - effectively preventing it from spreading and saving lives. Our ultimate goal of making melanoma a chronic rather than a terminal illness is now so much closer to being achieved."
The researchers conducted two 12-month trials, COMBO-AD and CheckMate 238, with one being immunotherapy-based and the other using targeted therapies.
The COMBI-AD trial involved patients randomised into two groups, with one receiving a combination of targeted therapies (dabrafenib and trametinib) and the other given placebo for 12 months.
The targeted therapies work to block the action of a particular gene which is a driver for melanoma. This trial was aimed at patients who are BRAF positive and the results revealed that it prevented resected stage III melanoma from recurring and increased overall survival.
Meanwhile, the CheckMate 238 trial involved patients with high-risk stage III and stage IV disease, whose melanoma had been surgically removed, and were randomised to be treated with the immunotherapy nivolumab or ipilimumab for 12 months.
Immunotherapies work by rebooting the immune system in order for it to attack the melanoma cells.
Nivolumab was found to decrease the chance of relapse and had a superior safety profile over ipilimumab. This was seen in patients regardless of BRAF mutation status. It is too soon to determine long-term survival rates.
Previous research demonstrated that targeted and immune therapies can successfully treat patients with advanced (stage IV) melanoma that couldn't be surgically removed.
The Institute claims that these are the world's first clinical trials to give melanoma patients treatments at an earlier stage of the disease to prevent spread and recurrence.
Professor Long concluded: "These clinical trials show we now have ammunition to prevent melanoma spreading and progressing, which until now was a critical area of disease behaviour where we had no control.
"This will change how melanoma is treated around the world, as we no longer have to passively wait to see if the melanoma spreads.
"We can now actively and effectively attack the melanoma at an earlier stage, reducing the dreadful anxiety for patients about progressing to a potentially terminal illness and ensuring they have much better outcomes."
The research has been published in the New England Journal of Medicine and the results will be presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Spain.
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|Date:||Sep 11, 2017|
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