Advancements in Immunotherapy for Melanoma Skin CancerJul 3, 2013
Researchers studying immunotherapy drugs have made progress that may soon lead to improved treatments for people with advanced melanoma. Although not as common as some other types of skin cancer, melanoma can be more dangerous. Standard cancer treatments such as surgery, chemotherapy, and radiation are typically not effective in advanced stages of the disease. Immunotherapy can help some patients with advanced disease, and newer types of immunotherapy are showing promise.
Immunotherapy drugs help the body’s immune system attack melanoma cells. The new findings in immunotherapy for advanced melanoma were presented at this year’s American Society of Clinical Oncology (ASCO) meeting. While the results are encouraging, the studies are still in early stages. The new drugs being studied are not yet available outside of clinical trials.
Anti-PD-1 Drug Studies
Melanoma cells often have a protein called PD-L1 on their surface that helps them avoid being found and destroyed by the body’s immune system. New drugs that block the PD-L1 protein, or the corresponding PD-1 protein on immune cells, can help the immune system recognize the melanoma cells and attack them.
Researchers from cancer centers around the world tested an anti-PD-1 drug called lambrolizumab in 135 patients with advanced melanoma. In more than a third of the patients, 38%, the melanoma shrank significantly in response to the drug, and in many others the disease stopped growing. On average, it took longer than 7 months for the cancer to get worse in patients taking lambrolizumab.
Also at the ASCO meeting, researchers presented longer-term data about another anti-PD-1 drug: nivolumab. It was tested in 107 people with advanced melanoma. The new results showed that overall, about one-third of patients responded to treatment with the drug. This confirms earlier results of the study that began about a year ago.
A third study presented at the ASCO meeting combined nivolumab with Yervoy (ipilimumab). Yervoy is another type of immunotherapy drug that is already approved to treat advanced melanoma. In the trial, researchers from Memorial Sloan-Kettering Cancer Center and colleagues gave a combination of the drugs to 53 people with advanced melanoma. Forty percent of them responded to the drug. About half of the patients had a serious side effect while getting both drugs, but these could usually be reversed.
Creating options for patients
Co-author of the lambrolizumab study, Omid Hamid, MD, of the Angeles Clinic and Research Institute in Los Angeles said the newer immunotherapy drugs may open up additional treatment options for patients. He noted that patients in the trials had higher response rates to the newer drugs than has been seen in the past, and importantly a significant number of the responses were durable, which means the improvements lasted. In addition, risk of serious side effects was lower with the anti-PD-1 drugs.
Hamid said the findings also open up several other areas of research. Because the side effects from the different types of immunotherapy drugs don’t overlap, they can be taken together. Combinations of drugs could potentially prove more effective than using them alone. Because not everyone responded to the drugs, Hamid said researchers are looking for predictive markers – ways to identify in advance which patients will respond.
And as with many cancer drugs, the new findings may lead to treatments for other cancers. Studies underway now are testing lambrolizumab and nivolumab in lung cancer patients. Hamid said future studies may include kidney cancer and brain cancer patients as well.
Safety and Tumor Responses with Lambrolizumab (Anti-PD-1) in Melanoma. Published online June 2, 2013 in the New England Journal of Medicine. First author: Omid Hamid, MD, The Angeles Clinic and Research Institute, Los Angeles.
Nivolumab plus Ipilimumab in Advanced Melanoma. Published online June 2, 2013 in the New England Journal of Medicine. First author Jedd D. Wolchok, MD, PhD, Memorial Sloan-Kettering Cancer Center, New York.