Doctors don’t like to give their patients false hope. Doctors who treat late-state cancer patients REALLY don’t like to do that.
So when statements like “astounding”, “striking” and “unprecedented” came out of the mouths of some of the country’s leading oncologists yesterday, one had to sit up and take notice.
They were talking about the results of two studies presented at the American Society of Clinical Oncologists (ASCO) annual meeting in Chicago that – for the first time – showed two new treatment options to extend the lives of patients with late-stage melanoma.
It is the deadliest skin cancer on earth.
Most patients die within a year of diagnosis. Equally troubling is the fact that, until now, oncologists have had very little ammunition in their drug arsenals to stop melanoma from running its course.
The first study released Sunday focused on an experimental drug called vemurafenib. It was given to 675 people worldwide with late stage metastatic melanoma. The drug targets a mutated gene that tells cancer cells to grow in 50 percent of all melanoma patients. But for nearly half of all the patients in the trial the drug not only killed cancer cells, it shrunk the size of tumors as well.
Vemurafenib was compared to a group of late-stage melanoma patients who were given a chemotherapy drug that’s been around since 1975 – and only 5.5 percent of them responded. Just 10 percent of melanoma patients have ever responded to the type of chemotherapy treatment followed in the study. Vermurafenib is also taken orally and does not cause as many nasty side-effects as chemotherapy.
“It’s very exciting. Melanoma has been the graveyard of our hopes for decades. For the very first time, we’re able to offer advanced melanoma patients the prospect for living longer,” ASCO President Dr. George Sledge told the NewsHour. He added that he expects FDA will move quickly on approval. “When you up your game tenfold all at once people are likely to move it through.”
One of the authors of the study, Dr. Paul Chapman of the Memorial Sloan- Kettering Cancer Center in New York City, was equally gushing. “I’m on a high,” he told the NewsHour. “Up until now, in my field, we’ve had some treatments but it only helped a small percentage of patients. With all of these studies, the underlying question is: Do people really live longer as a result of this. And that’s what we were able to show.”
Patients who took the drug found it worked within 72 hours. Six months later, 83 percent of them were still alive. That translated into a 63 percent risk of death.
The second study looked at how patients with late-stage melanoma did on another new drug sold under the name Yervoy. It does not target cancer cells; instead it stimulates the patient’s immune system, which allowed them to better ward off the spread of the disease.
Researchers said 21 percent of the Yervoy patients were alive after three years compared to 12 percent that got chemotherapy and placebo.
According to the American Cancer Society, melanoma is diagnosed in 68,000 people every year. Not all melanomas can be prevented, but doctors believe that limiting exposure to UV light can significantly reduce the risk of getting it.
Researchers in Chicago said now they have to figure out the best way to use the new drugs – whether to give them at the same time, or one at a time.
And they said it will take time before it’s known exactly how long the therapies can extend the lives of melanoma patients because they were so surprised at the success of vemurafenib that they stopped the trial so all the patients in the study could take it.
Dr. Lynn Schuchter, of the University of Pennsylvania’s Abramson Cancer Center, has treated her patients with vemurafenib and called the new drug “really practice-changing.”
“The responses can happen within days,” she said. “The nurses and I literally have tears of joy in clinic as we’re seeing hope in the eyes of our patients.”
Even so, she cautioned that there is much work to be done: While the response rate is “really dramatic,” she said, “after nine months or a year of therapy, the melanomas become resistant to the therapy and the cancer cells outsmart the drugs. So in general, this is an important new foundation to build upon.”
Read more on the study from ASCO here.