Dr. Randy Martin: Skin cancer is the most common form of cancer, with over 13 million cases diagnosed in the United States annually. Among the cancers in this group, malignant melanomas are the deadliest because once they have metastasized and spread, they can become very aggressive. But hope may be on the horizon in the form of a new drug according to medical oncologist Vasily Assikis, M.D.
For the last two decades, treatment options for malignant melanoma have remained few. But the FDA has recently approved a new form of therapy which may offer a glimmer of hope to a few patients with certain kinds of metastasized, malignant melanoma.
Most people are familiar with chemotherapy, which is a treatment option involving pharmaceutical agents that target cancerous cells in the body. In the process, the drugs attack many normal cells, causing many familiar symptoms such as hair loss. The new drug, produced by Bristol Myers-Squibb and going by the name of Yervoy, is a unique type of immunotherapy, which uses the body’s own defense system to fight cancer.
The drug works by inhibiting a protein on the surface of some of the most important cells of our immune system, called the T-cells. By blocking the action of this particular protein, the drug turns the body’s immune system on, allowing it to go into major battle preparation to attack any foreign substance in the body, including malignant melanoma.
In clinical trials, patients with metastatic melanoma who were treated with Yervoy lived longer than those in a control group. In fact, more than 20 percent of the patients who received Yervoy in the trial lived at least two years, with some living longer.
“While a few months of extra time may not seem like a great medical advance, it is significant because patients with extensive melanoma often have a very shortened lifespan,” says medical oncologist and hematologist, Vasily J. Assikis,M.D. “This drug will not help all patients with malignant melanoma, but it will offer some hope for some patients whose future was previously very dark.”
Nearly 68,000 people develop new cases of melanoma in the United States each year and that number is rising. Approximately 8,700 people die each year from malignant melanoma.
But this new drug does not come without its own side effects. For starters, it’s estimated that it may cost $120,000 for a complete course of treatment four infusions, given over a three-month period of time. Also, because the drug turns on the body’s immune system, there can be some significant immune and autoimmune reactions including severe fatigue and diarrhea. And lastly, the effects are not immediate, because it does take some time for the immune system to begin its attack.
But for someone with extensive, stage four, malignant melanoma throughout the body, the side effects might be worth the extra time.
“For a patient, the extra time might mean going to his daughter’s wedding,” says Assikis. “Until now, the outlook for patients with advanced stages of this disease was really hopeless. The fact that we are finally seeing some movement towards better treatments for malignant melanoma is exciting.”
Dr. Randy Martin: So, while Yervoy is no silver bullet, people in the oncology community like Dr. Assikis are excited about this new direction in treatment options. And remember, in most cases, melanoma is preventable and treatable if detected early. Limiting exposure to the sun and getting regular checkups are still your best first line of defense against this category of disease.