Skin cancer’s deadliest form

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TAMPA, Fla. (Ivanhoe Newswire) – It brightens the day, and helps the grass grow. But the sun is taking more lives every year in the United States. Now, there's a new treatment for metastatic melanoma.

Christine Postoian has metastatic melanoma. It’s a skin cancer that spreads rapidly and aggressively. She says it’s no wonder — she spent most of her life soaking up the sun.

“I'd use baby oil and sometimes you'd add that little iodine to color your skin even further,” Postoian told Ivanhoe.

The survival rate for metastatic melanoma was eight months, but now it's up to 23 months, thanks to a newly approved FDA combination of drugs. The two drugs are known as BRAF and MEK drugs.

“You're better off today with our new repertoire of drugs than people ever were in the past,” Jeffrey Weber, MD, PhD, Director, Comprehensive Melanoma Research Center Moffit Cancer Center, Tampa, FL, told Ivanhoe.

This new drug combo essentially blocks all the pathways so the tumor can't spread. Dr. Weber compares it to a police chase.

“If you’re clever, not only do you block the main highway, but you block all the exits and all the other ability of the bad guy to get off the road. In that case you will definitely catch him, because he has no place to go,” Dr. Weber said.

For Postoian, the new treatment is like a ray of sunshine that hopefully means better health is on the horizon.

The cost of this new treatment is 16,000 dollars a month.

Epidemiologists tell us that sun exposure in the first three decades provide the greatest risk for melanoma.

To prevent melanoma — don't schedule outside activities during 11 a.m. and 3 p.m. Wear a wide brimmed hat with sunscreen and make a mole map of your body and keep track of it.

BACKGROUND: Melanoma is the most common form of cancer for young adults aged 25 to 29 and the second most common cancer in adolescents and young adults aged 15 to 29. In 2009, nearly 63,000 people were diagnosed with melanoma in the U.S., resulting in about 8,650 deaths. Metastatic melanoma means the disease has spread to other parts of the body and is difficult to treat and potentially fatal. It tends to affect those younger in age than other cancer patients. Until now treatments have been limited to single drugs, immunotherapy, and sometimes chemotherapy. The American Cancer Society projects that nearly 77,000 will be diagnosed and 9,500 will die from melanoma this year. (Source: American Cancer Society)

CAUSES: Metastatic Melanoma can start as a freckle or mole. It can develop from increased sun exposure. Some doctors think it develops during the first three decades of life. Preventing the disease can be as simple as staying out of the sun: limit sun exposure during the hottest parts of the day and use SPF 50 liberally when in the sun. (Source: American Cancer Society)

NEW TECHNOLOGY: Two new drugs taken every day have proven to block the spread of the tumors. The drugs are called Mekinist and Tafinlar. Dr. Jeffrey Weber compares the new treatment to a police chase: all exits must be blocked to capture the bad guys. These two drugs are used to block all pathways the cancer would normally take to spread, restricting its movement. The drugs, when taken together, have very few side effects, but some include fever and fatigue. The cost of this treatment can be $16,000 a month. (Source: Dr. Weber)

Jeffrey Weber, M.D., Senior Member, Director of the Comprehensive Melanoma Research at the Moffitt Cancer Center in Tampa, talks about a new drug combination to treat melanoma.

What are the two drugs?

Dr. Weber: There’s a BRAF inhibitor and a MEK inhibitor. These are two oral drugs that inhibit the so-called MAP kinase pathway at different points along the pathway. The BRAF inhibitor is a twice a day oral drug and the MEK inhibitor is taken once a day. Think of it this way: if you’re a policeman and you’re chasing a thief, and the thief is on the highway, how are you going to stop the thief? You lay these metal traps along the road at a road-block so he gets a flat tire and you capture him. But the thief is not stupid, the thief sees the trap and the road-block up the road and he gets off at an exit and avoids it. Then he gets back on after taking a side road and he manages to avoid getting arrested and he gets away. That’s the equivalent of resistance to BRAF. But if you’re clever, not only do you block the main highway but you block all the exits and negate the ability of the bad guy to get off the road. In that case you’ll definitely catch him because he has no place to go. So blocking the exits and blocking the main road is like adding a BRAF inhibitor and a MEK inhibitor, you add inhibition of this pathway that the tumor cells addicted to at multiple points along the pathway, which would give you a greater chance of killing the tumor cell and of prolonging survival for the patient.

So for the patients this is good stuff?

Dr. Weber: This is a major advance for melanoma patients. What’s very interesting about this, based on work in the lab and work in animals, is it’s one of the few times when you’ve added drugs together in our field and instead of increasing the side effects, you actually reduce the side effects. It turns out that when you give the BRAF inhibitors you have certain types of side effects, they’re not horrible compared to certain chemotherapies for example. .

Do you take them every day?

Dr. Weber: You take it continuously. We’ve had people almost four years on these two drugs doing fine.

So this combination is for?

Dr. Weber: Anyone with metastatic melanoma. It’s approved in either line of therapy, meaning you could be treated with these drugs if you’ve never had prior treatment for your melanoma, or if you failed a prior treatment. So we would use these drugs in people who failed immunotherapy or we would use them if the patients had never had prior systemic treatment for their disease.