Skin cancer trial results 'exciting'

scan of lungs The image on the left shows melanoma which has spread into the lungs - the large grey area are tumours. On the right, the tumours have shrunk after treatment.

The results of two international trials against advanced skin cancer have been hailed as "exciting and striking".

Both treatments, for advanced melanoma, are designed to enable the immune system to recognise and target tumours.

The findings were released at the American Society of Clinical Oncology conference in Chicago.

The experimental drugs, pembrolizumab and nivolumab, block the biological pathway cancers use to disguise themselves from the immune system.

Advanced melanoma - skin cancer which has spread to other organs - has proved very hard to treat.

Until a few years ago average survival was around six months.

Improved survival

In a trial of 411 patients evaluating pembrolizumab - 69% of patients survived at least a year.

The drug, which used to be known as MK-3475, is also being tested against other tumour types which use the same mechanism to block attack from the immune system.

Dr David Chao, consultant oncologist at the Royal Free London NHS Foundation Trust, is conducting trials in both melanoma and lung cancer patients. He said:

"Pembrolizumab looks like it has potential to be a paradigm shift for cancer therapy."

One of his patients, Warwick Steele, aged 64, has been receiving infusions of pembrolizumab every three weeks since October.

Before the treatment started he could barely walk because the melanoma had spread to one of his lungs and he found it hard to breathe.

"I got tired simply standing up and was literally too exhausted to shave. But now I feel back to normal and can do gardening and go shopping".

Scans of his lungs - shown above - reveal that after just three infusions, the drug appears to have completely cleared the cancer from his lung.

Warwick Steele says the treatment that cleared his lung of cancer has been a lifeline

Combination therapy

The other drug, nivolumab, was tested in combination with an existing licensed immunotherapy, ipilimumab.

In a trial of 53 patients, survival was 85% after one year, and 79% after two years.

John Wagstaff, Prof of medical oncology at Swansea College of Medicine is part of a larger trial of these two drugs.

He said: "I am convinced that this is a breakthrough in treating melanoma.

"The trial is still "blinded" so we don't know what treatments the patients are getting, but we have seen some spectacular responses."

Professor Peter Johnson, Cancer Research UK's chief clinician, said: "It's exciting to see the range of new treatments that are emerging for people with advanced melanoma."

But doctors are urging caution. The results which have been published are of Phase I, early stage trials.

Much larger Phase III trials are underway involving many UK hospitals.

Only when they report, in about a year's time, can clinicians be sure what the likely benefits will be.

Like all drugs, the experimental treatments have side effects. Warwick Steele said he experienced night sweats and even had two brief blackouts when on the new drug.

But he said it was well worth it, and doctors were now treating these symptoms.

Fergus Walsh Article written by Fergus Walsh Fergus Walsh Medical correspondent

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  • rate this

    Comment number 88.

    If like me you have been through cancer, albeit not skin cancer, you look upon these results with great pleasure and respect for the people carrying out the research and hope for the day when all cancers will be a thing of the past.

  • rate this

    Comment number 75.

    Softly Softly catchee monkey....

    We are beating cancer, a little more each decade, but it is so painfully slow for those who are suffering.

    Even if these drugs do not eventually pan out as the more optimistic forecasts predict, they will add to the knowledge for the next generation of science.

    This is good stuff .... if bewilderingly complicated!

  • rate this

    Comment number 29.

    Having had a type of Skin cancer 3 years ago(mine has been completely cleared so far) this is a very exciting development and if this can be used on other tumours the positives could be endless.But lets be patient and cautious but also positive that breakthroughs are happening like this.

  • rate this

    Comment number 28.

    We have had a number of cancer breakthroughs dealing with specific cancers. These have been real and relevant to those cancers.This breakthrough, however, is highly significant and has the potential to treat many cancers where tumours defy detection by the immune system.

    Folk are right to be cautious, for hopes mustn't be raised, nor should we change our caution regarding sunbathing or smoking!


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