Genomic medicine may revolutionize melanoma treatments

May 25, 2010 6:11:56 PM PDT
Melanoma is the fastest growing cancer in the U.S. and worldwide. If it's not caught early, it's deadly. There are few treatment options available, but that could be changing thanks to genomic medicine.

The median lifespan for patients with advanced melanoma is less than a year. But there's growing excitement among the melanoma community about some experimental treatments in clinical trials right now at St. Mary's Hospital in San Francisco.

The new treatment consists of pink pills called PLX 4032. It is a novel treatment for melanoma. It's targeted therapy given only to patients with a genetic mutation called B-RAF that causes their cancer to rapidly multiply.

Earlier research showed impressive results; one of the patient's tumors all but disappeared 15 days after taking the pills.

It turns out, about 60 percent of malignant melanoma patients are B-RAF positive, including Marian Erickson.

"I found a mole on the back of my leg, and it had changed a little, it was a little red. And my mom said 'you should have that checked,'" she said.

She had that mole removed and melanoma was believed to have been caught early enough. But four years later, she noticed a lump in her groin she thought was a hernia.

"I had let it go a year without, not having it checked, not thinking anything of it, not knowing the seriousness of it," she said.

The melanoma had invaded her lymph nodes. She had surgery last year, but the cancer came back.

Since Marian is B-RAF positive, she qualified for a stage-3 clinical trial testing PLX 4032 against the standard of care for advanced melanoma -- chemotherapy. The trial is randomized, but Marian just learned she'll be on the new drug -- B-RAF inhibitor.

"I've been given a new lease on life, that's how I took it. I was really depressed, and I mean I felt my prognosis was poor, even though it was localized, I could feel the nodes growing in my leg," she said.

Dr. Lynn Spitler is director of the Northern California Melanoma Center at St. Mary's in San Francisco.

"There are a number of really very novel, promising agents available now that we've never had before," she said.

Spitler is also involved in a clinical trial of Oncovex, which is injected into melanoma tumors under the skin.

"It's genetically engineered so that it enters the tumor cells and leaves normal cells and causes the tumor cells to break down," she said.

And it's designed to boost the patient's own immune response to attack other tumors that weren't injected. But Spitler points out clinical trials are critical in determining whether these new treatments are truly effective.

"There have been a lot things in the past that have looked very promising. Bio-chemotherapy was used all over the country and they were reporting 70 percent response rates, but at the end of the day when it was tested against DTIC or combination chemotherapy, it wasn't any better," she said.

Marian is just grateful for the chance to take part in a study that could revolutionize the treatment of melanoma.

"This is like, really a new lease on life," she said.

St. Mary's is the only location in Northern California where these two clinical trials are taking place and both are still recruiting.


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