Melanoma breakthrough

ack

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May 6, 2010
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Immunotherapy again

In what is being hailed as one of the biggest breakthroughs in melanoma treatment since the advent of immunotherapy, a new study has revealed that drug treatment before surgery is effective in preventing deadly spread of the disease.


The study, published today in the prestigious journal Nature Medicine, pooled data from six clinical trials where drug therapy was given before surgery, known as neoadjuvant therapy.


Researchers found that giving Stage III patients a short course of pre-operative targeted immunotherapy was effective, and the stronger a patient's response to that treatment in the first six to nine weeks, the greater the likelihood their disease would not recur after surgery. Remarkably, in the 75% of patients who responded well to dual immunotherapy given before surgery, only 3% saw their tumors return after surgery, suggesting that 97% will likely be cured.


"The neoadjuvant approach is a new way of dealing with melanoma and is a game changer for stage III patients with bulky disease that has spread to their lymph nodes," said Professor Georgina Long AO, Melanoma Institute Australia (MIA) Co-Medical Director and study senior author.


"We have flipped the 'surgery-then-drugs' rationale on its head. By using our arsenal of ground-breaking new treatments before surgical removal of the tumors, this approach is proving effective in stopping melanoma in its tracks and preventing its recurrence and spread to distant organs."


 
Awesome for sure. Cancer can be beaten. I had Stage 3 melanoma, fortunately it was resectable, had not spread to my lymph nodes. A double mole excision cured me.
 
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Congrats. Enjoy life!
 
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Keep out of the sun it’s just not worth the risk getting this terrible disease.in my teen years I used to go to the beach on a hot day without any sunscreen.because of this I get my skin checked every year.
 
Definitely a hot area in drug development. These drugs are quite safe, too. I'd imagine that the patient needs to express PD-L1 for the therapy to work (or other checkpoints).
 
I lost a dear friend to Melonoma. She was gone before I could visit her. Don't take this disease lightly.
 
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Definitely a hot area in drug development. These drugs are quite safe, too. I'd imagine that the patient needs to express PD-L1 for the therapy to work (or other checkpoints).
Could be PD1 or PDL1 checkpoint blockade therapy, but target can be upregulated with the appropriate combo therapy. CI therapy is circulating and that is possibly why they have limited effect on solid tumors compared to liquid cancers.
 
Perhaps even Yervoy CTL4 could be effective here too. I am amazed that this was took so long to be developed as a technique, as it seems so obvious. Combo therapy is based on this logic. Signalling molecules in combo with circulating CI infusions.
 
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Could be PD1 or PDL1 checkpoint blockade therapy, but target can be upregulated with the appropriate combo therapy. CI therapy is circulating and that is possibly why they have limited effect on solid tumors compared to liquid cancers.
Circulating, meaning that the Mab doesn't distribute out of the blood (to the actual tumor, where, hopefully, the T-cell is)? I see what you mean, I think. These are large proteins, and I think that their volume of distribution is about that of blood volume (~ 5 L), but I might be wrong. The interesting thing (among other things) is that there are patients who have very long responses. They have had confirmed complete responses that last very long. The other thing is that, at least initially, the investigators thought the patients had progressed because the tumors were increasing in size, but it was the TILs that were making the tumor look big, which is known as pseudo-progression.
 

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