Two new studies give hope to melanoma patients

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FARMINGTON - Skin cancer, also known as melanoma, is the most common form of cancer in the United States and it is the only major cancer that is increasing in prevalence over time. Over 70,000 new cases of melanoma are diagnosed each year in the United States and while early detection can lead to safe removal, more advanced forms of melanoma kill over 10,000 patients annually. Two recently published studies are giving new hope for people who develop skin cancer.

Your skin cells are constantly being rubbed or scraped off and they need to be able to form new replacement skin cells. Cancer cells are normal skin cells that lose the ability regulate cell division and growth, they simply don’t know when enough is enough and they invade and push aside normal cells. The immune system is supposed to eliminate these cells but in cancer patients they don’t detect these cancer cells. So it is a two part problem, broken cell regulation and inability to mount an immune response. Current therapies include trying to kill cancer cells with toxic chemicals or try to regulate hormones that tell the cells to grow faster. What makes these experimental therapies special is they activate the immune system so it recognizes these cancer cells and selectively kills them.

The first therapy is in late phase clinical trials and uses a genetically modified herpes virus that invades cancer cells but cannot enter normal cells. This modified virus from Amgen called T-VEC invades the cancer cells makes them produce a chemical called GM-CSF which the immune system can detect and the cells that were hidden from the immune system get attacked. In advanced skin cancer, patients receiving T-VEC survived for 41 months instead of 21 months without this therapy and several were still cancer free three years after the therapy. The second new therapy is more preliminary and the results of the first ever study in humans was just released. This new experimental therapy is an autovaccine where a sample of an individual patients cancer cells are taken and the genes sequenced and run through computer algorithms to determine which parts will most activate the immune response. Those parts, called neoantigens, are created and given to the patient as a vaccine. By giving the neoantigen as a vaccine, the immune system identifies it and then can detect it on cancer cells as well. This study just evaluated whether the immune system was activated or not and it was highly activated. Further studies will have to be conducted to determine the proper dose and to see if patient cancer free survival is impacted.

During the middle part of the day in summer months, you need to protect the skin from the sun with clothing, a hat, and sunscreen with both UVA and UVB protection. The higher the SPF, the better but keep it at SPF 15 or more. Make sure you reapply every couple of hours if you remain in the sun because activity and sweat can take off your sunscreen. In addition, know what your skin looks like and if you detect a mole that looks different than it did before, is growing larger than it had been, or is no longer round, get it checked by a doctor so if it is skin cancer it can be removed quickly.

Michael White; Dept. Of Pharmacy Practice, UConn School of Pharmacy