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skin cancer

FDA Expands Approval of Ipilimumab to Include Pediatric Patients 12 Years and Older With Unresectable or Metastatic Melanoma

Today, the U.S. Food and Drug Administration (FDA) expanded the indication for ipilimumab (Yervoy) injection for intravenous use to now include the treatment of unresectable or metastatic melanoma in pediatric patients 12 years of age and older. Ipilimumab was evaluated in 2 trials of pediatric...

Skin Cancer
CNS Cancers

Expert Point of View: Lynn Schuchter, MD

DISCUSSANT LYNN SCHUCHTER, MD, the C. Willard Professor of Medicine at the Abramson Cancer Center at the University of Pennsylvania, Philadelphia, said the findings herald “a new era on two fronts…. Systemic therapy as initial treatment for patients with asymptomatic central nervous system (CNS)...

Skin Cancer
CNS Cancers

Drug Combinations Prove Effective Against Melanoma Brain Metastases

STUDIES PRESENTED at the 2017 ASCO Annual Meeting have shown that for melanoma that metastasizes to the brain, the combined use of checkpoint inhibitors and targeted agents can be effective.  In COMBI-MB, 58% of patients responded intracranially to the BRAF inhibitor dabrafenib (Tafinlar) plus the...

Skin Cancer

Educating Young People on Sun-Safe Behaviors and Reducing the Risk of Melanoma

“If minors don’t tan, then they may never become adult tanners,” Jeffrey E. Gershenwald, MD, said in explaining the emphasis on teaching sun safety behaviors to young children as part of the Melanoma Moon Shot Program at The University of Texas MD Anderson Cancer Center, Houston. Dr. Gershenwald is ...

skin cancer

Nivolumab Treatment Beyond Disease Progression in Advanced Melanoma

In a retrospective analysis reported in JAMA Oncology, Long et al found that a substantial proportion of patients with advanced melanoma derived benefit from continued nivolumab (Opdivo) treatment after Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1–defined disease...

skin cancer

Overall Survival With Nivolumab vs Chemotherapy in Ipilimumab-Refractory Advanced Melanoma

As reported in the Journal of Clinical Oncology by Larkin et al, the phase III CheckMate 037 trial has shown no difference in overall survival with nivolumab (Opdivo) vs investigator’s choice of chemotherapy in ipilimumab (Yervoy)-refractory advanced melanoma. More chemotherapy patients never ...

skin cancer
issues in oncology

Delaying Lymph Node Biopsy After Melanoma Diagnosis May Not Adversely Affect Survival Rates

Postponing lymph node biopsy more than 30 days after melanoma diagnosis does not adversely impact long-term clinical outcomes, according to findings published by Nelson et al in the Journal of the American College of Surgeons. Today, management of high-risk melanomas starts with surgical removal...

skin cancer

Dabrafenib Plus Trametinib in BRAF V600–Mutant Melanoma Brain Metastases

A phase II trial has shown that the combination of the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinst) produces responses in brain metastases in patients with BRAF V600–mutant melanoma. These findings were reported by Davies et al in The Lancet Oncology. Study ...

skin cancer

Melanoma-Specific Survival With Completion Dissection vs Observation for Sentinel Node Metastasis

The phase III MSLT-II trial showed that completion dissection was not associated with improved melanoma-specific overall survival vs observation in patients with sentinel node metastasis, although a benefit was observed in regional disease control. The findings were reported in The New England...

skin cancer

ASCO 2017: Higher Gut Bacteria Diversity Tied to Slower Metastatic Melanoma Progression

The blend of bacteria in the digestive tract of metastatic melanoma patients is associated with disease progression or delay in patients treated with immunotherapy, reported Wargo et al at the 2017 ASCO Annual Meeting (Abstract 3008). Their study of fecal samples from 105 patients treated with...

Skin Cancer

New Immunotherapy Combinations Gain Ground in Advanced Melanoma, but Results Preliminary

Attention is focused among the cancer community on identifying the optimal immunotherapy combinations, with more than 800 ongoing trials of combination therapy. Two studies presented at the 2017 Annual Meeting of the American Association for Cancer Research (AACR) reported promising preliminary...

Skin Cancer

Intratumoral Plasmid Interleukin-12 Boosts Response to Pembrolizumab

In patients with stage III/IV melanoma, immunologically “cold” tumors were rendered immunologically active through intratumoral injections of plasmid interleukin-12 (IL-12) combined with pembrolizumab (Keytruda).1 Describing the approach at the 2017 ASCO-SITC Clinical Immuno-Oncology Symposium,...

Skin Cancer

Immunotherapy Clinical Trials in Metastatic Melanoma

A Danish study reported in the European Journal of Cancer by Marco Donia, MD, PhD, of the Center for Cancer Immune Therapy, Herlev Hospital, Denmark, and colleagues indicates that more than half of patients with metastatic melanoma do not satisfy requirements for enrollment in phase III trials of...

Skin Cancer

Intermittent Vismodegib Regimens in Basal Cell Cancers

In a phase II trial reported in The Lancet Oncology, Brigitte Dréno, MD, of Nantes University, Nantes, France, and colleagues found that two long-term intermittent vismodegib (Erivedge) dosing regimens provided a similar reduction in the number of clinically significant basal cell carcinomas among...

Skin Cancer

Avelumab in Merkel Cell Carcinoma

On March 23, 2017, avelumab (Bavencio) was granted accelerated approval for treatment of patients aged ≥ 12 years with metastatic Merkel cell carcinoma. Avelumab is the first U.S. Food and Drug Administration–approved product to treat this disease.1,2 Supporting Efficacy Data Approval was based on ...

Skin Cancer

Neoadjuvant Immunotherapy in High-Risk Melanoma: A New Approach

Melanoma is an immunogenic tumor, as it expresses various melanoma-specific antigens. However, it is both biologically and clinically heterogeneous. Biologically, it expresses different melanoma antigens and has diverse genetic profiles among different patients. Clinically, it varies in the amount ...

Skin Cancer

Expert Point of View: Gary K. Schwartz, MD

Gary K. Schwartz, MD, Chief of Hematology/Oncology and Deputy Director of the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Medical Center, New York, is not sold on using the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) for all patients with...

Skin Cancer

Nivolumab/Ipilimumab Combination Improves Survival Over Ipilimumab Alone in Patients With Melanoma

The race is on to identify combinations of immune checkpoint inhibitors that can improve outcomes over the use of immune checkpoint inhibitor monotherapy. Updated results of the phase III CheckMate 067 trial found the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) improved survival in...

skin cancer

Novel Imaging Method for Predicting Immunotherapy Response

Although cancer immunotherapy can produce dramatic responses, only a minority of patients benefit from such therapy. Being able to differentiate treated responders from nonresponders early in the course of therapy would help to triage nonresponding patients away from ineffective therapies, reducing ...

Skin Cancer

Expect Questions About Continued Risk of Melanoma

Survivors of melanoma are more likely to limit their exposure to ultraviolet radiation than those who have not had the disease, but more than 10% continue to intentionally tan, according to a study published in Cancer Epidemiology, Biomarkers and Prevention.1 The study surveyed 724 people diagnosed ...

Skin Cancer

Some Melanoma Survivors Continue to Seek Sun Exposure, Risking Second, Potentially More Serious Melanoma

Long-term survivors of melanoma are more likely than those who have not been diagnosed with the disease to use sunscreen, protective clothing, and other means to limit exposure to the sun, according to a survey of melanoma survivors and controls about ultraviolet radiation exposure and protective...

Skin Cancer

Pembrolizumab Active in Mucosal Melanoma in KEYNOTE Studies

Three clinical trials of the immunotherapy pembrolizumab ­(Keytruda) have shown that it is active against a rare subtype of skin cancer, mucosal melanoma. The findings were presented by Butler et al at the 2017 European Cancer Congress (ECCO).1 Mucosal melanoma has often been excluded from...

Skin Cancer

Expert Point of View: Suzanne L. Topalian, MD

“Avelumab (Bavencio) is the very first drug approved for Merkel cell carcinoma, an orphan disease that is uncommon in the United States. For that reason, pharmacologic development has been slow. In this case, laboratory evidence provided a rationale for testing checkpoint inhibitors in Merkel cell ...

Skin Cancer

Avelumab Produces Durable Responses in Merkel Cell Carcinoma, Becomes First Drug Approved for the Rare Disease

Avelumab (Bavencio) achieved durable responses in patients with metastatic Merkel cell carcinoma, according to longer-term follow-up of the phase II JAVELIN study, the largest study conducted to date in this relatively rare orphan cancer.1 Results were presented at the 2017 American Association for ...

skin cancer

Conditional Survival After Initial Diagnosis and Treatment of Stage III Melanoma

In an Australian study reported in the Journal of Clinical Oncology, Haydu et al found that conditional melanoma-specific survival was worse within the first 2 years of diagnosis of stage III disease for men, increasing age, and increasing American Joint Committee on Cancer (AJCC) stage. The...

skin cancer

Ratio of T-Cell Invigoration to Tumor Burden Associated With Immunotherapeutic Response

Matching the size of a tumor to the body’s immune response could help physicians tailor immunotherapy treatments for patients with metastatic melanoma. Researchers found that patients who didn’t respond to treatment had an imbalance between the size of their tumor and how exhausted...

Skin Cancer

FDA Approves Avelumab for Metastatic Merkel Cell Carcinoma

The U.S. Food and Drug Administration (FDA) granted accelerated approval to avelumab (Bavencio) on March 23, 2017, for the treatment of adults and pediatric patients 12 years and older with metastatic Merkel cell carcinoma, including those who have not received prior chemotherapy. ­Avelumab is a...

skin cancer

AACR 2017: Ipilimumab/CVA21 Combination Treatment Shows Promise in Advanced Melanoma

Treatment with a combination of ipilimumab (Yervoy) and coxsackievirus A21 (CVA21; Cavatak) led to durable responses in a number of patients with advanced melanoma, including some whose melanoma had progressed despite prior treatment with an immune checkpoint inhibitor, and fewer-than-anticipated...

skin cancer

AACR 2017: Adding the IDO-Pathway Inhibitor Indoximod to Pembrolizumab Improved Response Rate in Melanoma

Adding the investigational immunotherapy indoximod to the immunotherapy pembrolizumab (Keytruda) increased the proportion of patients with advanced melanoma who responded to treatment compared with previously reported response rates for pembrolizumab monotherapy, according to interim results from a ...

Skin Cancer

Gut Bacteria May Enhance, or Hamper, Response to Anti–PD-1 Agents

The microbiome has become an area of intense interest for many health-related reasons. Add to this list the potential for a positive or a negative effect on responsiveness to immunotherapy. Gut microbiota that were more diverse, and that contained an abundance of a particular bacterial species,...

skin cancer

AACR 2017: Combination of Nivolumab and Ipilimumab Improved Overall Survival in Advanced Melanoma

Among patients with advanced melanoma, those who received both nivolumab (Opdivo) and ipilimumab (Yervoy) had improved overall survival compared with those who received only ipilimumab, and appeared to have more favorable survival outcomes compared with those who received nivolumab, according to...

skin cancer

Survival in Advanced Melanoma With Ipilimumab at 10 mg/kg vs 3 mg/kg

In a phase III trial reported by Ascierto et al in The Lancet Oncology, treatment with ipilimumab (Yervoy) at 10 mg/kg vs 3 mg/kg resulted in improved overall survival in patients with advanced unresectable or metastatic melanoma. As noted by the investigators, although options for first-line...

skin cancer

FDA Approves Avelumab for Metastatic Merkel Cell Carcinoma

The U.S. Food and Drug Administration (FDA) today granted accelerated approval to avelumab (Bavencio) for the treatment of adults and pediatric patients 12 years and older with metastatic Merkel cell carcinoma, including those who have not received prior chemotherapy. Avelumab is a programmed cell...

Issues in Oncology
Skin Cancer

Progress Being Made in Understanding Immunotherapy Resistance

A key challenge in advancing immunotherapies is to understand mechanisms of response and resistance. Emerging research in this area—including evidence that early on-treatment biopsies can predict response—was discussed at the 2017 ASCO-SITC (Society for Immunotherapy of Cancer) Clinical...

skin cancer

Belgian Study Combines BRAF and MEK Inhibition in Advanced BRAF 600–Mutant Melanoma

In a Belgian two-center phase II trial reported in The Lancet Oncology, Schreuer et al found that rechallenge with the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) showed activity in patients with BRAF V600–mutant melanoma whose disease had progressed on...

skin cancer

Binimetinib vs Dacarbazine: Which Was More Effective in NRAS-Mutant Melanoma?

In the phase III NEMO trial reported in The Lancet Oncology, Dummer et al found that treatment with the MEK inhibitor binimetinib improved progression-free survival vs dacarbazine in patients with advanced NRAS-mutant melanoma. Study Details In the open-label trial, 402 patients from 118 sites in ...

skin cancer

Marie-Andrée Forget, PhD, on Metastatic Melanoma: Update From MD Anderson

Marie-Andrée Forget, PhD, of The University of Texas MD Anderson Cancer Center, discusses study findings on the impact of checkpoint blockade prior to adoptive cell therapy using tumor-infiltrating lymphocytes for metastatic melanoma. (Abstract 138)

skin cancer

Howard Kaufman, MD, on Merkel Cell Carcinoma: Treatment Update

Howard Kaufman, MD, of Rutgers Cancer Institute of New Jersey, discusses a subgroup analysis of efficacy results on avelumab in chemotherapy-refractory metastatic Merkel cell carcinoma. (Abstract 80)

skin cancer

Are Most Patients With Metastatic Melanoma Eligible for Immunotherapy Clinical Trials?

A Danish study reported in the European Journal of Cancer by Donia et al indicates that more than half of patients with metastatic melanoma do not satisfy requirements for enrollment in phase III trials of immune checkpoint inhibitors. Study Details The study involved 276 unselected cases...

skin cancer

ASCO-SITC Clinical Immuno-Oncology Symposium: Response to Cancer Immunotherapy May Depend on Gut Bacteria

Researchers have found a link between microbes in the gut (the microbiome) and response to immunotherapy. In the study, the ability of patients with advanced melanoma to respond to programmed cell death protein 1 (PD-1) immune checkpoint inhibitors depended on the presence of a diverse microbiome...

skin cancer

Health-Related Quality of Life in Pivotal Trial of Adjuvant Ipilimumab in Stage III Melanoma

As reported in The Lancet Oncology by Coens et al, there was little difference between adjuvant ipilimumab (Yervoy) vs placebo in health-related quality of life in patients with high-risk stage III melanoma in the phase III EORTC 18071 trial supporting the 2014 approval of ipilimumab in this...

skin cancer

Disease Symptoms Are the Most Frequent Indicators of Recurrence in Patients With Stage II Melanoma

Recurrences of early-stage (stage II) melanoma are more often detected by patients and their physicians than by routine imaging tests, according to study results published by Berger et al in the Journal of the American College of Surgeons. “We are most concerned about patients who have stage ...

skin cancer

Intermittent Vismodegib Regimens in Patients With Multiple Basal Cell Carcinomas

In a phase II trial reported in The Lancet Oncology, Dréno et al found that two long-term intermittent vismodegib (Erivedge) dosing regimens provided a similar reduction in the number of clinically significant basal cell carcinomas among patients with multiple lesions. Study Details In the ...

Skin Cancer

Link Between Alcohol Intake and Increased Risk for Melanoma

Although alcohol consumption is associated with increasing the risk of many cancers, including liver, pancreatic, colon, rectal, and breast, the link between alcohol and higher risk of melanoma is equivocal. Now, a large prospective study by Andrew Rivera, MD, of Harvard Medical School, Boston, and ...

skin cancer

ECCO 2017: Pembrolizumab Shows Activity in Mucosal Melanoma in Multiple KEYNOTE Studies

Three clinical trials of the immunotherapy pembrolizumab (Keytruda) have shown that it is active against a rare subtype of skin cancer, mucosal melanoma. The findings were presented by Butler et al at the 2017 European Cancer Congress (ECCO) (Abstract 1142). Until now, mucosal melanoma has often...

skin cancer

ECCO 2017: Melanoma Death Rates Will Fall by 2050, but Number of Deaths Will Increase

By 2050, the death rates from malignant melanoma will have decreased from their current levels, but the numbers of people dying from the disease will have increased due to the aging of populations. However, if new treatments for the deadly skin cancer prove to be effective, the numbers of deaths...

Skin Cancer

New President of the Skin Cancer Foundation Emphasizes Public Education to Reduce Skin Cancer Incidence and Deaths

The statistics on the rising rates of skin cancer are alarming. According to the Skin Cancer Foundation, each year over 5.4 million cases of nonmelanoma skin cancer are treated in more than 3.3 million people, and an additional 76,380 people are diagnosed with the deadliest form of skin cancer,...

skin cancer

Results of International Cross-Sectional Survey Reveal Gaps in Primary and Secondary Skin Cancer Prevention, Perceptions, and Knowledge

A large international survey on sun exposure behaviors and skin cancer detection found there are many imperfections and geographic disparities in primary and secondary prevention of skin cancer. This information could help inform future awareness campaigns developed to address the global need to...

Skin Cancer

Investigational Immunotherapy for Advanced Melanoma

The investigational immunotherapeutic IMC-20D7S was found to be well tolerated and somewhat active in patients with advanced melanoma, including one complete response, according to the results of a phase I/Ib trial reported by Danny N. Khalil, MD, PhD, and colleagues in Clinical Cancer Research....

Skin Cancer

Novel Immunotherapy Combinations May Be the Future of Melanoma Treatment

The future treatment of melanoma may rely on combinations of immunotherapy agents beyond the current checkpoint inhibitors, and they are entering clinical trials, according to Jeffrey Weber, MD, PhD, Deputy Director of the Laura and Isaac Perlmutter Cancer Center at New York University Langone...

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