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Mario E. Lacouture, MD, of Memorial Sloan Kettering Cancer Center, discusses the effect on patients of dermatologic toxicities associated with targeted therapies: their psychosocial impact, financial burden, physiological pain, and potential to alter therapy. But the side effects of targeted treatments can and should be addressed.
John A. Thompson, MD, of the Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance, discusses the latest immunotherapeutics for advanced melanoma, including pembrolizumab, trametinib, nivolumab, and dabrafenib.
Anthony J. Olszanski, RPh, MD, of Fox Chase Cancer Center, and Jedd Wolchok, MD, PhD, of Memorial Sloan Kettering Cancer Center, discuss therapies for treatment-naive patients with advanced melanoma (Abstract LBA1).
Claus Garbe, MD, of the University of Tuebingen, and Anthony J. Olszanski, RPh, MD, of Fox Chase Cancer Center, discuss the survival of sentinel lymph node-positive melanoma patients with and without complete lymph node dissection (Abstract LBA9002).
Andrew James Martin, PhD, of NHMRC Clinical Trials Centre, University of Sydney, and Anthony J. Olszanski, RPh, MD, of Fox Chase Cancer Center, discuss a form of vitamin B3 that reduced the incidence of new nonmelanoma skin cancers in high-risk patients (Abstract 9000).
Andrew James Martin, PhD, of NHMRC Clinical Trials Centre, University of Sydney, discusses a form of vitamin B3 that reduced the incidence of new nonmelanoma skin cancers in high-risk patients (Abstract 9000).
Jedd Wolchok, MD, PhD, of Memorial Sloan Kettering Cancer Center discusses therapies for treatment-naive patients with advanced melanoma (Abstract LBA1).
Claus Garbe, MD, of the University of Tuebingen, discusses the survival of sentinel lymph node biopsy–positive melanoma patients with and without complete lymph node dissection (Abstract LBA9002).
Shailender Bhatia, MD, of the Fred Hutchinson Cancer Center, discusses his paper on interleukin-12 DNA and regression of Merkel cell tumors (Abstract 504).
Catherine C. Park, MD, of the University of California, San Francisco, summarizes results from three clinical trials of radiation therapy for various cancers: metastatic melanoma, oropharyngeal squamous cell carcinoma, and breast cancer (Abstracts 215, 3, and LBA7).
Bristol-Myers Squibb announced on January 23 that the U.S. Food and Drug Administration (FDA) has approved nivolumab (Opdivo) in combination with ipilimumab (Yervoy) for the treatment of patients with BRAF V600 wild-type and BRAF V600 mutation–positive unresectable or metastatic...
At NYU Langone Medical Center and its Laura and Isaac Perlmutter Cancer Center, researchers have discovered an inherited genetic marker that might provide clinicians with a personalized tool to gauge an individual’s survival and determine which patients require closer monitoring in the years...
Melanoma is on the rise in women of childbearing age. Those at the greatest risk, according to new Cleveland Clinic research, are women younger than 50 who are pregnant or have recently been pregnant. After adjusting for age, tumor location, and stage, researchers from Cleveland Clinic's...
Physicians treating patients with metastatic melanoma may soon have a superior tool in their efforts to closely track the disease. A new study shows that a blood test that monitors blood levels of DNA fragments from dead cancer cells does a better job than the current standard test at tracking the...
Melanoma of the skin remains a fatal disease, and its incidence continues to rise, mostly in young adults during their prime. Surgery remains the most effective therapeutic modality, but patients’ survival depends on the stage of the disease at the time of diagnosis. Various therapeutic agents have ...
Daiichi Sankyo announced that applications have been submitted for market approval for vemurafenib (PLX4032/RG7204) for the treatment of metastatic melanoma to the FDA and the European Medicines Agency (EMA). Additionally, a premarketing application for approval for a companion diagnostic test has...
The FDA announced that sunscreen products meeting modern standards for effectiveness may be labeled with new information to help consumers find products that, when used with other sun protection measures, reduce the risk of skin cancer and early skin aging, as well as help prevent sunburn. The...
Novel treatments for metastatic melanoma dominated the buzz at the 2011 ASCO Annual Meeting and across the major news outlets, with reports that two agents with entirely different mechanisms of action could extend survival. The studies’ inclusion in the ASCO Plenary Session attested to the...
With two effective new treatments for advanced melanoma, the question has become how to best use them and how to manage their toxicities. Vemurafenib (Zelboraf) and ipilimumab (Yervoy)1 have different pharmacokinetics, which lend themselves to different patient types. Omid Hamid, MD, of The...
Vemurafenib (Zelboraf) received FDA approval on August 17, 2011, for treatment of metastatic or unresectable melanoma, based on the results of the phase III BRIM3 trial.1 BRIM3 compared vemurafenib to dacarbazine in 675 untreated patients with the BRAF V600E mutation. Vemurafenib targets the...
In this introductory installment of In the Clinic, The ASCO Post provides an overview of two new melanoma agents recently approved by FDA, with discussion on pivotal data leading to approval, dosage and administration, and managing drug-related toxicities. Watch for more on clinical use of novel...
At the Best of ASCO® Miami meeting, Omid Hamid, MD, The Angeles Clinic and Research Institute (www.theangelesclinic.org), Los Angeles, California, reviewed abstracts that received a great deal of attention at this year’s Annual Meeting—the new treatments for metastatic melanoma. He also described...
The first-in-class Hedgehog pathway inhibitor vismodegib appears to be a successful treatment for advanced basal cell carcinoma, a disfiguring and debilitating disease, according to a pivotal multicenter nonrandomized trial presented as a Best Abstract at a Presidential Session during the recent...
Researchers at the University of Pittsburgh Cancer Institute have documented the molecular activity through which the Merkel cell polyomavirus contributes to 80% of cases of Merkel cell carcinoma—a finding that holds promise for future therapies. The researchers are now working on testing more than ...
Vismodegib is a small-molecule, orally active hedgehog pathway inhibitor that has shown considerable promise in treating basal cell carcinoma and is currently being evaluated alone and in combination in early-phase trials in medulloblastoma and a long list of other cancers.1 Owing to its...
Physician-based screening leads to detection of thinner melanomas that were less likely to have negative prognostic attributes such as ulceration and dermal mitosis, according to a retrospective review of patient records and biopsy logs from 394 patients diagnosed with cutaneous melanoma. The...
When sentinel lymph node biopsy for the regional staging of melanoma was first introduced, it was recommended for any patient with a melanoma 1.0 mm in Breslow thickness or greater. Patients with thin melanomas were not thought to have a sufficiently high risk to warrant the additional cost and...
Patients with a previously diagnosed cancer have an increased risk of developing cutaneous melanoma, with the highest risk among patients who have had a prior diagnosis of melanoma, according to a report published in the Archives of Dermatology.1 Key Findings Using Surveillance, Epidemiology, and...
The FDA has approved ingenol mebutate (Picato) gel for the topical treatment of actinic keratosis. At a concentration of 0.015%, the gel is used once daily on the face and scalp for 3 consecutive days, whereas a 0.05% dosage form is used once daily on the trunk and extremities for 2 consecutive...
The FDA has approved vismodegib (Erivedge) to treat adult patients with basal cell carcinoma, the most common type of skin cancer. The drug is intended for use in patients with locally advanced basal cell cancer who are not candidates for surgery or radiation and for patients with metastatic...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication Peginterferon alfa-2b (PegIntron, Sylatron) was recently ...
“The development of nonmelanoma skin cancers secondary to RAF inhibitor treatment has been recognized since 2005, having been seen initially with sorafenib (Nexavar),” noted Mario E. Lacouture, MD, of Memorial Sloan-Kettering Cancer Center. Commenting on recently published studies in this setting,...
Keratoacanthomas and cutaneous squamous cell carcinomas are frequently observed in patients receiving the RAF inhibitor vemurafenib (Zelboraf) for treatment of BRAF-mutated melanoma. As discussed by Lacouture and colleagues in a recent Journal of Clinical Oncology article, these effects appear to...
The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology have become the most widely used guidelines in oncology practice. The Guidelines cover 97% of all patients with cancer and are continually updated by expert panels. The 2012 Guidelines include some completely...
In advanced melanoma, combination therapy with two investigational drugs—one targeting BRAF and the other the MEK pathway—achieved a median progression-free survival of 7.4 months, which rose to 10.8 months in patients who were optimally dosed, reported Jeffrey S. Weber, MD, PhD, Director of the...
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. The MEK inhibitor trametinib...
Metastatic melanoma was long considered untreatable and incurable. The FDA approval of ipilimumab (Yervoy) and vemurafenib (Zelboraf) ushered in a new era for this disease, and now additional treatment options are in late stages of clinical development. Dabrafenib, a novel oral BRAF inhibitor, and...
Delcath Systems, Inc, announced that it has submitted a New Drug Application (NDA) to the FDA, seeking approval for its chemosaturation system (CHEMOSAT) for use with melphalan hydrochloride in the treatment of patients with unresectable metastatic melanoma in the liver. The system is designed to...
I first became interested in treating skin issues associated with cancer about 10 years ago, during my dermatology residency training at the University of Chicago. Many of the agents under clinical development at the time, such as cetuximab (Erbitux) or sorafenib (Nexavar), were causing...
“This is a very exciting time in melanoma,” said Michael Sabel, MD, of the University of Michigan, Ann Arbor. “For years, we chugged along with few options for systemic therapy. Then in 2010 and 2011, we saw melanoma data presented at ASCO plenary sessions. At ASCO 2012, we expanded in these areas...
The likelihood of developing basal cell carcinoma was approximately 40 times higher among participants of the Childhood Cancer Survivor Study (CCSS) who received a dose of 35 Gy or more to the skin from radiation therapy than survivors who were not treated with radiation, according to a study...
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Indication In January 2012, vismodegib (Erivedge) was approved...
Two late-breaking studies presented at the 2012 European Society for Medical Oncology (ESMO) Congress highlight the promising potential of combining dual BRAF and MEK inhibitors for the treatment of BRAF-mutated metastatic melanoma. A phase II study showed that combining full doses of the BRAF...
Multikinase inhibitors (sorafenib [Nexavar], sunitinib [Sutent], pazopanib [Votrient], axitinib [Inlyta], regorafenib [Stivarga]) block various proteins including vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR). They have been approved by...
Tremelimumab did not produce a statistically significant advantage in overall survival compared to first-line standard-of-care chemotherapy in a phase III randomized trial reported in the Journal of Clinical Oncology. At final analysis, median overall survival by intent to treat was 12.6 months...
Mutational activation of BRAF is the most prevalent genetic alteration in melanoma, with ≥ 50% of tumors expressing the BRAF(V600E) oncoprotein. Vemurafenib (Zelboraf) produces tumor regression and improved survival in patients with late-stage BRAF-mutated melanoma. However, most patients relapse...
In a multicenter phase II study, trametinib showed “significant clinical activity” in a cohort of BRAF inhibitor–naive patients with BRAF-mutant cutaneous melanoma previously treated with chemotherapy and/or immunotherapy. Only minimal clinical activity, however, was observed among a cohort of...
At the recent American Academy of Dermatology 71st Annual Meeting in Miami Beach, researchers presented interesting findings regarding melanoma and other skin cancers. The ASCO Post brings you the following news briefs on these topics. Melanoma Incidence Decreases among Adolescents and Children An...
The FDA has approved technetium Tc 99m tilmanocept (Lymphoseek Injection), a radioactive diagnostic imaging agent that helps doctors locate lymph nodes in patients with breast cancer or melanoma who are undergoing surgery to remove tumor-draining lymph nodes. Tilmanocept is an imaging drug that...
At the recent American Academy of Dermatology Annual Meeting in Miami, researchers presented interesting findings regarding melanoma and other skin cancers, as well as dermatologic effects of cancer agents. The following is a summary of one such study. While alopecia is a common side effect of many ...