5 minutes with Associate Professor Georgina Long
17 December 2015
What research projects and trials are you currently working on?
There are many research projects and clinical trials that I am working on, most of which are collaborations across MIA, or collaborations with national and international colleagues. The projects cover a range of areas, including: the genetic characteristics of melanoma itself; why melanoma responds or becomes resistant to drug therapies (and we have projects looking at combined targeted therapies and combined immunotherapies); and projects as to why some people’s genetics might predispose them to certain side-effects with drug therapies.
We are working on numerous clinical trials many are MIA home-grown trials, including the neoadjuvant study of targeted therapy for bulky stage III BRAF-mutant melanoma. This study has a dual purpose: 1) to see if we can shrink the melanoma to become more easily resectable by the surgeons; and 2) whether we can give a course of drug therapy to prevent melanoma spreading to distant sites like the liver, lung and brain.
We are also in the midst of writing a protocol for a similar neoadjuvant approach, however using combined immunotherapy and targeted therapy. We have recruited more than half the number of patients required for the Australian Brain Collaboration, which is exploring combined nivolumab and ipilimumab versus nivolumab alone in active brain metastases.
In 2016 we will be opening trials of new combinations of immunotherapies for patients with metastatic melanoma. We are recruiting very well to an adjuvant study for stage III melanoma of pembrolizumab versus placebo because at the moment, the standard of care for stage III is observation with close monitoring. This gives you an idea of some of the projects, but I’ve really only touched on 10% of all the work we are doing. We have recently submitted the first results from our Genome Project to be reviewed for publication, and these results have very important implications for patients with acral or mucosal melanoma.
You presented world first research at the biggest melanoma conference in the world recently. Tell us about this research?
I presented some exciting results from several international phase 1 clinical trials that we have conducted here at MIA. The first was a phase 1 (first in humans) study of pembrolizumab, an anti-PD-1 antibody, combined with ipilimumab, an anti-CTLA-4 antibody. I reported on the first efficacy results and toxicities. It was well tolerated using a smaller dose of ipilimumab, and only 17% of patients developed a grade 3-4 immune related adverse event. The response rate, meaning those that had a deep response in their melanoma, was 56% which is similar to what has been reported in a large study of nivolumab, another anti-PD-1 drug, combined with ipilimumab, however with ipilimumab at a full dose.
The second study I presented was another world-first phase 1 study (first in humans) of the oncolytic virus T-VEC with pembrolizumab. This had a response rate of 56%; however this was only in 16 evaluable patients, so very small numbers. The combination was very well tolerated with no new side effects, but similar side effects to what you may see with each drug alone.
Another study I presented was a pooled analysis of over 600 patients who had received combined targeted therapy, a BRAF and MEK inhibitor (dabrafenib and trametinib), for BRAF-mutant melanoma across several randomised trials in stage IV. Interestingly, the greatest predictor of overall survival was the patient’s level of LDH before they started the drug. LDH is a protein that we produce when our normal cells turnover, however may rise above normal levels if the melanoma is particularly aggressive.
What are your goals for research in the future?
I have a very simple goal and that is to prevent and cure melanoma and hope that the results we see in melanoma can be used in other cancers.
What drives you to work so hard and achieve such amazing results?
My drive is doing something positive for the human race. Although I love doing things for individuals and I am driven by the patients I see in clinic, the greatest thing is to think that you may be impacting thousands of people, not only those with melanoma, but people with other cancers. It is hard work to conduct so many clinical trials: it’s not easy, it requires a lot of effort, expertise and teamwork, but it’s worth it when you see the results we have seen in the last 3-4 years. And we believe we are curing some people with metastatic or stage IV melanoma.
How will you celebrate Christmas this year?
I will be celebrating Christmas with my family. If it wasn’t for my family and their support, there is no way I could do what I do. My husband is an amazing support for me and the work I do. In fact, the results I see from the work I do with my colleagues at MIA, I really have to say are the result of his hard work as well.
Clinicians around the world now have access to a new online calculator that predicts the risk that a patient’s primary melanoma has spread to nearby lymph nodes.
Professor Long has been appointed as an Officer (AO) of the Order of Australia (General Division) for distinguished service to medicine, particularly, to melanoma clinical and translational research, and to professional medical societies.
“I had a complete response within about six months. All of my tumours disappeared."
‘We are extremely proud of our ongoing contribution to the global effort to save lives from melanoma, with Dr Silva’s prestigious award proof that we continue to lead the way,'
MIA's Co-Medical Director, Professor Richard Scolyer, has achieved a Google Scholar h-index of 100.
We know what Melanoma March means to our community, so when we had to cancel our physical events, we created Melanoma March Virtual so that everyone across Australia could still connect to honour loved ones and support each other.
A must-read personal account by Garry Maddox in The Sydney Morning Herald of how immunotherapy is revolutionising melanoma treatment.
On Friday, a publication that lays out the steps needed to find out if a systematic screening program for melanoma would benefit all Australians was published in the Australia & New Zealand Journal of Public Health.
Melanoma March events have been cancelled. A Virtual March will be held on Sunday 29th March. Read this statement from MIA CEO Matthew Browne.
Thank you to the thousands of Aussies who bought ‘Game On Mole‘ t-shirts, took selfies, shared t-shirt pics on social media and started lifesaving conversations around sun safety and skin health.
Melanoma patients now have greater access to subsidised immunotherapy thanks to additional treatments today being listed on the PBS.
Brisbane couple Leon and Tamra Betts were, like thousands of others around Australia, on the couch watching MAFS when newlywed Natasha ran through her weekly beauty routine. When they heard the 26-year-old mention solarium use, they were shocked, and then saddened, prompting this open letter to all young Australians.
Professor Richard Scolyer, Co-Medical Director of Melanoma Institute Australia, will welcome international attendees this weekend to a sold-out, two-day course on ‘Pigmented Lesions and Other Hot Topics in Dermatopathology’.
It is time for a reality check on solariums.
They have no place in anyone’s beauty routine.
Throughout January our community created, hosted and participated in some amazing events, each of them helping us on our quest to reach zero deaths from melanoma.
Australian television presenter, interior designer and mother Kyly Clarke has been announced as the new Ambassador for Melanoma Institute Australia (MIA) and its national awareness and fundraising campaign Melanoma March.
Melanoma Institute Australia has recently partnered with three other organisations to boost support for melanoma patients and their carers across Australia.
Melanoma patients and their families across Western Australia will benefit from strengthened and expanded services with the merging of melanomaWA and Melanoma Institute Australia.
Australian researchers have played a critical role in the discovery of a potential new test to predict which early stage melanoma patients are at high risk of their disease recurring and progressing.
We are extremely grateful for our community fundraisers, who, even in this difficult time, have given up their time and effort to fundraise so we can continue to work towards our goal of zero deaths from melanoma.