Australian researchers stopping melanoma in its tracks
11 September 2017
A team of Australian researchers has made the ultimate move in the battle to beat melanoma, successfully trialling a combination of new treatments to stop the disease in its tracks and prevent it from spreading or metastasising to distant organs.
Melanoma is the deadliest form of skin cancer, with one Australian dying from advanced melanoma every five hours.
Ground-breaking results from two international clinical trials conducted by investigators at Melanoma Institute Australia are being presented today at one of the world’s largest medical oncology conferences, the European Society for Medical Oncology (ESMO) 2017 Congress in Spain. The research has also been published in the prestigious New England Journal of Medicine today.
The trials, COMBI-AD and CheckMate 238, proved successful in preventing the spread of disease in Stage III melanoma patients whose tumours had been surgically removed. Until now, these patients were at a high risk (40−70 per cent) of their disease progressing to advanced and fatal melanoma.
“These results will change the way we treat melanoma patients as well as their quality of life,” says study author Professor Georgina Long (pictured), Conjoint Medical Director of Melanoma Institute Australia and Chair of Melanoma Medical Oncology and Translational Research at The University of Sydney.
“Until now, Stage III melanoma patients who have had their tumours surgically removed have simply had to play the waiting game, to see if their melanoma would metastasise or spread. Living with such fear severely affected them and their loved ones.
“Results from these clinical trials suggest we can stop the disease in its tracks – effectively preventing it from spreading and saving lives. Our ultimate goal of making melanoma a chronic rather than a terminal illness is now so much closer to being achieved,” she said.
In the COMBI-AD trial, patients were randomised to receive a combination of targeted therapies (dabrafenib and trametinib) or placebo for 12 months. Targeted therapies block the action of a particular gene which is a driver for melanoma. It was aimed at patients who are BRAF positive. It not only prevented resected Stage III melanoma from recurring, but it increased overall survival.
The CheckMate 238 trial involved patients with high risk Stage III and Stage IV disease who had had all melanoma surgically removed. They were randomised to be treated with the immunotherapy nivolumab or ipilimumab for 12 months. Immunotherapies reboot the immune system to attack the melanoma cells. Results showed nivolumab decreased the chance of relapse, and it had a superior safety profile over ipilimumab. This benefit was seen in patients regardless of BRAF mutation status. The follow up period is too short to yet determine long-term survival rates.
Research had already shown that targeted and immune therapies can successfully treat patients with advanced (Stage IV) melanoma that could not be removed surgically.
These clinical trials are the first in the world to give the treatments to melanoma patients at an earlier stage of the disease to prevent spread and recurrence.
“These clinical trials show we now have ammunition to prevent melanoma spreading and progressing, which until now was a critical area of disease behaviour where we had no control,” Professor Long said.
“This will change how melanoma is treated around the world, as we no longer have to passively wait to see if the melanoma spreads.
“We can now actively and effectively attack the melanoma at an earlier stage, reducing the dreadful anxiety for patients about progressing to a potentially terminal illness and ensuring they have much better outcomes,” she said.
History teacher and mother Renae Aslanis was a patient on the COMBI-AD trial. After having 10 lymph nodes removed, she decided to enter the clinical trial rather than just "watching and waiting". Now four-and-a-half years later, she is still "going strong"! Read more.
- Long G.V, et al. Adjuvant Dabrafenib Plus Trametinib for Stage III BRAF-Mutated Melanoma. New England Journal of Medicine.
- Weber, J. et al. Adjuvant Nivolumab Versus Ipilimumab in Resected Stage III or IV Melanoma. New England Journal of Medicine.
"International collaboration remains the key to ensuring this pioneering research continues so we can increase survival rates for advanced melanoma patients and move us closer to achieving our goal of zero deaths from melanoma," says Professor Georgina Long, of the clinical trial results presented at ESMO 2018.
Research that could change clinical practice for high-risk Stage III melanoma patients has been presented at the European Society for Medical Oncology (ESMO) Congress in Munich.
A larger, monthly dose of immunotherapy can give melanoma patients more freedom without sacrificing effectiveness.
The Australasian Melanoma Conference, hosted by the Australasian Melanoma Conference Committee, was held in Melbourne on the weekend, with many of MIA's clinicians in attendance.
The two men who discovered checkpoint inhibitors, the brakes of the immune system, were awarded the Nobel Prize in Physiology or Medicine on Monday, October 1.
The World Health Organisation (WHO) is releasing the 4th edition of Classification of Skin Tumours.
Former Executive Director of Melanoma Institute Australia Professor John Thompson awarded the prestigious 2018 RPA Foundation Research Medal.
Clinicians, patients and other stakeholders in the cancer community are invited to make submissions in support of the PBS listing for pembrolizumab.
The World Congress on Cancers of the Skin 2018 has featured many minds from MIA sharing their expertise and wealth of knowledge with over 1000 attendees from around the world.
Melanoma Institute Australia is delighted to announce the appointment of Matthew Browne as Chief Executive Officer (CEO).
It was a full house this week at Melanoma Institute Australia thanks to our ‘Melanoma in Practice: Nurse Conference’.
A new study from The University of Sydney shows that sunscreen reduces melanoma risk by 40 per cent when used from a young age.
Melanoma Institute Australia (MIA) has launched a free e-learning portal to educate healthcare professionals about the latest advances in melanoma diagnosis and treatment.
When David lost his life last year, he was 33, with three daughters under six.
Clinical trials are just that – trials in a clinical setting to evaluate the effectiveness or otherwise of individual and combination treatments.
Melanoma Institute Australia scooped the award pool at the Annual Scientific Meeting of the International Academy of Pathology.
Melanoma patients across Australia will benefit from the release of updated clinical care guidelines.
An American study has discovered a link between early detection and marital status in melanoma diagnosis.
An international course on melanoma pathology in Paris, France co-directed by Professor Richard Scolyer took place over the weekend.