Breast cancer drug may hold key to tackling most deadly type of melanoma

Breast cancer drug may hold key to tackling most deadly type of melanoma

23 July 2019

Barbara Holland tried everything to stop headaches for months before her doctor sent her for an MRI. Her scans showed a tumour in her sinus passages, and four tumours in her brain. In August 2015, she was diagnosed with mucosal melanoma.

Mucosal melanoma, which occurs on the inner surfaces of the body such as the mouth, nose and anogenital region and is not linked to UV exposure, has a very poor prognosis with less than 20% of patients surviving five years after diagnosis.

Now, an Australian-led international team of researchers has discovered that a drug traditionally used to treat a type of breast cancer may hold the key to treating this aggressive and deadly form of melanoma.

The international study, led by researchers from Melanoma Institute Australia, QIMR Berghofer Medical Research Institute and The University of Sydney as part of the Australian Melanoma Genome Project, has uncovered the diverse genetic drivers for mucosal melanoma as well as identified potential treatments.

Lead study author Professor Richard Scolyer, Co-Medical Director Melanoma Institute Australia, The University of Sydney and Royal Prince Alfred Hospital says the study allowed researchers to not only look for new drug targets, but to also match available targeted drugs to the specific genetic drivers in mucosal melanoma.

“We now understand the genetic drivers of mucosal melanoma, and can match those to potential treatments,” Professor Scolyer said. The study revealed that a currently available class of drug commonly used to treat breast cancer looks promising for treating mucosal melanoma.

“The ramifications of this study are immense and are critical in us reaching our goal of zero deaths from melanoma.”

Published online at Nature Communications, the study detailed the genetic analysis of 67 mucosal melanoma tumours from patients from Australia, China, the United States and Europe. Using both whole-genome sequencing and whole-exome sequencing, the authors identified diverse drivers that suggested that mucosal melanoma has potential therapeutic targets.

The majority of mucosal melanomas sequenced in the study showed potential susceptibility to currently available classes of drug. One in particular, CDK4/6 inhibitors, are a class of drug used to treat HR-positive, HER2-negative breast cancer.

“While advancements in treatment have drastically improved survival outcomes for cutaneous (or skin) melanoma patients, those treatments do not work as well for mucosal melanoma patients,” Professor Scolyer added.

“But now we can build our treatment arsenal for this group of patients – starting with CDK4/6 inhibitors used to treat a subtype of breast cancer.”

The study also found possible reasons why mucosal melanoma is less responsive to immunotherapy which has had such success in saving the lives of UV-related melanoma patients. It revealed that a mutation in some mucosal melanomas locks immune cells out of the tumour, rendering immunotherapy treatment ineffective.

“I’m one of the lucky ones,” said Barbara.

The tumour in her sinuses was removed with surgery, and after three years of immunotherapy, one of her brain tumours is no longer measurable and the others are stable.

“This news is so exciting for other mucosal patients and their families. Hopefully in the near future, they will be able to have the same positivity that I have.”

While rare in Western populations like in Australia, where it makes up less than 2% of all melanoma cases, mucosal melanoma makes up a third of all melanoma cases worldwide.

A previous study also coming from the Australian Melanoma Genome Project found that mucosal melanoma is not linked to UV radiation, as is the case with cutaneous (or skin) melanoma.

There are no known risk factors for mucosal melanoma, making prevention strategies difficult. It is also usually diagnosed at a later stage of disease due to the challenges of monitoring sites where it is found – the internal surfaces of the body.

“The next exciting step is for Melanoma Institute Australia to develop a clinical trial to test classes of drugs and their effectiveness for treating mucosal melanoma,” said study author Professor Georgina Long, Co-Medical Director Melanoma Institute Australia The University of Sydney and Royal North Shore Hospital

“This is the new frontier in melanoma treatment, with very real benefits for patients internationally, and we are proud to be leading the world in saving lives.”

Barbara is no longer on treatment and comes to MIA for three monthly scans.

“It’s amazing to know that there could soon be new treatments for this horrible disease. I think the best part about this discovery is that it gives hope,” said Barbara.

Australasian Melanoma Conference AMC2021
19 Nov - 20 Feb 2021

Australasian Melanoma Conference AMC2021

The 2021 Australasian Melanoma Conference (AMC2021) will held in Sydney, Australia.

Amie St Clair 10th Annual Ball
26 Jun 2021

Amie St Clair 10th Annual Ball

Celebrate the 10th anniversary of Amie St Clair Melanoma at the Annual Ball in Wagga Wagga!   

Riverina Melanoma Ride
14 Oct - 21 Oct 2021

Riverina Melanoma Ride

Melanoma survivor Matt Kean is doing a 1000km bike ride around the Riverina this October, to increase awareness of melanoma and raise funds for Amie St Clair Melanoma - MIA. There are many ways you can be part of this life-changing ride!

Queen's Birthday Honour for Professor Richard Scolyer
13 Jun 2021

 Queen's Birthday Honour for Professor Richard Scolyer

MIA's Prof Scolyer has been appointed as an Officer (AO) of the Order of Australia. 

Tags: melanoma
Sharing our research on the global stage at 2021 ASCO Annual Meeting
07 Jun 2021

Sharing our research on the global stage at 2021 ASCO Annual Meeting

Research from MIA was once again in the spotlight as findings were shared at the virtual ASCO21. 

Tags: melanoma
Australian researchers lead world in successful trial of new cancer treatment
03 Jun 2021

Australian researchers lead world in successful trial of new cancer treatment.

In a breakthrough which could extend to the treatment of other cancers, a new immune checkpoint inhibitor has proven effective in helping save the lives of advanced melanoma patients.

Tags: melanoma
Thank you doesn't seem enough for our melanoma nurses.
28 May 2021

Thank you doesn't seem enough for our melanoma nurses.

Whilst our research and clinical teams are trialling new treatments to save lives, it is our nurses who are on the front line providing care and support.

Tags: melanoma
Sharing our knowledge of melanoma on the global stage
20 Apr 2021

Sharing our knowledge of melanoma on the global stage

As leaders in the field of melanoma, clinicians and researchers from MIA shared their knowledge at the virtual 10th World Congress of Melanoma. 

Tags: melanoma
Community Fundraising Wrap Up Jan-Mar 2021
15 Apr 2021

Community Fundraising Wrap Up Jan-Mar 2021

The easing of COVID restrictions has meant the return of community events, and we recognise the generous support of our community fundraisers.

Tags: melanoma
Melanoma patients and their families urged to speak up and put national spotlight on melanoma.
15 Apr 2021

Melanoma patients and their families urged to speak up and put national spotlight on melanoma.

Melanoma patients and their carers are being urged to participate in a ground-breaking survey which will shape the future of melanoma treatment, research, support and funding in Australia.

Tags: melanoma
Support for Melanoma March has come from everywhere
12 Apr 2021

Support for Melanoma March has come from everywhere

We have been buoyed by the wonderful support for our Melanoma March campaign, and our mission to cover Australia in footprints continues into April!

An inspiring WA Melanoma Community Forum
26 Mar 2021

An inspiring WA Melanoma Community Forum

There was a wonderful feeling of community support amongst the melanoma patients, families and friends at the WA Melanoma Community Form. 

Tags: melanoma
Family of 8-year-old with melanoma calls on all Australians to step up to help save lives
26 Mar 2021

Family of 8-year-old with melanoma calls on all Australians to step up to help save lives

The Price family has decided to share their story to inspire Australians to support research into new melanoma treatments.

Tags: melanoma
Rethinking skin surveillance for high-risk melanoma patients
18 Mar 2021

Rethinking skin surveillance for high-risk melanoma patients

New research has provided evidence in favour of a structured skin surveillance program for high-risk melanoma patients.

Tags: melanoma
Australia's oldest melanoma survivor steps up to save lives on his 105th birthday
11 Mar 2021

Australia's oldest melanoma survivor steps up to save lives on his 105th birthday

Melanoma research saved Bert's life at 101 and now he wants to give back. 

Tags: melanoma
Predicting disease spread in thin melanoma
05 Mar 2021

Predicting disease spread in thin melanoma

A new MIA online risk calculator for clinicians can determine the likelihood of thin melanoma spreading.   

Tags: melanoma
Exploring our own clinical questions through MIA's new trials initiative
04 Mar 2021

Exploring our own clinical questions through MIA's new trials initiative

MIA has recently established a new division of our Clinical Trials Program which co-ordinates and manages investigator-led multi-centre trials. 

Tags: melanoma
Young researchers awarded Fellowships to pursue innovative treatments for melanoma
04 Mar 2021

Young researchers awarded Fellowships to pursue innovative treatments for melanoma

Two young researchers from MIA and The University of Sydney awarded Cancer Institute NSW fellowships.

Tags: melanoma
Young researchers receive boost to develop innovative treatment for melanoma
04 Mar 2021

Young researchers receive boost to develop innovative treatment for melanoma

Two young researchers from MIA and The University of Sydney awarded Cancer Institute NSW fellowships.

Tags: melanoma
Launch of Melanoma March 2021
01 Mar 2021

Launch of Melanoma March 2021

Aussies urged to leave their footprint on melanoma as efforts step up to save lives from the disease.

Tags: melanoma