High-risk Stage III melanoma patients to benefit from Australia/Netherlands collaboration

High-risk Stage III melanoma patients to benefit from Australia/Netherlands collaboration

23 October 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.

The OpACIN-Neo study, led by a team out of the Netherlands with a large number of patients recruited from Melanoma Institute Australia, showed a modified combination of the immunotherapies ipilimumab and nivolumab given prior to surgery produced a response in over 70% of patients. Importantly, there were drastically reduced side effects for patients and remarkably, none of these patients have relapsed to date.

Stage III patients are those whose melanoma has spread to their lymph nodes. Standard therapy for these patients is to undergo surgery to remove their melanoma, however those who undergo surgery alone have a significant risk (40-70%) of their disease recurring and progressing to Stage IV. Research in Stage IV melanoma patients demonstrates that combining ipilimumab and nivolumab is more effective than nivolumab alone, however this combination of drugs often causes extreme side effects for patients with many unable to continue treatment. Extrapolating from this data, the OpACIN-Neo study aimed to modify the dose of combined ipilimumab and nivolumab to reduce the incidence of toxicity while extending the efficacy seen in Stage IV patients to those with high-risk Stage III disease.

Previous research has shown that giving immunotherapy prior to surgery shrank the number of melanoma cells and increased long-term relapse-free survival. Neoadjuvant (pre-surgery) ipilimumab and nivolumab was also found to induce a stronger immune response, leading researchers to believe that when the immunotherapy is able to see the melanoma cells, they are able to assist the immune system to mount a more effective response.

In the OpACIN-Neo trial, researchers modified the standard dosing schedule by decreasing the dose of ipilimumab and increasing the dose of nivolumab and gave these prior to surgery. They found that after six weeks of therapy, the toxicity of the combination therapy was drastically reduced (only 20% of patients suffered a severe toxicity compared with those who received the standard dosing in that 6 weeks) while the efficacy was largely unchanged with a pathologic response seen in 77% of patients.

"These results are promising in that they provide an insight into the effects of altering the dosage and timing of giving combination immunotherapy to Stage III melanoma patients," said Co-Medical Director of Melanoma Institute Australia, Professor Georgina Long. "To have such a high level of response, coupled with greatly reduced toxicity for patients, means we are heading in the right direction with this vital area of immunotherapy research. The high rate of pathological response is exciting, as we know from a pilot study that those patients who had a pathological response haven’t had disease recurrence."

Stage III melanoma patients with bulky lymph node disease have the worst prognosis of Stage III patients, with 70-80% of them expected to recur within the first two years. After three years of follow-up in this pilot study, every patient who presented with a pathological response is yet to recur.

Promising results from a host of clinical trials investigating the use of neoadjuvant therapies in metastatic melanoma are being analysed by the International Neoadjuvant Melanoma Consortium, which also met at ESMO. This international group of researchers and clinicians aims to increase collaboration and standardise efforts in neoadjuvant treatment for melanoma. "This is one of the most exciting things happening in drug therapy in melanoma and has the capacity to ultimately change clinical practice around the world," Professor Long added.

Australasian Melanoma Conference AMC2021
19 Nov - 20 Feb 2021

Australasian Melanoma Conference AMC2021

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

Sharing our knowledge of melanoma on the global stage
15 Apr 2021

Sharing our knowledge of melanoma on the global stage

As leaders in the field of melanoma, clinicians and researchers from MIA will be sharing 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
Olivia Vivian announced as MIA ambassador
12 Feb 2021

Olivia Vivian announced as MIA ambassador

Olivia is using her Ninja star power to shine a spotlight on melanoma prevention - in memory of her dad. 

Tags: melanoma
Melanoma breakthrough - neoadjuvant treatment saving lives.
09 Feb 2021

Melanoma breakthrough - neoadjuvant treatment saving lives.

Drug treatment before surgery, known as neoadjuvant therapy, is being hailed as one of the biggest breakthroughs in melanoma treatment since the advent of immunotherapy.

Tags: melanoma
Melanoma breakthrough - neoadjuvant therapy saving lives.
09 Feb 2021

Melanoma breakthrough - neoadjuvant therapy saving lives.

Drug treatment before surgery, known as neoadjuvant therapy, is being hailed as one of the biggest breakthroughs in melanoma treatment since the advent of immunotherapy.

Tags: melanoma
Are cancer patients on immunotherapy at a greater risk of severe COVID-19 infection?
04 Feb 2021

Are cancer patients on immunotherapy at a greater risk of severe COVID-19 infection?

New research, led by MIA, has revealed that cancer patients treated with immunotherapy are not at a higher risk of developing severe COVID-19 infection compared to other cancer patients.

Tags: melanoma
Are cancer patients on immunotherapy at a greater risk of severe COVID-19 infection?
04 Feb 2021

Are cancer patients on immunotherapy at a greater risk of severe COVID-19 infection?

New research, led by MIA, has revealed that cancer patients treated with immunotherapy are not at a higher risk of developing severe COVID-19 infection compared to other cancer patients.

Tags: melanoma
A message to all Australians from melanoma patient Stuart Taylor
16 Dec 2020

A message to all Australians from melanoma patient Stuart Taylor

Stuart has advanced melanoma which is not responding to treatment. He has shared his story on ABC's 7:30 in the hope that others can escape the same fate. 

Tags: melanoma