Update from ASCO 2017
17 June 2017
Our researchers and clinicians recently returned to Sydney from the world’s largest oncology conference, ASCO, in Chicago where they proudly shared MIA research with global colleagues.
With the leaps and bounds that have been made in melanoma research in recent years, many of this year’s presentations were around the more precise use of current treatments to ensure optimal treatment for each patient.
“Many patients with metastatic melanoma now have long-term survival with drug therapy,” comments Dr Alex Menzies, medical oncologist at MIA and ASCO presenter. “Melanoma researchers from around the world are trying to work out ways to accurately predict who these patients are when they first attend the clinic, so that they can receive the right therapy for them upfront, while those who are not likely to respond can be offered new treatments through clinical trials. In those who do well with current treatments, we are keen to discover if we can safely stop treatment at some point. Data from ASCO suggests we can.”
A new era for melanoma patients with brain metastases
Melanoma patients often develop brain metastases, and until recently, most patients only lived for a few months. This year, three clinical trials in patients with asymptomatic brain metastases who had not previously received local therapy (e.g. surgery, radiotherapy), demonstrated that modern melanoma drugs shrink brain metastases and prolong survival. This offers great hope to melanoma patients and changes current clinical practice.
The COMBI-MB trial of the targeted therapies dabrafenib and trametinib, demonstrated impressive response rates and superior survival to what has been seen previously. While most patients had shrinkage of brain metastases initially, most then became resistant to treatment after only a few months, such that only a few patients had long-term disease control. This resistance phenomenon, also seen in patients without brain metastases, remains a barrier and research continues to identify why this occurs and to prevent it.
In contrast, two trials of immunotherapy, MIA’s ABC clinical trial and the CheckMate 204 trial, demonstrated not only a high rate of response but also durable survival with a combination of nivolumab and ipilimumab. These impressive results, similar to those seen in patients without brain metastases, indicate that some patients may not necessarily need to undergo surgery or radiotherapy to the brain, and that they may have long-term survival with drug therapy alone. The only caveat is that those who progress at 12 weeks — approximately a third of patients — have no benefit at all.
Read more about MIA’s research presented at ASCO this year and watch the video below of Professor Georgina Long explaining the latest research on immunotherapy in melanoma presented at the conference.