Research Providing Promising New Treatments for Melanoma

In a paper published online November 30, 2016, in Melanoma Management, Adam Riker, MD, Professor of Surgery and Chief of Surgical Oncology at LSU Health New Orleans School of Medicine, reviews approaches to manage melanoma, including one tested at LSU Health New Orleans that provoked a complete response in a patient with a long history of the disease.

The editorial provides an overview, including progress made over the last few decades in treating this potentially fatal skin cancer. More recent studies have shown the promise of vaccines and immunotherapy. Combinatorial immunotherapy represents the newest advance. Riker and colleagues recently reported results of a novel combinatorial immunotherapy Phase II clinical trial at LSU Health New Orleans. Twenty-five patients were given a combination of an interferon and a melanoma vaccine genetically altered to trigger a potent immune response. The researchers found that the approach clearly activated the immune system in a select few, including the astounding complete response in a patient who had melanoma for eight years at the time of the study.

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“I saw this happy patient back in my office just a few months ago, still without evidence of disease,” Riker reports.

Riker and co-author Erika Bisgaard, now an MD and an alumna of LSU Health New Orleans School of Medicine, also discuss a first-of-its-kind therapy for inoperable melanoma in the skin and lymph nodes. The FDA recently approved talimogene laherparepvec (IMLYGIC®, T-VEC). It uses herpes simplex virus-type 1 designed to selectively replicate within tumors and produce GM-CSF, a white blood cell growth factor that enhances systemic anti-tumor immune responses. This combination has shown a complete response rate of 10.8%. Ongoing trials are studying its possible use in melanomas that are operable as well.

“We still have much work ahead in our continuing efforts to identify effective treatment options that will stimulate and activate the immune system to destroy melanoma wherever it may grow,” notes Riker. “Current research is very promising, though,” he adds. “We have entered a truly exciting era in our ability to successfully treat patients with melanoma.”

Melanoma is a form of skin cancer in which cancer cells form in melanocytes (cells that make melanin, a pigment giving skin its color). Melanoma can occur anywhere on the skin. It is more likely than other skin cancers to metastasize or spread to other parts of the body, and the number of new cases has been increasing over the past 40 years. The death rate varies by age – fewer people younger than 50 have been dying from melanoma since the mid-1980s, with the death rate on the rise in people age 50 and older.