A Place for Hope

At the beginning of 2011, there were only two FDA approved treatments for metastatic melanoma: dacarbazine and interleukin-2.  These drugs caused melanoma tumors to shrink in only 10-20% of patients and the benefits of these treatments were short-lived in all but a very small minority of patients.  Since 2011, there have been two parallel revolutions in the treatment of metastatic melanoma that have helped patients to live longer and better lives: immune therapy and targeted therapy. 

 

For patients whose melanoma whose melanoma has a broken growth switch called “BRAF,” targeted therapy pills called dabrafenib (Tafinlar) and vemurafenib (Zelboraf) cause rapid and often dramatic shrinkage of melanoma tumors.  Yet, these improvements last only 6 months on average.  Here at UCSF, laboratory and clinical scientists have designed several promising clinical trials to try to help patients with BRAF mutant melanoma to stay well for longer.   These include options for patients who are no longer benefiting from dabrafenib or vemurafenib and options for patients with untreated brain metastases.  We also have options for patients whose melanoma has a broken “NRAS” rather than a broken “BRAF” growth switch.

The immune therapy revolution started with ipilimumab (Yervoy), a drug that is now FDA approved, and it continues with a new class of drugs called PD-1 antibodies.   Both ipilimumab and the PD-1 antibodies take the “brakes” off the immune system’s natural  response against melanoma.  Ipilimumab can cause metastatic melanoma to go into long-term remission with only 4 outpatient infusions, and PD-1 antibodies may work for more patients with fewer side effects.  Here at UCSF, we have multiple PD-1 antibodies trial that are currently open to new patients and we are developing new strategies to help the immune system to fight against melanoma.

Now is a time for hope.  Just ask our growing group of long-term metastatic melanoma survivors.  There are more ways to treat metastatic melanoma than ever before, and we are here to help.  Please do not hesitate to contact us for more information regarding clinical trials or to schedule a consultation.

Warm Regards,

Alain Algazi, MD and Adil Daud, MD