The war against melanoma continues. This editor lost a courageous family member to this frighteningly aggressive cancer on July third, hence this article is being written with a broad view, personal experience and clarity in the clinical trials system. Every medicine has its destiny and much has been written about the promise of Yervoy and the first extension of the lives of advanced melanoma patients. As always, in oncology, cardiology, diabetes, hypertension and other diseases and conditions, COMBINATION therapy emerges as part of what we all should expect in rational therapeutics and optimal results (outcomes). This editor thinks that more often than not, it's time to load more than one gun.
NCT 01024231 (visit www.clinicaltrials.gov) gives families and clinicians the latest--and as time will tell, perhaps greatest duo of combination treatment for melanoma that has spread (metastasized). Readers should know that it is the very nature of melanoma to spread. Spread to lungs, spread to other areas on the skin, spread to the brain, intestines, lungs, lymph system and crucial glands such as the adrenal gland. Melanoma DOES NOT WAIT and if you or a family member has received such a diagnosis, get treatment today/as soon as humanly possible and have an evaluation at a center that specializes in melanoma.
It is crucial to know and remember that NOT ALL CENTERS/HOSPITALS treating cancer ARE THE SAME. Depending on the stage of your melanoma, nature of mutations, kinds of advantages that the melanoma has to survive and other factors, very early clinical trials (phase one or one b) may make sense. All centers simply do not offer these early forms of treatment. Since phase one, two and three phases are the stages BEFORE FDA approval, it is important to get balanced, informed and the latest information regarding risks and benefits, possible side effects and pathways of removal of the medicine depending on your own body and the strengths or weaknesses and even other chemo or immune based drugs you may have already been given.
Remember, even the top centers may not offer all of the available treatments. The editor has first-hand experience in this where a family member was told of only two available options at a major center, when in fact there were more than five. Glitches in kindness, care and consideration can still happen at the best centers. The Joint Comission on Healthcare Accreditation evaluates most US hospitals. They have a program called SPEAK UP and it is meant to help patients and families express concerns when things go wrong. It is also difficult to focus when your treatment changes or things don't go as expected. It's important for you to select a coach in your treatment to help follow up on tests and be involved in meetings--advocating for you.
While searching valid and objective sites can be a daunting task for families and patients, visitingwww.clinicaltrials.gov gives a snapshot of what is available (although it may be somewhat dated information), tells which patient and cancer characteristics and included and excluded and can be a valuable investigation of upcoming treatments. Looking here in concert with your oncologist can help immensely. Even if an investigational medicine has not worked, It is important to remember to ask your oncologist if there is anything else at another medical center that might be appropriate treatment for your individual melanoma.
Many readers have heard of Yervoy (ipilimumab) from the American Society of Clinical Oncology (ASCO) meeting. This novel therapy removes a break that melanoma places on the immune system and gives your body a chance to better fight the cancer. This was recently approved by the FDA. Combining Yervoy with another medicine makes great sense and NCT01024231may give excellent results. This new protocol brings Yervoy to patients combined with one of the more interesting new treatment approaches. The new drug is called BMS 936558 (also known as MDX 1106). It belongs to a family of medicines known as anti-Programmed Death-1 (PD-1) monoclonal antibodies.
PD-1 is an inhibitory receptor that is found (expressed) on activated T cells which may suppress antitumor immunity. What this means is that the anti-PD-1 medicine works to restore the immune system ability to fight tumors! The combination of Yervoy (inhibits CTL4 thus boosting the immune system) PLUS BMS-936558 (boosts tumor fighting ability) may finally give patients the ability to aggressively fight the melanoma that has had such an aggressive ability to spread and cause death. Please visitwww.clinicaltrials.gov for more information, treatment sites and details and as always…talk to your doctor about how this new combination might help you or a family member.