Sunday, November 6, 2016

Immunotherapy first may be best for advanced melanoma

CANCER DIGEST  – Nov. 6, 2016 – When it comes to melanoma, the deadliest form of skin cancer, what has worked best in recent years have been therapies based on the genetics of the cancer. For melanoma with mutations of the BRAF gene, there have been two approaches. Targeted therapies that seek to selectively kill the cancer and stop it from spreading, and immunotherapies that seek to boost the immune response the cancer.

In a new study researchers at McMaster University in Ontario, Canada, analyzed 15 randomized controlled clinical trials done between 2011 and 2015, involving 6,662 patients with melanoma that had spread to the lymph nodes. Surgery was not an option for these patients. They compared the outcomes for those treated with the targeted approach with those of patients treated with the immunotherapy and found that they were both equally effective in improving overall survival. But because the immunotherapy had fewer risks of life-threatening complications, the researchers recommend the immunotherapy first, when quick action is not a priority.

The study led by Feng Xie, an associate professor in the Department of Clinical Epidemiology and Biostatistics, McMaster University was published online Oct. 27 in the JAMA Oncology.

“This is the first analysis to draw comparison between targeted and immune therapies for BRAF-mutated melanomas,” said Feng Xie. “Our results will help patients and clinicians choose treatments.”

While the study found the two approaches equally effective in improving overall survival, the odds of surviving advanced melanoma remains troublesome. According to the American Society of Clinical Oncology, five-year survival for melanoma that has spread to nearby lymph nodes is 63 percent and only 17 percent survive that long when the cancer has spread to other parts of the body.

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