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The Congress gave a record-setting number of researchers the opportunity to discuss and share information about new therapies under investigation. The over 500 registrants of this year’s Congress signals the excitement generated by new understanding about the underlying genetic malfunctions that cause the cancer and the unprecedented opportunities to find novel therapies.
The meeting focused on information-sharing among leaders in the research community about the fundamental “errors” that occur in cells and discussion of therapies under investigation. Over 50 researchers offered their peers overviews and discussion forums that gave participants a compelling view into several trials that will likely culminate in the next 12-24 months.
“With the incorporation of new technologies into experimental and clinical research, we expect rapid advances in cutaneous melanoma prevention, diagnosis and therapy,” said Ze’ev Ronai, Ph.D., organizer of this year’s Congress and Program Director at the Burnham Institute for Medical Research. “We’re thrilled with the strong presence of researchers and clinicians at this meeting.”
A turning point in melanoma research occurred approximately five years ago with the first discovery of a gene mutation (BRAF) triggered a cascade of understanding about the genetic underpinnings of melanoma. Further research has shown that the disease is not simply one genetic malfunction, but rather more typically, a genetic malfunction paired with other disturbed pathways that cause disease.
Now the research community is poised to make unprecedented strides in the understanding about prevention and treatment of advanced melanomas. Clinical studies are already showing that new therapies are slowing down the progression of this fast-moving disease. In addition, basic science is revealing ways that existing drugs can be effectively used to turn back the disease.
David E. Fisher, M.D., PhD of the Dana Farber Cancer Institute, presented one such example. A patient with a mutation in a gene known as “c-KIT,” only identified by researchers a year ago, enrolled in a new clinical trial aimed at targeting the mutation with Gleevec. The drug is currently on the market and used to treat two other cancers including chronic myeloid leukemia (CML) and gastrointestinal stromal tumor (GIST). “This patient’s cancer exhibited a dramatic response to a single pill a day based upon accurate targeting of the drug to the mutation within the tumor—a first experience of this sort for melanoma,” said Dr. Fisher. While only about five percent of patients with advanced melanoma have the c-KIT mutation, this finding represents a promising new treatment pathway for those with the mutation, and indicates how growing understanding of genetic mutations is already yielding new treatments for other patients.
Another exciting discovery centered on immunotherapies. Jedd Wolchok, M.D., Sloan Kettering Cancer Center, led a discussion about new approaches to stimulating an immune response in patients with melanoma that will attack the cells in melanoma tumors. Two drugs, Interferon and Interleukin-2, have been used with only limited effectiveness. While they are successful in stimulating the number of killer T-cells, the increase in the number of T-cells has not correlated to effective killing of the cancer cells and there is significant toxicity related to the drug regimens. Researchers have identified a protein found in cells, called CTLA-4, which mounts a defense against the T-cells, allowing cancer cells to survive. New therapies aimed at suppressing CTLA-4 and effectively “training” T-cells to recognize and target cancer cells have shown success in patients in Phase II and Phase III trials, and may carry less toxicity than Interferon or Interleukin-2. These therapies are being used in Phase III trials and may be reviewed by the FDA in the near future. It is likely that these therapies will not be used alone, but rather in conjunction with targeted therapy to block the impact of specific genetic changes.
A recurring theme in all the research discussed at this year’s Congress is that, to achieve meaningful results, therapies must be targeted to patients according to the specific mutations and pathways that are corrupted. As new medications emerge, personalized therapy will likely be the new standard of care.
The next Congress in the U.S. is planned for November 2009 in Boston, Massachusetts. Additionally, there will be a joint meeting of SMR and the International Pigment Cell Conference (IPCC) in Sapporo, Japan in May of 2008.
About the Society for Melanoma Research
The Society for Melanoma Research (SMR) is an all-volunteer group of scientists working to find the mechanisms responsible for melanoma and, consequently, new therapies for this cancer. SMR contributes to advances in melanoma research by bringing together researchers in a non-competitive way to unite the scientific community. The Society has commissioned the Roadmap for Melanoma which outlines the key targets for research and therapy that need to be addressed by 2010.
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