More than half of people diagnosed with advanced melanoma now survive for at least 10 years when they receive a double hit of immunotherapy drugs, a trial has found. The combined treatment has transformed survival rates for a form of skin cancer that once had a grim prognosis, with some patients now living long enough that they die from other causes.
Fifteen years ago, only one in 20 patients with advanced melanoma survived for five years, with many dying within six to nine months of the condition being confirmed. James Larkin, a consultant medical oncologist at the Royal Marsden NHS foundation trust and a professor at the Institute of Cancer Research, stated, “The definition of cure is to return someone to their normal life expectancy for their age and state of health. Having treated a lot of these patients over the past 10 years, it seems that some are cured: they’re back to their normal lives, they’re getting on with things.”
The trial explored two drugs, ipilimumab and nivolumab, both immune checkpoint inhibitors, in 945 patients with stage 3 or 4 melanoma, where tumours were spreading. The drugs work by disabling “brakes” built into the immune system to prevent it from turning on healthy tissues. Cut the brakes and the immune system can recognize and attack the cancer cells.
Results presented at the European Society for Medical Oncology in Barcelona on Sunday, and published in the New England Journal of Medicine, show that the melanoma-specific survival rate for patients in the trial was higher than the overall survival rate, meaning they were starting to live long enough to die from other causes. At 10 years, the melanoma-specific survival rate for patients treated with both drugs was 52%.
Many toxic anti-cancer drugs that destroy tumours cells stop working over time, but the response to immune checkpoint inhibitors is long-lasting. The trial marks the longest follow-up to date of patients receiving the drugs for advanced melanoma, giving doctors crucial information on how long the treatment is effective for, the overall survival rates, and side-effects. While some patients experienced side-effects early on, no new problems arose later. Patients who stopped treatment early because of significant side-effects still benefited from the combination therapy, as the drugs had already taken effect on their immune systems.
Lucy Davis, 47, joined the trial funded by Bristol-Myers Squibb, the drug manufacturer, after being diagnosed in 2011 with stage 3 melanoma. She had surgery to remove the cancer and surrounding lymph nodes, but two years later was told the disease had progressed to stage 4 and she had only months to live. Davis shared, “Before I started the trial I was really ill, I could barely eat, I was losing weight and was in a lot of pain, but three months later I felt completely different, my appetite was back and scans showed that the treatment was working. My children were five and seven years old when I received the news that I had just months to live; and they are now 16 and 18. I have been able to see them complete their exams and go to college, which is absolutely amazing.”
While the results are impressive, efforts are now focused on the substantial portion of patients who do not respond to the immunotherapies. It is unclear why the drugs fail in many patients, and there is probably no single answer, with roles for the biology of the patient’s tumour and their immune system. Dr. Sam Godfrey, the science engagement lead at Cancer Research UK, stated, “Over the last decade, there have been big improvements in survival for people with advanced melanoma skin cancer, partially because of the introduction of a group of immunotherapy drugs called checkpoint inhibitors. This study indicates that combining two of these checkpoint inhibitors led to more people surviving their disease for 10 years or more. Promising results like this show how vital ongoing research into cancer is, to help people live longer, better lives.”
Subheadings:
The Impact of Combination Drug Therapy on Long-Term Survival Rates
Patient Testimonials: Stories of Hope and Resilience
Challenges and Future Research in Advanced Melanoma Treatment
The Impact of Combination Drug Therapy on Long-Term Survival Rates
The groundbreaking trial that explored the combination of two immune checkpoint inhibitors, ipilimumab and nivolumab, in patients with advanced melanoma has shown remarkable results in long-term survival rates. With over 52% of patients surviving for at least 10 years, the treatment has significantly improved outcomes for individuals with a once grim prognosis. This breakthrough has transformed the landscape of melanoma treatment, offering hope and extended life expectancy to many patients.
Patient Testimonials: Stories of Hope and Resilience
Lucy Davis’s story is just one of many that highlight the transformative impact of combination drug therapy on advanced melanoma patients. Diagnosed with stage 3 melanoma in 2011, Davis was given a dire prognosis of only months to live when the disease progressed to stage 4. However, after joining the trial and receiving the dual immunotherapy treatment, Davis experienced a dramatic turnaround in her health. The treatment not only halted the progression of the disease but also allowed her to witness significant milestones in her children’s lives. Her story serves as a testament to the power of innovative treatments in combating advanced melanoma and providing patients with a renewed sense of hope and resilience.
Challenges and Future Research in Advanced Melanoma Treatment
While the results of the trial are promising, there remains a significant portion of patients who do not respond to immunotherapy treatments. Understanding why these treatments fail in some individuals is crucial for improving outcomes and developing more effective therapies. Researchers are now focusing their efforts on unraveling the complexities of the disease, including the role of the patient’s tumor biology and immune system in treatment response. By addressing these challenges and investing in ongoing research, the medical community aims to enhance the effectiveness of treatments and provide better outcomes for all patients with advanced melanoma.