A group of researchers at Peter Mac have spent the past year working with patients, family
members, nurses and medical oncologists to develop a series of videos for patients about to start
immunotherapy. We developed these videos “brand free” so they are suitable for use by all
patients, irrespective of the type of cancer they have, where they are being treated and what
organisation they belong to.
There are five videos in total. They were designed by our consumer steering committee to cover the
topics most important to them, and feature patients, family and nurses. Each video covers a specific
topic relating to starting immunotherapy treatment. They include: general information, or ‘what you
need to know’, how to best prepare for your immunotherapy infusion, side-effects, lifestyle and
support.

Video links:

Video 1: What you need to know about Immunotherapy

Video 2: Preparing for Immunotherapy

Video 3: Immunotherapy and side-effects

Video 4 Immunotherapy and lifestyle

Video 5: Seeking support and Immunotherapy

The post Patient videos for those about to start immunotherapy appeared first on Melanoma Research Victoria.

The post About Melanoma Skin Cancer appeared first on Melanoma Research Victoria.

Melanoma is a type of skin cancer that begins in pigment-producing cells called melanocytes. This cancer typically occurs in areas that are only occasionally sun-exposed; tumors are most commonly found on the back in men and on the legs in women. Melanoma usually occurs on the skin (cutaneous melanoma), but in about 5 percent of cases it develops in melanocytes in other tissues, including the eyes (uveal melanoma) or mucous membranes that line the body’s cavities, such as the moist lining of the mouth (mucosal melanoma). Melanoma can develop at any age, but it most frequently occurs in people in their fifties to seventies and is becoming more common in teenagers and young adults.

Melanoma may develop from an existing mole or other normal skin growth that becomes cancerous (malignant); however, many melanomas are new growths. Melanomas often have ragged edges and an irregular shape. They can range from a few millimeters to several centimeters across. They can also be a variety of colors: brown, black, red, pink, blue, or white.

Most melanomas affect only the outermost layer of skin (the epidermis). If a melanoma becomes thicker and involves multiple layers of skin, it can spread to other parts of the body (metastasize).

The post NIH Genetics Home Reference – Melanoma appeared first on Melanoma Research Victoria.

A new set of National Comprehensive Cancer Network (NCCN) guidelines have been created for the diagnosis and management of uveal melanoma. During the 2018 NCCN Annual Conference, a member of the NCCN Melanoma Subcommittee, Christopher A. Barker, MD, presented the inaugural guidelines as “the first pathway-based guidelines” to be developed for the disease.¹
The unique biological characteristics of uveal melanoma necessitated a need for its own set of guidelines, separate from the guidelines for cutaneous melanoma, explained Barker, the director of clinical investigation in the Department of Radiation at Memorial Sloan Kettering Cancer Center, during an interview with Targeted Oncology. Local treatment for uveal melanoma, differing from cutaneous melanoma, consists of globe-preserving therapies or enucleation.
“Ocular or uveal melanoma is genetically and biologically a very distinct form of melanoma that has very little overlap with cutaneous melanoma,” agreed Daniel G. Coit, MD, a surgical oncologist at Memorial Sloan Kettering Cancer Center, and the chair of the NCCN Uveal Melanoma Subcommittee, in an interview with Targeted Oncology. “What we have wanted to do for years is to codify the treatment [of patients with uveal melanoma] so that practitioners would have a consistent management algorithm.”
read the original full article

The post Inaugural NCCN Guidelines Designated for Uveal Melanoma appeared first on Melanoma Research Victoria.

Skin cancer is the most commonly diagnosed cancer worldwide. However, if detected early, it can be one of the easiest to cure. With this in mind, Derma.plus developed the following study to better understand the geographical and geopolitical factors which make skin cancer incidences more common, and sometimes deadly, in certain regions over others.

The study is divided into two sections: first, the Skin Cancer Susceptibility Index analyses the UV factor, the skin-tone by demographic percentages and rate of incidences from a range of countries to identify geographically where the highest rates of skin cancer are most likely to occur. Secondly, the Socioeconomic Treatment Index cross references national health spending and individual income against mortality rates to better understand the efforts undertaken worldwide to combat the disease.

“The incidence of both non-melanoma and melanoma skin cancers has increased dramatically over the past decades,” states Prof. Dietrick Abeck, Chief Medical Advisor for Derma.plus. “Worldwide, more than 3-million non-melanoma skin cancers and 150,000 melanoma skin cancers are diagnosed each year. One in every three cancers diagnosed is a skin cancer.”

The post Skin Cancer-Index appeared first on Melanoma Research Victoria.

The guideline cover a wide spectrum of cancers.

The post National Comprehensive Cancer Network Guidelines for patients. appeared first on Melanoma Research Victoria.

Yvonne-Saenger, MD
source: OncLive

Melanoma care has fortunately undergone a whirlwind of changes over the past several years. Novel immunotherapies are perhaps the most exciting recent development in cancer care because patients can enjoy long-term benefit from these treatments, meaning that they are possibly “cured.” Thus, it is now considered possible to rid the body of cancer using immunotherapy in a significant fraction of patients with advanced melanoma. Immunotherapy can be very toxic, but it lacks the characteristic poisoning effects of chemotherapy and has the appeal of offering a more “natural” solution to cancer as it builds on the body’s own innate defense mechanisms to cause tumor rejection. Over the coming decades, the challenge will be to expand the minority currently curable with immunotherapy and also to introduce immunotherapies earlier in the disease course to prevent systemic spread in the first place.

In 1981, interleukin-2 became the first immunotherapy approved for treating patients with melanoma.

The drug reliably produces an approximate 15% response rate and a “cure” rate perhaps slightly below 5%. However, the mechanisms of action of interleukin-2 are largely unknown and skeptics of immunotherapy have remained unimpressed by the data for the drug. The key development that led to the real expansion of immunotherapy for melanoma was the observation that blockade of a negative regulator of T-cell activity, CTLA-4, could result in melanoma regression.

CTLA-4

CTLA-4 is a protein expressed by T cells in response to activation, and it serves to dampen the immune response, thereby preventing autoimmunity. Thus, mice deficient in CTLA-4 develop widespread autoimmune disease. In this way, CTLA-4 serves to protect normal tissues against the immune system; however, it is sometimes used by cancer cells to hide from the immune system. By blocking CTLA-4, the tumor can be revealed as a foreign threat.

While the initial data for CTLA-4 blockade showed efficacy not far superior to interleukin-2, follow-up studies have shown impressive rates of survival following CTLA-4 therapy, with 4-year survival rates of approximately 40% in previously untreated patients treated with high-dose CTLA-4 blockade on clinical studies. These data suggest that, while most patients do not experience immediate tumor shrinkage, tumors may respond later in the treatment course, resulting in improved survival. The CTLA- 4–blocking antibody ipilimumab (Yervoy) was approved for the treatment of melanoma in March 2011.

PD-1/PD-L1

The success of CTLA-4 blockade spurred further research, resulting in the discovery of a second clinical target, PD-1. PD-1, similar to CTLA-4, is expressed by activated T cells, and it appears to be induced by chronic inflammation. Similar to CTLA-4, PD-1 signaling leads to inactivity and sluggishness of T cells. Thus, CTLA-4 and PD-1 are described as “checkpoints” in immune activation. One way to describe the role of PD-1 is that the immune system might decide to tone down a prolonged immune response, as it appears unlikely that the foreign entity will be successfully eliminated and the attack becomes a waste of resources. Thus, PD-1 expression is high on T cells during chronic viral infections and in T cells infiltrating tumors.

Blockade of PD-1 has produced impressive responses in melanoma patients. In a phase I study, the PD-1 inhibitor pembrolizumab (MK-3475) had an overall response rate of 34%, and preliminary evidence suggests that these responses are durable.1 In another phase I study, combination therapy with the PD-1 inhibitor nivolumab and ipilimumab produced responses in 40% of patients.2 The latest data on pembrolizumab and nivolumab were presented in June at the 2014 ASCO Annual Meeting, and both drugs are expected to eventually be approved by the FDA.

The post Immunotherapy Advances in Melanoma appeared first on Melanoma Research Victoria.

Safety and Tumour Responses with Lambrolizumab (Anti-PD-1) in Melanoma. Hamid et al.

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1305133

Nivolumab plus Ipilimuamab in Advanced Melanoma. Wolchok et al.

http://www.nejm.org/doi/pdf/10.1056/NEJMoa1302369

The post ASCO 2013 – publications appeared first on Melanoma Research Victoria.

Clinical diagnostic methods that can accurately identify BRAF mutated patients and the types of mutations are critical to the clinical management of patients. In order to make sure that the methods being used were the best possible, DNA from patients of the Melbourne Melanoma Project and a second group of patients from Western Australia were exchanged and tested independently in two laboratories using four different methods for the detection of BRAF. The tests were carried out at the Peter MacCallum Pathology Department in collaboration with Barry Iacopetta at the Translational Cancer Research Laboratory at the Sir Charles Gairdner Hospital in Western Australia.

Recently published in Scientific Reports, the study found that current methods of clinical testing were highly accurate between the two sites. This included a high concordance in the detection of rarer but still significant BRAF mutation types

The findings of this study have confirmed that the strategy for the detection of BRAF mutations for the Melbourne Melanoma Project gives accurate diagnostic information. For those wishing to see the publication, it is open access, and available via the link below.

Richter A, Grieu F, Carrello A, Amanuel B, Namdarian K, Rynska A, Lucas A, Michael V, Bell A, Fox SB, Hewitt CA, Do H, McArthur GA, Wong SQ, Dobrovic A, Iacopetta B. A multisite blinded study for the detection of BRAF mutations in formalin-fixed, paraffin-embedded malignant melanoma. Sci Rep. 2013 Apr 15;3:1659.

To download the paper please click here.

The post New Melbourne Melanoma Project Scientific Publication appeared first on Melanoma Research Victoria.

The post Short Course Medical Genetics and Genetic Pathology appeared first on Melanoma Research Victoria.