Melanoma drug keeping patients alive, gives researchers hope of ‘penicillin moment’ in cancer treatment

Source: ABC.net.au, April 2015

A new melanoma drug that tricks the body into destroying cancer cells is keeping patients alive for years longer than expected, with some researchers calling the breakthrough in immunotherapy a “penicillin moment" in cancer treatments.

Kathy Gardiner and her fiancé, Anthony Pukallas, are due to get married in a fortnight.

The wedding did not seem likely just over a year ago when Kathy was diagnosed with terminal cancer.

CT scans showed five major tumours on her lungs.

“You go through a lot of emotions when you’re told that you have a terminal diagnosis," Ms Gardiner told 7.30.

“You first progress with disbelief and then you go through trying to work out why this has happened to you, and eventually it’s the anger, and at that point you have to reach a level of acceptance."

But now Ms Gardiner has been given a new chance at life.

When she was diagnosed, she was given an new immunotherapy drug called Pembrolizumab as part of the drug company’s compassionate access scheme.

After less than a year on Pembrolizumab, there is only one tumour visible on Ms Gardiner’s lungs.

Each new scan shows that the tumours have shrunk.

“The opportunity to have life extension is one of the best gifts that could be granted," Ms Gardiner said.

Pembrolizumab is one of a new class of melanoma drugs which is keeping some patients alive for years longer than previously expected.

The category of immunotherapy called anti-PD1 tricks the body’s immune system into destroying cancer cells.

And there is hope the drugs could be effective against other cancers.

For the first time, the national drugs regulator, the Therapeutic Goods Administration, approved an anti-PD1 drug for use against melanoma.

Pembrolizumab is hugely expensive — costing patients between $10,000 and $15,000 a month — but oncologists expect that it will be fast-tracked for subsidy under the Pharmaceutical Benefits Scheme (PBS).

The drug, also known by the trade name Keytruda, was also the subject of a study published on Monday in the New England Journal of Medicine.

The study said it was far more effective than existing treatments for advanced melanoma.

Sydney Westmead Hospital oncologist Rick Kefford said the new immunotherapy treatments were having an extraordinary impact.

“I’ve been in this game for 30 years — for the first 25 it was quite heartbreaking looking after secondary melanoma because we had no effective drug treatment," Professor Kefford said.

“The majority of patients died within two years. “There’s been a complete transformation in our clinics, in what we’re doing [and] in the expectations of patients.

“Many go off and have babies, go on round-the-world trips. Many return to work and absolutely normal living. “It’s a complete transformation."

‘Penicillin moment for drug therapy for cancer’

The study included the results of patients from the Melanoma Institute of Australia in north Sydney.

It said 75 per cent of patients who responded to the drug had lived beyond 12 months.

Other anti-PD1 drugs were also being trialled.

Patient Peter Heywood said his trial drug had reduced his tumours by 70 per cent.

“What it’s meant is we can actually look to the future again," he said.

“We can make travel plans rather than thinking that within 12 months I could be dead."

Associate professor Georgina Long, a clinical researcher at the Melanoma Institute of Australia, believed the drug could be used on other cancers.

“Not just for the melanoma world but for the cancer world, this is a very significant time in cancer drug development," she told 7.30.

“This is what one of my colleagues would say is a penicillin moment really for drug therapy for cancer."

Drug would mean ‘severe financial strain’ without PBS approval

But there are some issues with the drug, with doctors unsure why about 50 per cent of patients do not respond to the immunotherapy treatments.

And then there is the cost.

“We’re probably looking at the order of something like $12,000 to 15,000 per month," Professor Kefford said.

“Without PBS approval there would be a severe financial strain for most of our patients.

“One of the problems of the cost of these drugs is that we just don’t know, at the present, how long you’d really have to continue them.

“If it were only for, say, three months of treatment, it becomes more affordable.

“But if you need it for 12 months or two years, it becomes an astronomical amount of money."

Ms Gardiner said she was not allowing herself to think that she could be cured.

“We’re very much living for the now, rather than planning for the future," she said.

“Which is very difficult to do when you’re planning a wedding."