Melanoma arises in the pigment producing cells (melanocytes) and is the deadliest of the skin cancers. It accounts for nearly 200,000 new cases of cancer each year worldwide and in the U.S. over 76,000 new diagnoses are expected in 2016. Melanoma incidence in the U.S. has tripled over the last three decades, and the death rate has increased at a time when mortality for other common cancers has declined. When caught early, melanoma can be successfully treated by surgery, while those diagnosed with widespread metastatic disease (Stage IV) have a median survival of less than one year if untreated. Notably, 11 new treatments have been approved by the FDA to treat melanoma since 2011 and have revolutionized the field, provided new hope for patients, and showcased melanoma as the cancer that is on the frontlines of oncology innovation. These treatments fall into two categories: 1) targeted therapies that block growth-promoting pathways in melanomas with activating mutations in BRAF (vemurafenib, cobimetinib, dabrafenib, and trametinib); and 2) immunotherapies that target the “brakes” on the immune system via checkpoint inhibitor antibodies to CTLA-4 (ipilimumab) or PD-1 (nivolumab and pembrolizumab) as well as the first oncolytic viral therapy (T-VEC). Precision medicine in melanoma arrived in 2011 with targeted therapies, combination treatments are approved and biomarkers continue to be advanced. With anti-PD-1 drugs active in other cancers including kidney cancer, lung cancer and Hodgkin lymphoma, it’s clear that lessons learned from melanoma are already applicable across oncology. The benefits can be expected to continue through research and the engagement of all stakeholders, including academia, biopharma, government, patients, entrepreneurs and donors.
Upon completion of this session, participants should be able to: