For the first time, melanoma deaths could start to fall


Doctors battling melanoma - the deadliest form of skin cancer - may soon get new weapons, which researchers say can stop the disease from spreading and killing their patients.

In a study published in the New England Journal of Medicine, researchers at the Melanoma Institute Australia announced they had successfully trialled a combination of new treatments to prevent melanoma from spreading and metastasising to distant organs.

"Our ultimate goal of making melanoma a chronic rather than a terminal illness is now so much closer to being achieved," Georgina Long, the institute's conjoint medical director, said.

About 14,000 people in Australia will be diagnosed with melanoma this year and about 1800 are expected to die from it.

The researchers conducted two trials (one immunotherapy-based and the other targeted therapies-based) and both proved successful in preventing the spread of the disease in stage three melanoma patients whose tumours had been surgically removed.

In normal circumstances, stage three patients were at a high risk (40 to 70 per cent) of their cancer returning and progressing to fatal melanoma.

The first trial required participants to take immunotherapy drugs nivolumab or ipilimumab for one year. Immunotherapies reboot the immune system to attack the melanoma cells.

"So now I can tell patients after they've had surgery they can have 12 months of drug therapy, which will reduce the chance of the cancer coming back from 50 per cent to 25 per cent (by the ipilimumab drug) and another 35 per cent (by nivolumab)," Professor Long said. "That's massive."

In the separate trial, patients received a combination of targeted therapies, which block the action of a particular gene, a driver for melanoma.

"Twelve months of these tablet therapies decreased the chance of the melanoma coming back - compared to doing nothing, our standard is chop it out and watch - by 53 per cent," Professor Long said.

"So if your chance of your melanoma coming back and killing you is 50 per cent and I say you take these drugs for 12 months and I'll reduce that to 25 per cent or less, that's huge," she continued.

"What's more, because that trial is more mature, we also have a survival benefit and the decrease in the improvement in survival is we decrease your risk of death from melanoma by 43 per cent."

Professor Grant McArthur, executive director of the Victorian Comprehensive Cancer Centre, described the studies as "extremely important".

He said melanoma was one of the hardest cancers to treat and chemotherapy had little impact, if at all.

"We're now following in the footsteps of what we've seen chemotherapy do for other cancers," he said.

"Where I think we're heading now with these results is that we can reduce the total mortality from melanoma for the first time."

He said that, with these new treatments, he could have very different conversations with his patients.

"We can now get on the front foot and try to kill off the melanoma before it returns and spreads around the body," he said.

Renae Aslanis of Newtown was one 870 patients in the targeted therapies trial.

The history teacher was told about the time she had surgery that the survival rate for stage three patients was 54 per cent.

But 4?? years later, despite side-effects such as headaches and weight gain, she feels she can "envisage a future".

"Before, I was living from scan to six-monthly scan ??? thank you, you have given me life that may have been cut short," Ms Aslanis told Professor Long at the institute's head office in Sydney.

"You're most welcome," Professor Long replied. "Yes, now it's less likely to pop up on the scan, whereas you'd normally be gritting your teeth and it's awful.

"This will make a huge difference in being able to help you focus on your work and on your family, because you're not sitting there worried about all this other stuff," she added. "You can live."

The trials were sponsored by pharmaceutical companies that produced the drugs.

The results will be presented at the European Society for Medical Oncology 2017 Congress in Spain on Monday.


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