Breakthrough melanoma treatment on horizon

The world is approaching its first effective treatment for the usually lethal
secondary tumours generated by melanoma, and Australia is at the forefront of the
research effort.
Two experimental drugs, both well advanced clinical trials and shown to cause "very
dramatic" shrinking in tumours, could be approved for broadscale use from as soon as
late next year.
Professor Rick Kefford heads one of the trials at Sydney's Westmead Hospital, and he
said it was exciting work that pointed to a breakthrough treatment for melanoma.
"This isn't like an incremental advance in the management of breast cancer or
something, this is the first family of drugs that have very significant activity
against the disease, full-stop," Prof Kefford told AAP on Thursday.
"These drugs will find their way almost certainly into all levels of care ... but of
course before you can do that you have to prove they work in metastatic disease.
"That's what we've been doing and they definitely work - there is no question."
Australian melanoma patients have been involved in clinical trials for both drugs,
each in separate development by pharmaceutical company rivals GlaxoSmithKline (GSK)
and Roche.
An update on this work will be released in scientific papers to be presented on
Friday at the International Melanoma Congress, a major gathering of skin cancer
experts in Sydney this week.
Prof Kefford said it would confirm the ability of the drugs to block the activity of
a mutated gene (BRAF) known to power the growth these secondary tumours, and with
spectacular results.
"It's very dramatic, the majority of patients develop very significant tumour
regressions and that happens within weeks," he said.
"What's even more dramatic, within days, the patients have a dramatic resolution of
symptoms and they go from being very sick people to returning to full-time work,
they throw away their narcotic analgesics.
"It's is quite extraordinary, I've never seen anything like that in oncology let
alone in melanoma."
There are some downsides. Only about half of all people with melanoma are found to
have mutated BRAF. Among those melanoma patients who have gained a benefit from
taking the drugs, there were "very few" cases of complete cancer regression and most
relapsed within a year.
Prof Kefford said Roche was likely to reach the stage of applying for approval for a
rollout of their drug first, with an end-stage trial now almost complete.
"They will probably have an early analysis sometime around Easter, we hope, and if
that's positive the drug could be approved by the end of next year," he said.
"The GSK drug is about nine months behind (that)."
Work could then begin on finding optimal ways to use the drugs or in conjunction
with existing treatments - a process that has delivered an array of increasingly
effective therapies for other cancers.
"We just haven't been able to get a foot on the ladder yet (with melanoma) ... so
this is a foot on the ladder and a significant one."