Posts for: August, 2011
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Many patients have asked about the new treatments for advanced melanoma that have been covered in the media of late. In March, Bristol-Myers Squibb's Yervoy (ipilimumab), a slow-acting immunotherapy for patients with advanced melanoma, was approved by the FDA. On August 17, Roche Genentech's Zelboraf (vemurafenib), which targets a BRAF V600E mutation which is found in 40 to 60 per cent of patients' melanomas, also received FDA approval. While both shown promise in their ability to prolong the lives of patients with metastatic melanoma, neither is a cure for these patients. Although previous therapies have shown little benefit, the good news is that both of these treatments have been able to give affected patients a significant remission from their disease, but the bad news is that no long-lasting remissions or cure from melanoma can be expected.
Also, only about half of patients tested responded to Zelboraf. Since BRAF mutations are more common in yougner patients who have melanoma, younger patients are more likely to respond.
Since the two act via different but complementary mechanisms, they may work better together, and a Phase III trial is about to start using them in combination. We are hoping better results will be seen. In the meantime, since Yervoy is slow to act wheras quick remissions have been seen with Zelboraf, Yervoy will probably be used in patients with metatastic disease that is not rapidly advancing, saving Zelboraf for later more advanced disease, and Zelboraf may be used for patients with rapidly advancing disease. There may still be a role for the more familiar treatment with Interleukin-2 (IL-2), since the side effects with Yervoy can be severe. The role of the current therapies of interferon and DTIC, as well as IL-2, may be uncertain without comparative studies, but undoubtably there will be a role for each of these agents for some patient.
The best cure is PREVENTION. Come and learn about what your specific risk factors might be and what you can do to minimize those risks.
Read more about these treatments at http://www.skinandallergynews.com/views/commentaries/single-article/q-a-putting-the-new-melanoma-drugs-to-work/3e51744e17.html
I hope all of my patients fared well in today's storm. I felt I should stay in my building and watch over things to make sure there were no damages or flooding (as coop president, with no live-in super) and actually slept through most of it. It is still very windy out there, and walking around was really invigorating.
I was on call for the shelters since the New York City Medical Corps serves the city in case of natural disaster or terrorism events, but so few people needed the shelters I was not asked to come in. As usual, New Yorkers came together and were ready to help each other out. I love living in New York!
Did you know their is a pill that can prevent sun damage to your skin. Derived from tropical ferns, leucovorum polypodium can prevent all the harmful effects of ultraviolet light, including damage to pyrimidine dimers in DNA, while still alowing vitamin D production. I have been using it for patients with disorders of the skin due to sun sensitivity, such as solar urticaria or polymorphous light eruption, but it may be helpful in skin cancer prevention as well. Take one capsule 30 minutes prior to prolonged sun exposure, and a second capsult 2 to 3 hours later.
It is sold under the name Heliocare and is available at drustore.com and Amazon.
There is a troubling new wrinkle in melanoma epidemiology: An appreciable blip in cases that first appeared about 10 years ago in American women aged 30-34 has been attributed to an increased use of tanning salons among teenage girls that started in the 1980s. I cannot emphasize strongly enough how important it is to stay away from tanning beds!
To read more, go to Tanning Beds/Tanning Booths and .http://www.skinandallergynews.com/views/the-mole-the-skin-allergy-news-blog/blogview40771/blog-melanoma-heads-down-the-genetic-pathway/4633ea74f9.htmland\