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First branch of national Melanoma Tissue Bank to open in Pittsburgh

i Nov 5th No Comments by

From autism to prostate cancer, researchers rely on specialized banks of donated human tissue to explore how diseases attack the body and what might stop them.

But melanoma specialists worry that the absence of a national tissue bank of cancerous skin is slowing new treatments, even as the disease has become the fastest-growing cancer in new diagnoses nationwide.

The University of Pittsburgh Cancer Institute will begin filling the research gap next year, when Pitt is expected to open the first of four branches of the new Melanoma Tissue Bank, organizers confirmed Tuesday.

“It’s hard to underestimate how important the access to these tissues will be in research of the future,” said Dr. John Kirkwood, the Pitt skin cancer program director and a longtime tissue bank advocate, who will help oversee the Pittsburgh branch.

Other branches are planned at California Pacific Medical Center in San Francisco, Northwestern University near Chicago and Oregon Health and Science University in Portland, although researchers have yet to announce opening dates.

Pitt and the three other institutions formed a consortium to establish the first national tissue bank for melanoma. Smaller collections exist in hospitals and research institutions based on cases they treat.

Advocacy groups in Illinois and California are helping to raise more than $3 million for the consortium.

Kirkwood said every branch hopes to collect each year from patients who give their consent at least 50 melanoma tissue samples, tiny frozen slivers ranging from the size of a No. 2 pencil eraser to a fraction of that.

Branch directors will make tissue and tissue data available for peer-reviewed research projects around the world, including at the host institutions. Pitt researchers are still sorting out where to house the local branch, which Kirkwood said will need several new employees.

For the 600 melanoma patients treated annually in the Pitt skin cancer program, researchers said proximity to the bank should mean easy access to cutting-edge treatments developed at the school.

About one in 50 people in the United States will develop melanoma, up from 1 in 500 about 25 years ago, Kirkwood said.

“Even though we’ve raised money for the whole bank, our focus right now is getting (Dr.) Kirkwood up and running,” said Susan Steel, 56, a melanoma survivor who founded the Skin of Steel nonprofit outside Chicago. The group partnered several years ago with Aim at Melanoma, a San Francisco research organization, to raise money and plan the tissue bank.

Steel said the Pittsburgh branch will open first because Kirkwood, who has studied melanoma for more than three decades, is a research leader whose work commands international attention.

Publicity surrounding the local bank should bring a brighter spotlight to melanoma and early detection in Western Pennsylvania, said Julie Hudak, 46, of Squirrel Hill, whose husband, Daniel, died of melanoma in 2010.

“If it’s caught too late, there’s a chance of it being in the blood, and the survival rate is grim,” Hudak said.

She will join Kirkwood and other tissue bank supporters to discuss the plans at 6 p.m. Thursday in the Babcock Mansion, 5135 Ellsworth Ave., Shadyside. The meeting is open to the public.

Kirkwood said the bank should accelerate progress unfolding in melanoma research, which until 2011 had generated three government-approved treatments for the disease. Six more have emerged since then.

“We have made unbelievable, truly incredible strides in the past several years,” Kirkwood said.

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FDA approves Merck immune-stimulating drug for melanoma

i Sep 4th No Comments by

U.S. regulators on Thursday approved the first drug in a new class of cancer medicines that work by stimulating the immune system, a Merck drug developed for treating deadly skin cancer.

The Food and Drug Administration says it granted accelerated approval for the use of Merck & Co Inc’s immuno-oncology drug Keyrtruda, also know as pembrolizumab, as a treatment for patients with advance melanoma, who are no longer responding to other therapies.

The drug is the first in a promising new class of antibody-based drugs that work by taking a brake off the immune system so it can better recognize and attack cancer cells. The drug is designed to help the body’s own immune system fend off cancer by blocking a protein known as Programmed Death receptor (PD-1), or a related target known as PD-L1, used by tumors to evade disease-fighting cells.

“This is the latest in a string of major breakthroughs in melanoma treatment that will galvanize the field of melanoma research and cancer treatment,” Wendy Selig, Melanoma Research Alliance president and CEO, said in a statement.

“Pembrolizumab has demonstrated real potential to save the lives of late-stage melanoma patients who had little hope of survival just a few years ago,” Selig said.

Melanoma, the deadliest form of skin cancer, is diagnosed in around 76,000 Americans each year and around 10,000 will die from the disease annually, according to the National Cancer Institute.

The FDA said in a statement that clinical trials of Keytruda showed that it shrank tumors in around 24 percent of patients with advanced melanoma whose disease worsened after prior treatment.

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NCI renews SPORE grant of more than $12 million for melanoma, skin cancer research at UPCI

i Nov 12th No Comments by

JohnKirkwoodThe University of Pittsburgh Cancer Institute (UPCI) Melanoma and Skin Cancer Program (MSCP) led by John Kirkwood, M.D., has received renewal of its skin cancer research through the National Cancer Institute’s competitive Specialized Program of Research Excellence (SPORE) program. The grant is for more than $12 million.

Since, Aug. 2012, Jessica Fera, founder and executive director of The Woiner Foundation, has served as a patient advocate for Dr. Kirkwood’s SPORE program, and was part of the team that helped to submit the grant for renewal.  The Woiner Foundation directly supports Dr. Kirkwood’s work through its fundraising initiatives.

The award is the fourth grant awarded to UPCI through the prestigious SPORE program, which requires cancer institutes to document strong collaboration between eminent scientists and clinicians as well as outstanding programs in translational research. The other three grants at UPCI are in head and neck, lung and ovarian cancers.
The SPORE grant for skin cancer will fund three new projects and the expansion of one prior project. These include:

  • Biomarkers of the proinflammatory response and elements of immune suppression: The goal of this project is to find biomarkers in melanoma patients at diagnosis or early in the disease that may predict the benefit of treatment with the drugs ipilimumab or interferon-α (IFNα) for each individual, as well as to assess the risk of melanoma recurrence and death. This effort continues earlier research that revealed biomarker patterns associated with pro-inflammatory immune responses and with immunosuppression in both tumor tissue and circulating blood.
  • Multiple antigen-engineered dendritic cell immunization and IFNα-2b boost for vaccine immunotherapy of metastatic melanoma: This project tests an improved dendritic cell vaccine targeting tumor antigens given in combination with IFNα-2b with the aim of boosting the immune response against the cancer.
  • Safety and efficacy of vemurafenib and high-dose IFNα-2b for advanced melanoma: This project will test whether vemurafenib, a drug that inhibits a signaling protein called BRAF, can enhance the therapeutic efficacy of IFNα-2b in patients with metastatic melanoma. In earlier work, the team found BRAF inhibitors make melanoma cells more sensitive to the effects of IFN-α, suppressing cell proliferation and encouraging apoptosis, or programmed cell death; increase T cell-mediated immune responses to melanoma cells; and prolong the survival of mice in a model of melanoma.
  • A microneedle vaccine program for immunotherapy of melanoma and cutaneous T cell lymphoma

Dr. Kirkwood’s melanoma research team first received SPORE funding five years ago and the grant’s five past projects have focused on immune approaches to treatment of melanoma and other skin cancers. The incidence of melanoma continues to rise dramatically. There has not been effective therapy to improve overall survival for the majority of patients with inoperable metastatic disease, although progress in the molecular therapy and immunotherapy of melanoma now has improved prospects for patients with melanoma considerably.

“We want to improve our understanding of the molecular and immunologic mechanisms underlying melanoma progression and to validate prognostic and predictive biomarkers that will lead to the personalized treatment of melanoma and other skin cancers,” Dr. Kirkwood said. “Our research is unique because we have integrated an approach that includes experts in melanoma from medical oncology, dermatology, surgery, immunology, biostatistics, bioinformatics, and biomarker discovery.”

Nancy E. Davidson, M.D., director of UPCI and its clinical partner, UPMC CancerCenter, called the SPORE grant a “perfect storm” in that it combines UPCI’s long-term scientific and clinical expertise in melanoma and immunology with the activities of the Department of Dermatology under the leadership of Louis Falo, M.D., Ph.D., and is tightly linked to national and international clinical trials activities in the cooperative groups.

“Multidisciplinary care is at the crux of modern cancer medicine and is critical for scientific discovery and translation,” Dr. Davidson said. “This SPORE grant is a great example of that.”

About 76,000 new cases of melanoma are diagnosed every year in the United States and about 9,400 people will die every year from the disease, according to the National Cancer Institute.

Dr. Kirkwood said the work being done through the SPORE grants is already making a difference. There have been several new therapies for melanoma approved since 2011, compared to just three agents approved in the 30 years prior.

About UPCI
As the only NCI-designated comprehensive cancer center in western Pennsylvania, UPCI is a recognized leader in providing innovative cancer prevention, detection, diagnosis, and treatment; bio-medical research; compassionate patient care and support; and community-based outreach services. UPCI, a partner with UPMC CancerCenter, investigators are world-renowned for their work in clinical and basic cancer research.


Predicting cancer’s next move

i Nov 11th No Comments by

Research led by Broad senior associate member Levi Garraway and published this week in Nature offers a new approach to studying drug resistance in cancer. The approach helped them identify which biological pathways could be enabling melanoma to circumvent available anti-cancer treatments. Targeting the output of these pathways for treatment could potentially hinder the course of this often-fatal disease.

The researchers initiated the study to address a vexing clinical problem: on the rare occasions that drug treatments are found that effectively inhibit tumor growth, that success is often short-lived. As resistance mechanisms emerge, the therapies cease being effective and the tumors return.

Such is the case in melanoma. Roughly 50% of these cancers have been traced to a mutation in BRAF, a gene responsible for directing cell growth. Only a few years ago, drugs were developed that disrupt parts of the biological pathway that leads the mutation to spur unchecked growth in skin cells. Patients who have received the treatment have seen their tumors disappear – only to return an average of nine months later. Garraway’s team, which includes researchers from the Broad Institute and Dana-Farber Cancer Institute, wanted to find out in a comprehensive fashion what mechanisms might be involved in the development of drug resistance in these cases.

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Immune drugs hold hope of “clinical cure” for deadly skin cancer

i Sep 28th No Comments by

A new generation of drugs designed to trigger the immune system to fight cancer is offering the prospect of a “clinical cure” for some melanoma skin cancer patients who until a few years ago were more likely to be facing a swift death.

Cancer specialists gathering for a European conference at the weekend said the so-called immunotherapy drugs, a class led by Bristol-Myers Squibb’s Yervoy, or ipilimumab, have transformed an area of oncology in which until recently doctors barely had time to get to know their patients.

Stephen Hodi, assistant professor of medicine at the Dana-Farber Cancer Institute in the United States, said he was cautious about using the term cure, but described recent advances as a “paradigm shift”.

At the least, he said, the success of this new generation of medicines means some melanoma patients would now be living with a chronic disease, rather than facing imminent death.

“This is a really amazing time … A few years ago we could never have imagined using the C-word, cure, in melanoma,” he said. “But we are headed that way.”

“Ipilimumab opened a door, and now the field is moving extremely fast,” he told Reuters at the European Cancer Congress (ECC) in Amsterdam.

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Related article: ECC 2013: Longest follow-up of largest number of melanoma patients treated with ipilimumab shows some survive up to ten years

Melanoma drugs extend life for some patients

i Jun 3rd No Comments by

Researchers will present studies of three promising melanoma therapies today, part of a wave of new treatments for the most aggressive forms of the disease.

None of the new therapies are cures for melanoma.

But a fraction of patients see rapid improvement in their condition, with dramatic shrinkage of their tumors, says F. Stephen Hodi, director of the melanoma center at Boston’s Dana-Farber Cancer Institute.

Hodi, who studied a drug called ipilimumab, will discuss his findings in Chicago today at the annual meeting of the American Society of Clinical Oncology.

The Food and Drug Administration approved ipilumumab, sold under the brand name Yervoy, in 2011. Yervoy, the first new drug for melanoma to be approved in more than a decade, helped patients live a median of 10 months, four months longer than those who were given an alternative experimental therapy.

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Drug combos are the future of melanoma treatment

i Jun 3rd No Comments by

Giving experimental agents known as immune checkpoint blockers together or sequentially leads to improved outcomes in metastatic melanoma, according to the results of 2 studies published in the New England Journal of Medicine (NEJM) today.

The studies are both phase 1 trials, and therefore the outcomes are limited in their authority. However, the results are encouraging, especially the findings that the drug combinations did not result in a higher rate and severity of adverse events compared with the individual drugs alone, observes James Riley, PhD, of the Abramson Cancer Research Center at the University of Pennsylvania in Philadelphia. He wrote an editorial that accompanies the new studies.

The studies are also being presented here today at the 2013 Annual Meeting of the American Society of Clinical Oncology (ASCO®).

“The future is all about combination therapies,” said Jedd Wolchok, MD, PhD, a melanoma expert at the Memorial Sloan-Kettering Cancer Center in New York City. He spoke with Medscape Medical News in an interview. Dr. Wolchok said that melanoma will now go the way of other diseases such as tuberculosis and HIV, which have been increasingly successfully treated with the adoption of multiple drug regimens.

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FDA gives ‘breakthrough’ designation to Merck skin-cancer drug

i Apr 25th No Comments by

An experimental Merck & Co. (MRK) skin-cancer drug was designated as a “breakthrough therapy” by the U.S. Food and Drug Administration, which could ease the treatment’s path to market.

The drug, lambrolizumab, showed promise in an early-stage clinical trial of people with advanced melanoma, a serious form of skin cancer, according to results released in November that formed the basis of Merck’s request for breakthrough designation. A mid-stage trial is underway to test further the drug’s efficacy and safety; it hasn’t yet been approved for marketing.

Merck hopes the FDA’s new breakthrough designation will speed the drug’s path to market, though the company couldn’t quantify how much time might be shaved off the drug’s development.

“It opens up opportunities and lines of communication with the agency for creative ways to move development forward as quickly as possible,” said Gary Gilliland, senior vice president and oncology franchise head in Merck’s research division.

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Pitt analysis of 4 smartphone apps for evaluating melanoma finds many errors

i Mar 23rd No Comments by

Diagnosing skin cancer via smartphone?

Perhaps there should not be an app for that.

A study by the University of Pittsburgh evaluated four smartphone apps that evaluate melanoma by analyzing images submitted by the users.

One app functions by having a board-certified dermatologist look at the photos, while the other three apps analyze the photos by computer algorithm.

The best-performing of the computer-driven apps missed 30 percent of the melanoma cases, while the worst-performing missed 93 percent, according to the Pitt review.

The app that used actual physicians to diagnose the melanomas worked well, correctly identifying more than 98 percent of the submitted images.

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New device can diagnose melanoma with a flash of light

i Mar 23rd No Comments by

It is widely accepted that early cancer detection not only offers the best possible chances for successful treatment, but also saves health care costs and a large overburden to the health care system.

Innovations in the methods for early detection and treatment have helped to decrease overall US cancer mortality rates.  Some notable exceptions to the general decline of cancer rates are melanoma of the skin, cancers of the liver, pancreas, and uterus.  It is estimated that in the United States 76,250 men and women (44,250 men and 32,000 women) will be diagnosed with and 9,180 men and women will have died of melanoma of the skin in 2012.  That’s a slightly higher than 1 person every hour of every day in the US that dies of melanoma.

Whether you are a highly trained dermatologist using a dermatoscope (a magnifying lens with a light source) or even high-technology multispectral imaging systems or just performing a low-technology self exam in the comfort of your own home – using eyeballs alone to make a decision based on morphological assessment of a suspicious mole can confuse the best of them.

Few technological advances have been developed to help augment subjective visual diagnosis for early skin cancer detection. A new device has been developed in Canada using a real-time laser system called Raman spectroscopy.

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