Novel Treatment Approaches For Patients With Metastatic Melanoma (Page 2 of 5)

A method to my Madness

As you can see from above I tried Interferon, dacarbazine (DTIC), Then a novel new agent called CTLA-4, and then onto IL-2 (Interlukin-2).

The use of a combination of IL-2, other immunotherapy agents, and chemotherapy, known as biochemotherapy, has been shown to result in high response rates (RRs) in patients with stage IV melanoma, but long-term survival without recurrence occurs in less than 10% of patients.[7] Biochemotherapy has not been shown to prolong survival beyond that seen with chemotherapy alone, which has averaged only 7 to 8 months. Therefore, a reasonable consensus is that patients with unresectable stages III and IV melanoma should be referred to a clinical trial as the first treatment for metastatic disease. More than ever before, those patients have access to a broad variety of agents --both targeted biologic drugs and immunotherapy compounds -- that have shown promise in treating unresectable disease.
The landscape for the development of new drugs for the treatment of patients with metastatic and resected high-risk melanoma is more promising than at any time in recent memory. The understanding of signaling pathways at the biochemical and molecular level and the identification of new immunoregulatory receptor-ligand pairs associated with outcome in patients with metastatic melanoma are paving the way for new drug development. A number of novel targeted and biologic agents (see below) are showing promise. A new biologic agent, as well as 2 new immunotherapeutic drugs now in registration trials, have the potential to be the first agents approved by the FDA for use in patients with stage IV melanoma in over a decade.
Potential New Agents for the Treatment of Melanoma
Human Antibodies Directed Against Immune Regulatory Molecules
Human antibodies directed against immune regulatory molecules such as cytotoxic T-lymphocyte antigen-4 (CTLA-4) induce tumor regression and improve long-term survival in tumor-bearing mice. Early clinical studies in patients with melanoma have shown that disease stabilization and prolonged survival can be achieved by manipulation of the immune system.[8,9] CTLA-4 antibodies are currently being tested in phase 2/3 trials in melanoma and phase 1/2 trials in other tumor types. Currently, 2 human antibodies are in clinical testing: ipilimumab (MDX-010) and tremelimumab (CP-675206). Although the 2 agents have similar pharmacokinetic properties, tremelimumab has a 3-week half-life, which is slightly longer than that of ipilimumab.
As you can see, Dr. Kirkwood and I wanted to induce tumor regression by using my own immune system. If we could get my immune system to recognize the tumors as foreign, then we might have a fighting chance. So we decide to try the CTLA-4 Therapy,
Antitumor response with prolonged time to progression has been seen in patients with melanoma who have received either of the CTLA-4 antibodies,[10,11] and durable antitumor responses have been observed with ipilimumab in patients with melanoma,[12] ovarian cancer,[13] prostate cancer,[14] and renal cell carcinoma.[15] Of note, antitumor responses may be characterized by short-term progression followed by delayed regression.
An important, possibly unique, clinical characteristic of anti-CTLA-4 antibodies is that the duration of clinical response -- and even stable disease -- is often quite prolonged.