“The research efforts directed towards the development of novel therapies for patients with metastatic melanoma have been intense despite disappointing clinical outcomes. It is clear that monotherapy for metastatic melanoma will not be successful, with every study to date yielding minimal clinical outcomes
data. Therefore, we must realize that there is no magic bullet to cure melanoma, and we must develop multimodality strategies to enhance the immune response to melanoma from different angles. This will require an unprecedented collaborative effort by many in order to overcome the historical competition between large pharmaceutical companies striving for ‘total cure’ with their drug.”
~ Dr.Adam I Riker~
We should realize that the future of drug development and design will depend heavily on the recent trend towards molecular medicine, and in particular, gene profiling efforts using gene microarray analysis. We are entering an entire new field of research dedicated to the molecular basis of cancer. Such research has the greatest potential to impact the way we treat patients with melanoma, focusing results on the prognostic significance of particular genes from a melanoma patient and basing clinical decisions as to whether such patients will (or will not) respond to a particular agent. The development of molecular signatures using gene microarray analysis has come to the forefront of existing research efforts identifying patients who may have an aggressive (versus indolent) form of melanoma and those patients with particular prognostic gene
signatures that may predict the response to forms of immunotherapy. The identification of such gene signatures has had important implications in the development of targeted immunotherapies for patients with metastatic disease. Thus, we must focus our efforts towards an improved understanding of the molecular and immunologic events involved in melanoma development and progression. We should also re-evaluate our present approach to immunotherapy and trial design, with many past trials failing to show clinical efficacy because of a lack of appropriate preclinical data that provide the essential rationale to perform such studies.
Source: http://www.southalabama.edu/mci/spf90/riker2.pdf
Immunotherapy of melanoma: a critical review of current concepts and future strategies
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Take Care,
Jimmy B
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