The Skin Cancer Foundation Journal

MAY 2012

The 2012 edition of The Skin Cancer Foundation Journal features medically reviewed, reader-friendly articles such as tanning, the increasing incidence of skin cancer diagnoses among young women, & the prevalence of melanoma among white males over 50.

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Page 55 of 103

HEALTH Groundbreaking Treatments for Advanced Melanoma KEITH T. FLAHERTY, MD I n 2011, the US Food and Drug Administration (FDA) approved two new therapies for metastatic (spreading) melanoma. Their in- troduction represents a watershed event for patients with metastatic disease. Ipilimumab (Yervoy™) and vemurafenib (Zelboraf™) are the fi rst new melanoma treatments approved by the FDA since the introduction of high-dose interleukin-2 (IL-2, a natural immune protein artifi cially mass-produced) in 1998, and they are far more broadly effective than IL-2 or any other drug for advanced melanoma that came before.1 After IL-2's arrival, many new melanoma therapies were tried but failed in clinical trials. Prior to 2010, improved overall survival was never observed in patients with metastatic melanoma in a randomized phase III trial. Now, with ipilimumab and 54 vemurafenib, such observations are becoming commonplace. [Before being approved by the FDA for sale and use, a treatment's safety and effi cacy is tested in a series of clinical trials — typically phases I, II, and III. In some instances, a drug can be approved based on a Phase II trial, but most often, a successful phase III trial is required for, though not a guarantee of, approval.] IPILIMUMAB (YERVOY™): LANDMARK IN TARGETED IMMUNOTHERAPY Ipilimumab (Bristol-Myers Squibb) is the product of scientifi c discover- ies on the workings of the immune system that began two decades ago. The immune system has natural regulators that prevent an over- or underactive immune response. These regulators are expressed on the surface of immune cells, where they can be accessed by drug treatments. It has been known for years that the vast majority of advanced cancer patients, and nearly all advanced melanoma patients, have immune cells that specifi cally recognize tumor cells growing in their bodies. However, to eliminate the cancer cells, these immune cells must overcome a variety of molecular hurdles in the tumor that repel the immune cells' efforts. Recent insights into the complexities of immune system activation and deactivation have enabled research- ers to develop a diverse array of new therapies aimed at awakening these antitumor immune cells by targeting specifi c accelerators or decelerators. Ipilimumab represents the fi rst of these types of "targeted" immunologic treatments approved by the FDA. SK IN CANCER FOUNDAT ION JOURNA L GROUNDBREAKING TREATMENTS FOR ADVANCED MELANOMA. . . . . 54 FROM TERMINAL TO CANCER-FREE: A Melanoma Patient's Story . . . . . . . . . . . . . . . . . . . . . . 57 THE HIDDEN DANGERS OF NONMELANOMA SKIN CANCER. . 59 WATCH OUT FOR AGGRESSIVE PRECANCERS . . . . . 61 PHOTODYNAMIC THERAPY A New Frontier in Early Skin Cancer Treatment . . . . . . . . . . . . . 63 "Recent insights into the complexities of immune system activation and deactivation have enabled researchers to develop a diverse array of new therapies…" — KEITH T. FLAHERTY, MD

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