This week, I'm a new kind of statistic. I am celebrating the birthday that was at first thought to be one of my last, and beating the odds on melanoma. Fortunately for me, the lymph nodes came back as negative and I've been getting on with my life even though they've found other early-stage and unrelated skin cancers. My shot at being an old lady are good right now.
However, for thousands of others, who have third- and fourth-stage melanoma, there's always been another story. Melanoma is second only to leukemia in killing people of working age, but until now had no drug protocol or standard-of-care to even extend the lives of those who didn't catch the skin disease before it had entered the blood stream and spread.
That is, until now.
There are two drugs on the horizon that are offering the first glimmer of hope for families who are dealing with the later stages of the aggressive cancer. The first is Ipilimumab, which is a monoclonal antibody and has just completed phase 3 of randomized trials with 676 patients in the trial. It's expected to be the first drug approved by the FDA for the treatment of melanoma. This is the first real glimmer of hope.
The drug, a CTLA-4, works through the immune system, said Dr. Pedram Gerami, a dermatologist and researcher with Northwestern Memorial Hospital in Chicago. He's also my oncology dermatologist and has a great bedside manner, because he always talks about living with the disease as opposed to fighting off death. As a patient, it's the same information with an extremely different message and affects the way I approach my life. That's a very important aside to both those who have melanoma and those who are caring for patients or loved ones.
Ipilimumab finds the specific molecule on our system that is the molecular brake, which tells our body when not to attack, he said, and releases the immune system to instead go full force and fight off the cancer cells. Up until now, every other drug failed to show any measurable success at that during testing.
The results this time, for Ipilimumab, showed a significant, measurable increased rate of survival at 24 months of 24 percent.
The other drug is PLX-4032 and it's currently in phase 3 trials and is expected to be approved a little later as well. This drug works on melanomas with the B-RAF mutation that drives the cancer cells to proliferate. PLX-4032 inhibits the growth and with milder side affects than Ipilmumab. "It's very encouraging," said Dr. Gerami, "and we may be seeing these two drugs used in combination."
For more information on where to find compassionate care to receive this therapy, go to www.skinofsteel.org, a consortium for melanoma research started by Susan Steel, who is aggressively fighting her own battle against the disease. Steel has made great strides in creating open channels between researchers to hasten further drugs and maybe even a cure. On Sept. 21, there will even be a meeting of Chicago-based researchers, including Dr. Gerami from Northwestern, and doctors from Rush, Loyola and Lutheran General, among others to continue to share information.
"The two most promising therapies being presented are coming out of the private sector and not the government. That's a really important message right now," said Steel. "There's a new paradigm of cooperation."
"This is becoming a new outlook on cancer therapy," said Dr. Gerami. "We can identify the specific melanoma and apply individualized therapies. We may not be curing the cancer yet, but making it possible to live with the disease." Eventually, maybe five years out, investigators will become more familiar with the drug and begin using it as a prophylactic for people in Stage 2.
The best treatment, though, is always going to be catching the disease early. Check for any moles that are larger than the eraser end of a pencil, have changed color or size, are irregular in shape or color, or are blistering, and make sure a loved one checks the back.
A great big thank you to Executive Producer Jenny Bicks from the Showtime series, "The Big C," and her assistant, Alexis Davis. They heard about my friend and fan, William, who is having a rough time with the disease and sent him some bling from the show. If you haven't seen the moving and, at times, even funny take on a woman with fourth-stage melanoma, check it out on Monday nights. Go get checked everyone.
Martha's column is distributed exclusively by Cagle Cartoons Inc., newspaper syndicate. E-mail Martha at: Martha@caglecartoons.com.