Vermont has the highest rate of melanoma, the deadliest form of skin cancer, in the country. But new drugs that stimulate a patient's immune system are now showing promise in the effort to save lives and increase longevity.
More than 70,000 Americans are diagnosed with melanoma each year in this country. Most are diagnosed early and can be cured, but for those with advanced disease, the treatment is notoriously difficult.
"Once it spreads to different organs like the lung, or the liver or the bones, then it becomes, until today, incurable," said Dr. Claire Verschraegen, a Fletcher Allen Health Care-University of Vermont oncologist.
Now, there are new immunotherapy drugs improving survival for patients with advanced melanoma. They are monoclonal antibodies, like ipilimumab that stimulate the immune system.
"The new therapies are basically lifting the brakes that the cancer cells are putting on the immune system and by releasing the brakes, the immune system can go. And that fights the cancer. I mean it gives complete remission I think in some cases, cures," said Verschraegen.
Verschraegen likens chemotherapy to a pesticide applied on weeds, killing the cancer cells on contact. But immunotherapy plays a different, long-term role when cancer cells have traveled.
"The key to really cure cancer is to reshape the immune system of those patients so they can fight it themselves. And we are really in the infancy of understanding what's going on, but we've been coming up with some medications that have remarkable results, where without chemotherapy were even able to put some patients in complete remission, just by the power of their own immune system," said Verschraegen.
Fletcher Allen doctors treat about 35 people a year with advanced melanoma with the Food and Drug Administration-approved ipilimumab now available to those patients. It takes a minimum of 12 weeks to show true results, but 20-26 weeks to really inhibit cancer growth.
"I think that there are some patients that are going to get cured with this drug, but it's still in the range of maybe 10 percent. So it's a bit higher than in interleukin two, but not yet a general cure," said Verschraegen. "But with ipilimumab, the survival rate at two years is about 25 percent, which is way better than what we saw before."
And there are several other immunotherapy drugs now in clinical trial showing even better results. They're offering hope to patients who used to have none.
Fletcher Allen expects to begin clinical trials in September with another immunotherapy drug showing even better results. It's called nivolumab. Dartmouth Hitchcock is also participating in that drug trial underway right now.
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