Will melanoma medicine help with bladder cancer?

The new drug has shown effectiveness in the treatment of melanoma and bladder cancer

Anna Stavina, XX2 century

Clinical trials of the new immunotherapy drug pembrolizumab (pembrolizumab, trade name – Keytruda) have shown that it significantly prolongs the life of patients suffering from bladder cancer. The drug also proved effective against melanoma of the mucous membranes, a rare variety of one of the most dangerous malignant tumors. The test results were presented at the European Cancer Congress.

Until now, immunotherapeutic agents used for the treatment of other forms of this disease have not been used in the treatment of melanoma of the mucous membranes. Most often, melanoma occurs on the skin as a result of exposure to ultraviolet radiation (for example, sunlight). Melanoma of the mucous membranes develops in the cavities of the body, for example, in the respiratory tract, gastrointestinal tract or genitals. The causes of its occurrence are unknown.

Mucosal melanomas account for less than 1% of all cases of melanoma. The prognosis for this form of the disease is unfavorable, usually due to late diagnosis. Most patients with metastatic melanoma of the mucous membranes today live on average less than a year, receiving standard therapy.

A report on the results of three clinical trials of pembrolizumab in relation to the treatment of patients with advanced stages of mucosal melanoma was made by Dr. Marcus Butler, an oncologist from the Princess Margaret Cancer Center in Toronto. He said that the late stages of mucosal melanoma were registered in 84 patients out of 1567 who took part in the studies.

"16 (19%) patients responded well to treatment with pembrolizumab, and 12 of them are still alive. There are no signs of progress of the disease. To date, the longest period of successful treatment is 27 months," said Dr. Butler.

Of the 1,483 patients with other forms of inoperable melanoma who participated in the studies and received at least one dose of pembrolizumab, 33% responded to treatment. 72% are still alive, and the disease is not progressing. The average life expectancy during treatment was about 2 years (in patients with mucosal melanoma – 11.3 months).

"Melanoma immunotherapy has radically changed the way we think about the treatment of this disease. Some patients with mucosal melanoma who had a complete response to pembrolizumab therapy have already returned to normal life. In others, the benefits of treatment were less pronounced, however, it was present. Patients with mucosal melanoma were usually excluded from previous studies, as this form of the disease was considered too rare. However, the results of the latest work indicate that immunotherapy should be offered to patients with mucosal melanoma as a standard treatment option. But, since the response to therapy in this case may be observed less frequently, additional studies are needed to improve the effectiveness of treatment."

The chairman of the Congress and President of the European Cancer Organization (ECCO), Professor Peter Naredi, who did not participate in the work, noted: "It can be difficult to assess the effectiveness of the treatment of rare forms of cancer during clinical trials of the usual scale. But Butler and his colleagues combined data from three studies and demonstrated that treating patients with inoperable mucosal melanoma with pembrolizumab leads to long-term improvement in the condition of patients."

The second report on the use of pembrolizumab in bladder cancer was made by Dr. Andrea Necchi, doctor of the Department of Medical Oncology of the National Institute of Tumors of the IRCCS Foundation (it. Fondazione IRCCS Istituto Nazionale dei Tumori) in Milan, Italy. According to Dr. Nechchi, clinical trials have shown that patients with inoperable bladder cancer on the background of taking pembrolizumab on average lived longer and experienced fewer side effects compared to patients receiving chemotherapy.

He said: "The conducted research has become a landmark. It demonstrated the real benefits of using pembrolizumab as a second-line therapy drug in patients with inoperable bladder cancer. Pembrolizumab was the first drug capable of prolonging the life of these patients to a greater extent than chemotherapy.

Median survival in the pembrolizumab group was 10.3 months, and in the group receiving chemotherapy – 7.4 months. In addition, the proportion of patients whose tumor decreased or disappeared as a result of treatment in these groups differed almost twice, 21% and 11%, respectively.

In addition, against the background of the use of pembrolizumab, significantly fewer side effects were observed. This is important because a significant proportion of the study participants were elderly people with a large number of concomitant diseases. The results of the study allow us to consider pembrolizumab as a new standard of treatment for inoperable bladder cancer."

Currently, there is no effective second-line therapy that could be used in patients with bladder cancer in the late stages of the disease. As a rule, chemotherapeutic drugs are used: paclitaxel, docetaxel and vinflunin, but the benefits of their use are usually small. The emergence of a new effective drug could change this situation by improving the quality and life expectancy of patients with inoperable bladder cancer.

Portal "Eternal youth" http://vechnayamolodost.ru  01.02.2017