Melanoma

 Melanoma

 CTRT support has enabled us to run a comprehensive program of clinical trials for patients with melanoma. This allows access to the most modern treatments for our patients.

Historically, advanced melanoma has been very difficult to treat and conventional treatments such as chemotherapy and radiotherapy have only had a modest impact upon the disease and only for a minority of patients. However major advances have been made in the last 2-3 years based upon an improved understanding of both the molecular changes that drive the cancer cells to grow and the immune system. New drugs have been developed that have resulted in markedly improved outcomes for patients with advanced melanoma and at Mount Vernon we have been making a major contribution to these developments.

The Melanoma Unit has expanded, two consultant oncologists, Dr. Paul Nathan and Dr.Carie Corner lead the service. CTRT provides support to two specialist research nurses, two study co-ordinators and a research fellow.

As a result, the trials portfolio is internationally competitive and we are fortunate to be able to offer access to novel agents for many of our patients. At a time when there are real advances in development for patients with melanoma, it is important that we are an internationally leading centre to enable access to the most attractive new therapies.

 

Dr. Nathan is UK Chief Investigator for the METRIC, COMBI-D, COMBI-AD, Vemurafenib brain metastasis and UKMCC-1 studies and co-CI for SUAVE. He is principal investigator (PI) for NICAM, MELABIS, Lifestyle and IpilimumabvsNivolumabvs Combination studies.

Dr. Corner is PI for ANZ/MTG Adjuvant WBRT study and shortly due to open the RADVAN study.

We were top recruiters to the UK adjuvant study AVAST-M and made a major contribution to DOC-MEK. Both these studies reported at ASCO 2013.

Our CTRT funded research fellow, Dr Oliver Bassett, has presented data on braf mutation frequency and thickness of primary melanoma to the regional Melanoma Focus meeting.

The MELRESIST collaboration between Mount Vernon, Cambridge, Oxford and Norwich is elucidating mechanisms of resistance to the new thearpies in melanoma and CTRT is partly supporting this work at Mount Vernon.

A number of novel clinical trials in cutaneous and ocular melanoma are in development.

Recent Publications

Shaw HM, Nathan PD Vemurafenib in melanoma Expert Rev Anticancer Ther. 2013 May;13(5):513-22. doi: 10.1586/era.13.24.

Nathan P, Sharma A, Lorigan P

Urgent treatment of patients with metastatic melanoma using braf inhibitors in the absence of braf mutation status.Ann Oncol. 2013 Jun;24(6):1712-3. Epub 2013 Apr 23.

Gonzalez D., Fearfield L, Nathan P, Taniere P, Wallace A, Brown E, Harwood C, Marsden J, Whittaker S. BRAF mutation testing algorithm for vemurafenib treatment in melanoma: recommendations from an expert panel. Br J Dermatol 2013 Jan 29 [Epub ahead of print]

Ribas A, Kefford R, Marshall MA, Punt CJ, Haanen JB, Marmol M, Garbe C, Gogas H, Schachter J, Linette G, Lorigan P, Kendra KL, Maio M, Trefzer U, Smylie M, McArthur GA, Dreno B, Nathan PD, Mackiewicz J, Kirkwood JM, Gomez-Navarro J, Huang B, Pavlov D, Hauschild A. Phase III Randomized Clinical Trial Comparing Tremelimumab With Standard-of-Care Chemotherapy in Patients With Advanced Melanoma. J. Clin. Oncol. 2013 Jan 7 [Epub ahead of print]

Flaherty KT, Robert C, Hersey P, Nathan P, Garbe C, Milhem M, Demidov LV, Hassel JC, Rutkowski P, Mohr P, Dummer R, Trefzer U, Larkin JM, Utikal J, Dreno B, Nyakas M, Middleton MR, Becker JC, Casey M, Sherman LJ, Wu FS, Ouellet D, Martin AM, Patel K, Schadendorf D. Improved survival with MEK inhibition in BRAF-mutated melanoma. New Engl J Med, 2012 Jun 4.

Eisen, T., Marais, R., Affolter, A., Lorigan, P., Robert, C., Corrie, P., Ottensmeier, C., Chevreau, C., Chao, D., Nathan, PD., Jouary, T., Harries, M., Negrier, S., Montegriffo, E., Ahmad, T., Gibbens, I., James, MG., Strauss, UP., Prendergast, S., Gore, ME. (2011) Sorafenib and dacarbazine as first line therapy for advanced melanoma: phase I and open-label phase II studies. Br J Cancer. 2011 Jul 26;105(3):353-9.

Marsden JR, Newton-Bishop JA, Burrows L, Cook M, Corrie PG, Cox NH, Gore ME, Lorigan P, Mackie R, Nathan P, Peach H, Powell B, Walker C. (2010). Revised UK Guidelines for the Management of Cutaneous Melanoma.Br J Dermatol. Jul 1