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BY LINDSAY RAY | MAY 7, 2012
Today is Melanoma Monday, designated by the American Academy of Dermatology (AAD) to raise awareness about melanoma and other skin cancers while encouraging early detection. Today also kicks off skin cancer awareness month.
Skin cancer is the most common cancer in the United States, with more than a million in nonmelanomas expected to be diagnosed this year and about 76,000 melanoma cases. Melanoma rates are also on the rise in the young adult population. A study published in the April issue of the Mayo Clinic Proceedings found an eight-fold increase in melanoma cases in young women and a four-fold increase in young men when comparing diagnoses in the 1970s to 2000s. The study analyzed data from the Rochester Epidemiology Project to examine first-time diagnoses from 1970-2009. And although diagnoses increased during that time period, overall survival improved. And a recent study in the Journal of Clinical Oncology found that women with early-stage melanoma have a 30 percent survival advantage compared with male patients. (Men are also known to have a higher lifetime risk for melanoma.) The researchers hypothesize that this advantage could be due to biological differences between the sexes but state that there must be further research into this discrepancy.
Due to the increasing rates of skin cancers among young people, several states have enacted some form of legislation to limit tanning bed usage (a known carcinogen) in this age group. Just last week, Vermont joined California in banning tanning bed usage in those under 18. While other states also have age limitations or require parental permission, these are the only two states to have a ban in place up to 18 years of age.
So how can you be more aware of skin cancer? Or if you have/had skin cancer, how can you share information with family and friends?
• The SPOT Skin Cancer campaign from the AAD offers tools and information for prevention and detection.
• ListentoYourSkin.org, which is sponsored by Leo Pharma, Inc., in association with the AAD, offers information on detection, the precancerous condition actinic keratosis and tools like finding the UV index in your area.
• The David Cornfield Melanoma Fund put together the viral video "Dear 16-year-old Me" to raise awareness and encourage prevention.
• More information skin-cancer specific nonprofits can be found in our toolbox.
• Read recent treatment information from CURE's "Melanoma: Ready for Takeoff" feature published last summer.
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BY KATHERINE LAGOMARSINO | FEBRUARY 14, 2012
I recently joined CURE as managing editor of books and special projects. While I have been in journalism for many years now, this is my first foray, as an editor, into the complex world of cancer. But as a daughter--well, that's a different story.
During one of my first staff meetings here, someone brought up the often-used analogies to describe the cancer experience: a battle, a journey, a roller coaster. But when I think of cancer, I always envision it as a marathon, admittedly, another well-worn metaphor. Perhaps that's because my father was an avid runner. He finished seven marathons in his lifetime, counted Chariots of Fire as one of his favorite movies (the theme song was one of his favorite songs), and he even founded a nine-mile running race in our hometown.
But in April 2000, my father's real marathon began when he was diagnosed with metastatic melanoma. The doctors figured it was from a large malignant mole he had removed from his leg 15 years prior, but that was only a guess. Melanoma can lie dormant for years before it resurfaces in places like lymph nodes, which is where my father's recurred. A small, seemingly innocuous lump on his groin.
My father was a doctor himself--an ophthalmologist--so he knew that his prognosis would not be good. And it wasn't; it was of the "get-your-affairs-in-order" variety. But, being a stubborn man, a first-generation Italian from Newark and the son of a steeplejack, Dr. Bill, as his patients called him, was just warming up. He had only begun preparing for what was going to be a grueling six-year run filled with fatigue, dehydration, pain and emotional exhaustion.
There were runner's highs, like when a limb perfusion appeared to work, followed by extreme lows, when the brain mets appeared. And then there were the second, third and fourth winds when promising new studies came out. On he went, plodding from surgery to chemo to radiation. From clinical trial to clinical trial. Along the course, family and friend had lined up to cheer him on, give him water and food or tend to his injuries. In June 2006, my father hit the wall. His melanoma could no longer be controlled. He was spent, and he wanted to enjoy the final leg of the race at a slow amble, absorbing the sights and sounds of the course and the gathering crowd. On November 11, 2006, he crossed the finish line at peace--surrounded by his biggest fans.
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BY LINDSAY RAY | JANUARY 31, 2012
Skin Cancer
Ahead of its March 8 deadline, the Food and Drug Administration (FDA) approved Erivedge (vismodegib, GDC-0449) on Jan. 30 for patients with locally advanced basal cell carcinoma (BCC) that can't be treated with surgery or radiation or who have metastatic BCC, making Erivdege the first drug approved by the FDA for metastatic BCC. In another first, Erivedge is the first drug approved that works by inhibiting the Hedgehog pathway, which is involved in controlling cancer cell division and active in most BCCs. The drug is a pill taken once a day.
BCC, along with squamous cell carcinoma, is a non-melanoma skin cancer and one of the most common types of skin cancer, with an estimated 3.5 million cases diagnosed each year. Advanced BCC is rare, however, and disfiguring, which is why the drug fills an unmet need in this patient population. Last April, we covered some of the research about Erivedge (then known as GDC-0449) and even the first patient to try the drug, which you can read about here.
The approval in based on a multicenter trial with 96 patients. Of those with metastatic BCC, 30 percent had partial tumor shrinkage, and of those with locally advanced BCC, 43 percent had partial or complete tumor shrinkage.
Side effects include nausea, fatigue, hair loss, diarrhea, changes in taste and weight loss. Some serious side effects may occur, so a boxed warning will be included on the drug alerting physicians to potential risk of death or birth defects for an unborn baby. Doctors are required to verify pregnancy status before starting treatment.
A month's supply should cost $7,500, and Genentech (the drug's manufacturer) estimates a treatment course will last 10 months, totaling $75,000. The Patient Action Network Foundation has announced they will now offer co-payment assistance up to $7,500 per year for out-of-pocket expenses. To see the eligibility guidelines and for more information about the program, visit the Patient Action Network Foundation.
This drug should be available in one to two weeks, per the manufacturer.
For more information about Erivedge, visit www.erivedge.com.
Kidney Cancer
Just a few days before, on Jan. 27, the FDA also approved Inlyta (axitinib) for patients with advanced renal cell carcinoma (kidney cancer) who haven't responded to previous treatment.
Inlyta targets the vascular endothelial growth factor (VEGF) pathway, which is important to the development of new blood vessels in tumors, which helps tumors grow. The approval follows a 723-patient trial in which patients on Inlyta had a median progression-free survival of 6.7 months compared with the 4.7 months on the standard treatment, Nexavar (sorafenib).
Inlyta is a pill taken twice daily and is expected to cost around $8,900 per month. Side effects include diarrhea, fatigue, high blood pressure, decreased appetite and nausea. Because it can cause high blood pressure, individuals with this condition should have it controlled before taking Inlyta. Also, sometimes serious bleeding problems can occur, so patients with untreated brain tumors or gastrointestinal bleeding should not take Inlyta.
For more details, visit www.inlyta.com.
Non-Hodgkin Lymphoma
Finally, pixantrone was pulled from the FDA approval pipeline earlier this week. In 2010, the FDA rejected the drug, but Cell Therapeutics (its manufacturer) appealed and resubmitted the drug for approval as a treatment for non-Hodgkin lymphoma patients who no longer responded to other therapies. An FDA advisory meeting was set for Feb. 9, with a possible approval in April, but the manufacturer pulled the application to allow the company more time to prepare for the review. It plans to resubmit later this year.
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BY GUEST BLOGGER | AUGUST 19, 2011
Although it hasn't developed a huge following in the United States, Sunny 3, a revolutionary tanning cream that "triples the power of the sun on your skin," has taken Sweden, and most recently the UK, by storm. Due to Sunny 3's unbelievable results, consumers in Sweden have started throwing night tanning parties in order to obtain their unnatural glow--a trend dominated by the nation's youth. Thanks to multiple "night tanning" videos on YouTube and the international grapevine, it wasn't long before residents in the UK flocked to the Sunny 3 website to order their very own "miracle" product.
The only problem is, once your eager--and presumably pale-- finger clicks "Send!" the screen goes blank. And after the processing order pinwheel fades, the screen is flashed with text that reveals, "There is no such thing as Sunny 3."
That's right, the product is a fake. And the motive behind the elaborate scheme is revealed as you continue watching your hijacked screen. After the initial message fades another takes its place: "And there is no such thing as a safe suntan." Fade. "Sunburn leads to skin cancer." This message is then joined by seven graphic images of skin cancer that concludes with the tagline: "7 people die from it every day. To avoid being one of them, please visit www.skcin.org."
The Karen Clifford Skin Cancer Charity (Skcin), one of the masterminds behind the detailed hoax, is the UK's only skin cancer-specific charity, according to its website. Teaming up with McCann Erickson, an international advertising powerhouse, the organization crafted a thorough plot in order to reach the at-risk youth market. From posting dozens of videos on YouTube, most notably a false news report (see below) on the dangers associated with the new evening craze, to setting up fake accounts on social media sites like Twitter and Facebook and creating an intricate website full of smiling, sun-kissed clientele, Skcin did everything it could to lure in its target audience. And although the website was just launched a few weeks ago, more than 14,000 unsuspecting customers have already tried to order the fictitious product.
So after all is spammed and done, Skcin is left hoping that their effort will be effective. What do you think? Would this campaign have worked on you? Would you have fallen for it?
Taylor Walker, a graduate of the magazine journalism program at the University of Missouri-Columbia, is a summer editorial intern with CURE.
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BY LINDSAY RAY | AUGUST 17, 2011
On Aug. 17, the Food and Drug Administration approved Zelboraf (vemurafenib) for patients with the BRAF V600E mutation who have late-stage or unresected melanoma. Zelboraf is the second drug for advanced melanoma approved in the past six months. Yervoy (ipilumumab), which works by rallying the body's own immune system to fight the cancer, received FDA approval in March.
Zelboraf is a BRAF inhibitor and works by blocking the BRAF mutation, which occurs in about half of advanced melanoma patients. The accompanying genetic test, cobas 4800 BRAF V600 Mutation Test, was also approved to determine if patients carry this genetic mutation. An average course of Zelboraf treatment will last six months, and the estimated cost will be about $56,400 (compared with Yervoy's $120,000). The companion test will cost between $120 and $150.
The approval comes after a randomized international trial, which included 675 patients with advanced melanoma and no prior treatment, found that Zelboraf improved overall survival compared with patients receiving the approved decades-old chemotherapy regimen, dacarbazine (6.2 and 4.5 months respectively). At the time of interim review, the median survival for Zelboraf had not been reached and was 7.9 months for dacarbazine. The approval of the companion diagnostics test was also based on the clinical study that evaluated the safety and efficacy of Zelboraf.
Patients on Zelboraf should avoid sun exposure as the most common adverse effects include skin sensitivity to sunlight, joint pain and rash. About a quarter of patients developed cutaneous squamous cell carcinoma that was treated with surgery.
Roche and Bristol-Meyers Squibb (makers of Zelboraf and Yervoy respectively) will collaborate on a study to determine if the two drugs work better in combination or alone.
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BY ELIZABETH WHITTINGTON | JULY 7, 2011
With all the melanoma research news lately, it's easy to get caught up in the excitement of the current study results involving Yervoy (ipilumumab) and vemurafenib that were announced at ASCO.
However, these drugs only work in certain patients. While vemurafenib targets the BRAF mutation, which occurs in about half of melanomas, it still doesn't work for every patient -- even patients with melanomas that carry the specific BRAF mutation that is targeted.
At the American Association for Cancer Research, which was held back in April, Stand Up To Cancer (SU2C) announced the latest round of research grants, awarding nearly $10 million over three years to 13 early-career researchers who are pursuing "high-risk, potentially high-reward translational cancer research." (You can read more about the grants here.)
One of those grants, the Allan H. (Bud) and Sue Selig Stand Up To Cancer Melanoma Innovative Research Grant, was named in honor of Bud Selig, a melanoma survivor and Major League Baseball Commissioner. The recipient of the grant is a young investigator, Roger Lo, MD, PhD, from the University of California Los Angeles's Comprehensive Cancer Center, who is currently focusing on those BRAF-positive melanomas that are resistant to vemurafenib.
In addition, SU2C, partnering with the Melanoma Research Alliance (MRA), has committed to funding at least $6 million over a three-year period toward melanoma research. Wendy K.D. Selig, MRA's president and CEO, said in a statement, "This exciting collaboration comes at the perfect moment in the trajectory of melanoma research – a time when there is so much hope and optimism in the field about bringing better outcomes to patients and those at risk." (You can read Wendy Selig's guest blog on the future of melanoma research "The year of melanoma.")
This is just one example of how cancer research is staying one step ahead. Hopefully Lo can fulfill his hopes of "hitting a homerun" for Bud and others who are dealing with melanoma.
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BY LENA HUANG | JUNE 17, 2011
This week, the Food and Drug Administration announced new regulations on sunscreens that will go into effect next year. These regulations include:
• a maximum SPF of 50 because 50+ doesn't offer more protection,
• SPF will include UVA and UVB light protection (currently SPF only refers to UVB),
• and "waterproof" or "sweatproof" cannot be used to describe sunscreens but "water resistant" can be used if product testing proves it can be resistant at two intervals, 40 or 80 minutes.
The new regulations were the topic of the Diane Rehm show yesterday. As always, I found her show informative, and in her usual style, Rehm interviewed both proponents and critics, one critic who said it has taken the FDA over 30 years to come up with these rules, while skin cancer rates continue to multiply each year in the U.S.
While this may be true, it's important to focus on what we can do. Skin cancer is the most common type of cancer, and yes, skin cancer rates continue to climb each year. So what can we do about this now? The dermatologist that Rehm interviewed had some great suggestions. She said we should stop thinking sunscreen is just for the beach, but something we use every day we are exposed to the sun. Also, we need to reapply sunscreen every couple of hours because it can come off from sweat or rubbing with a towel or napkin.
I also learned from the show that sunscreen has about a two-year shelf life. Sunscreens that have been around longer than that may not provide the full protection, if any. For those who don't want to wear sunscreens, there are many options for sun protective clothing. The American Cancer Society provides some additional skin cancer prevention tips at its website.
The American Academy of Dermatology also has helpful online tools such as prevention tips, a "mole map" to help you determine skin cancer and locations where you can get free skin cancer screenings.
So while the FDA regulations may be late and won't be in effect for another year, don't use that as an excuse not to use sunscreen or wear protective clothing or hats. Every bit helps in the fight against skin cancer.
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BY ELIZABETH WHITTINGTON | JUNE 5, 2011
To add to what appears will be a melanoma-focused ASCO meeting (American Society of Clinical Oncology) this year, a phase 1/2 trial of a combination of experimental targeted agents looks to be generating interest as well.
On Saturday, researchers revealed that two targeted therapies, still going by their compound names of GSK212 and GSK436 (both are developed by the same company, GSK), worked synergistically together against metastatic melanoma.
GSK436 works against the same mutated BRAF gene that vemurafenib does (which you will hear about later in the meeting and the summer issue of CURE). The other agent works against MEK.
While BRAF inhibitors appear to have success against melanoma, the researcher presenting the data, Jeffrey Infante, MD, says the effects isn't durable, which is where the MEK inhibitor comes in. The combination had a high response rate (81 percent), either reducing tumor size or preventing future tumor growth in many patients.
Another interesting aspect of the trial is that when combined, the two drugs seem to have fewer side effects, including reduced incidence of squamous cell carcinoma and an acne-like rash. Infante said they weren't quite sure why the combination produced less side effects, but it could be because BRAF and MEK are on the same signaling pathway.
The next step of the trial is to continue accruing patients in the phase 2 portion of the study to continue looking at the best possible dose, including different doses for GSK436 with GSK212 and GSK212 alone. Infante says the trial is accruing quickly and he expects to finish enrollment of 150 patients in just a couple of months.
The study highlights that combinations could be key to melanoma progress. Add to it the recent news of two major drug companies' unique collaboration on a study combining newly approved Yervoy and experimental drug, vemurafenib, the field of melanoma is receiving the attention so many melanoma patients desperately need.
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BY LINDSAY RAY | MARCH 11, 2011
On March 26, a melanoma education symposium will be held in Santa Monica, Calif. Hosted by Aim at Melanoma and The Angeles Clinic, the event will include information on immunotherapy, BRAF-targeted therapy, and new directions in treating melanoma. A similar symposium will be held in Ann Arbor, Mich., on April 30. For more information on the current symposium lineup, check out this flyer.
Cancerandcareers.org has refreshed their website and made it gender neutral. Gone is the traditional pink and orange to a green-and-orange motif. The site still offers educational materials, tips, tools and an online coaching center. The site even offers advice for coworkers and health care professionals.
LIVESTRONG is partnering up with a soccer team in Kansas City and has unveiled the LIVESTRONG Sporting Park, which also references the soccer club's name, Sporting Kansas City. The stadium will feature state-of-the-art technology and be completely tobacco-free. The stadium will not only hold sporting matches but is also equipped for concerts. A portion of all ticket sales and concessions will go directly to LIVESTRONG.
You can check out the announcement video below.
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