“Your on-going dedication is enabling us to make huge strides in melanoma research” Dr James Larkin
This year, as part of our ongoing charitable objective to ‘fund research to find a cure for melanoma’, the Myfanwy Townsend Melanoma Fund donated £20,000 to assist The Royal Marsden Melanoma Unit. Here Dr James Larkin, Consultant Medical Oncologist FRCP PhD at the Melanoma Unit, explains how this significant donation is helping make an impact on melanoma and offering sufferers with renewed hope.
The Royal Marsden remains indebted to The Myfanwy Townsend Melanoma Research Fund for their long-standing commitment to melanoma research here at the hospital. The Royal Marsden Melanoma Unit was busier than ever in 2015, and saw significant breakthroughs in our work to develop new treatments for melanoma. We remain grateful to our supporters who enable such ground-breaking work to take place.
Immunotherapy represents an innovative new approach to treating cancer. Recently, drugs have been developed that stimulate patients’ immune systems to attack cancer cells with the most marked successes in melanoma.
Notably this year, both Professor Martin Gore and Dr James Larkin contributed significantly to a trial, Keynote 006. This trial aimed to demonstrate the superiority of the immunotherapy drug pembrolizumab to ipilimumab when treating patients with melanoma. The results of the trial demonstrated that the anti-PD 1 antibody pembrolizumab prolonged progression-free survival and overall survival and had less high-grade toxicity than ipilimumab in patients with advanced melanoma. The success of the trial led to a further publication in the New England Journal of Medicine and approval of the drug in both Europe and the US.
In June, the Unit received global media coverage with the presentation of the results of a large trial, Checkmate 067, comparing the immunotherapy drugs nivolumab, ipilimumab with both drugs combined, in the Plenary Session of the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago. The trial has been labelled a “game changer” by many oncologists, with Dr Larkin explaining, “By giving these drugs together you are effectively taking two brakes off the immune system rather than one, so the immune system is able to recognise tumours it wasn’t previously recognising and react to that and destroy them.
For immunotherapies, we’ve seen tumour shrinkage rates over 50% so that’s very significant to see. This is a treatment modality that I think is going to have a big future for the treatment of cancer.” Tumour shrinkage of 50% is almost unprecedented for immunotherapy drugs and the results have led to the approval of the combination drugs in the UK to treat advanced melanoma. Following on from the presentation at the Plenary Session at ASCO in the summer, Dr Larkin was also lead author on the paper published in the New England Journal of Medicine.
Dr Larkin also presented an update of the coBRIM trial at ASCO. The trial compared the drug vemurafenib, with the combination of vemurafenib and cobimetinib for advanced BRAF mutant melanoma, with the results of the trial demonstrating a 49% reduction in risk of disease progression. This combination was approved late in 2015 in the US and we anticipate that European approvals for both combinations of drugs should be accepted in early 2016.
Dr Larkin also featured prominently at the European Cancer Conference in Vienna in September of this year. He featured in a number of sessions including a verbal presentation of the Checkmate 067 results in specific subgroups of patients. This trial demonstrated the safety and efficacy of the combination of ipilimumab and nivolumab in all subgroups analysed, including those patients with the poorest prognosis and those over the age of 75.
Finally, in late November, Dr Larkin presented an analysis of ipilimumab and nivolumab therapies in mucosal melanoma at the Society for Melanoma Research in San Francisco. Mucosal melanoma is a rare and generally aggressive subtype of melanoma without defined standard of care treatments. Often patients with mucosal melanoma have been excluded from clinical trials but both nivolumab alone and in combination with ipilimumab have shown definite benefit and as such, these results are likely to establish the first standards of care in this disease. We believe that this could be a major breakthrough for treating this sub-type of melanoma.
Following the ASCO Conference coverage of Immunotherapy trials, a number of Royal Marsden patients featured very widely in the media, including an interview by John Humphrys on the Today programme with Dr Larkin and Vicky Brown, a patient treated in the trial. The trail was also covered by the BBC, The Guardian and The Daily Mail.
Expanding the team
The Melanoma Unit are looking forward to welcoming a new Consultant in Medical Oncology, Dr Samra Turajlic, in 2016. Dr Turajlic trained at The Royal Marsden and did her PhD with Dr Richard Marais at the Institute of Cancer Research. She will be combining her scientific studies in the laboratory of our collaborator Professor Charles Swanton at the Crick Institute, with clinical responsibilities on The Royal Marsden Melanoma Unit.
“Whilst 2015 was a year of success there remains a lot to do. The majority of those diagnosed with advanced melanoma in 2015 still die from the disease and our research efforts need to continue until this is no longer the case. On behalf of everyone in the Melanoma Unit here at The Royal Marsden, I’d like to thank The Myfanwy Townsend Melanoma Research Fund for their long-standing support of our work. Your on-going dedication is enabling us to make huge strides in melanoma research and we look forward to working with you again next year”.