Archive for March, 2011
See this press release from the FDA:
Melanoma patients lived longer with treatment
The U.S. Food and Drug Administration today approved Yervoy (ipilimumab) to treat patients with late-stage (metastatic) melanoma, the most dangerous type of skin cancer.
Melanoma is the leading cause of death from skin disease. An estimated 68,130 new cases of melanoma were diagnosed in the United States during 2010 and about 8,700 people died from the disease, according to the National Cancer Institute.
“Late-stage melanoma is devastating, with very few treatment options for patients, none of which previously prolonged a patient’s life,” said Richard Pazdur, M.D., director of the Office of Oncology Drug Products in the FDA’s Center for Drug Evaluation and Research. “Yervoy is the first therapy approved by the FDA to clearly demonstrate that patients with metastatic melanoma live longer by taking this treatment.”
Yervoy is a monoclonal antibody that blocks a molecule known as cytotoxic T-lymphocyte antigen or CTLA-4. CTLA-4 may play a role in slowing down or turning off the body’s immune system, affecting its ability to fight off cancerous cells. Yervoy may work by allowing the body’s immune system to recognize, target, and attack cells in melanoma tumors. The drug is administered intravenously.
Yervoy’s safety and effectiveness were established in a single international study of 676 patients with melanoma. All patients in the study had stopped responding to other FDA-approved or commonly used treatments for melanoma. In addition, participants had disease that had spread or that could not be surgically removed.
The study was designed to measure overall survival, the length of time from when this treatment started until a patient’s death. The randomly assigned patients received Yervoy plus an experimental tumor vaccine called gp100, Yervoy alone, or the vaccine alone.
Those who received the combination of Yervoy plus the vaccine or Yervoy alone lived an average of about 10 months, while those who received only the experimental vaccine lived an average of 6.5 months.
Common side effects that can result from autoimmune reactions associated with Yervoy use include fatigue, diarrhea, skin rash, endocrine deficiencies (gland or hormone), and inflammation of the intestines (colitis). Severe to fatal autoimmune reactions were seen in 12.9 percent of patients treated with Yervoy. When severe side effects occurred, Yervoy was stopped and corticosteroid treatment was started. Not all patients responded to this treatment. Patients who did respond in some cases did not see any improvement for several weeks.
Due to the unusual and severe side effects associated with Yervoy, the therapy is being approved with a Risk Evaluation and Mitigation Strategy to inform health care professionals about these serious risks. A medication guide will also be provided to patients to inform them about the therapy’s potential side effects.
Yervoy is marketed by New York City-based Bristol-Myers Squibb.
What do you think of this?
Adolescent girls and young women living in wealthy communities were more likely to be diagnosed with melanoma in a new study of skin cancer cases in California.
The authors think that might be because wealthier women may be spending lots of time out in the sun – at home and on vacation – and frequenting tanning beds.
“It’s frightening actually,” Dr. Elizabeth Tanzi, a dermatologist at Johns Hopkins University School of Medicine in Baltimore who was not involved in the study, told Reuters Health.
“The message of practicing safe sun is just not getting through to the people that need to heed the warning,” said Tanzi, who also heads the Washington Institute of Dermatologic Laser Surgery in Washington, D.C.
Melanoma is the most lethal form of skin cancer, killing almost 9,000 people in the U.S. last year, according to the National Cancer Institute. Exposure to ultraviolet (UV) light is known to increase the risk of melanoma.
Cases of melanoma have been rising in young white women in the United States in recent decades, more than doubling since the early 1970s.
In the current study, Dr. Christina Clarke of the Cancer Prevention Institute of California and her colleagues analyzed data from a registry of more than 3,800 melanoma cases in white California girls and women aged 15 to 39. They paired the cancer statistics with information from the U.S. census to determine the socioeconomic status of each of the women, based on household incomes and education levels in their neighborhoods.
Rates of melanoma were significantly higher in women in the highest socioeconomic categories according to the findings, which are published in the Archives of Dermatology.
In the wealthiest 20 percent of California neighborhoods, four or five out of 100,000 young white women were diagnosed with melanoma over the 5-year period from 1998 to 2002. For the poorest group, the rate was less than one in 100,000 over the same period.
Compared to data from a decade earlier (1988 to1992), rates of melanoma increased in white girls and young women as a whole – but the increases were most obvious in wealthier women.
Wealthy women weren’t more likely to get melanoma just because they lived in the sunniest areas of California. When the authors calculated how much UV light women in different neighborhoods were exposed to, they found that the wealthiest women living in areas with lots of UV radiation were still diagnosed with melanoma almost 75 percent more often than the poorest women who lived in communities with the most UV radiation.
Clarke said that it also wasn’t likely that wealthy girls would be diagnosed with melanoma more often just because they have better access to health care. Invasive melanoma, she told Reuters Health, “is going to get very serious very quickly” – it’s not something a woman would live with for years while thinking she was healthy.
A combination of outdoor sun exposure and tanning beds were probably to blame for higher rates of melanoma in wealthier girls, Clarke said. Mid-winter trips to Mexico or Hawaii, for example, require money and can be dangerous after skin has been covered up for months, she said.
Clarke said that wealthy girls especially are surrounded by the message that being tanned all year round is cool – they even have Katy Perry singing about it. But the new findings, she said, “should really cause us to think, ‘how cool is a tan if it puts lighter skinned women at risk of deadly cancer?'”
One solution, Clarke said, could be bans on tanning beds for young girls and more education for wealthy girls and women to try to make tanning “uncool.”
“The thought is that ‘well, it can’t happen to me,'” Tanzi said. “It’s the invincible nature of a teenager. Tanning is still seen as somewhat okay to do.”
The message that needs to get across, Tanzi said, is that “no tan is safe.”
Have a look at this article which I found quite interesting:
The evolution of nevi is a complex process involving several constitutional and environmental factors. Although histopathology is the gold standard for the diagnosis and classiﬁcation of melanocytic nevi, the widespread use ofin vivo diagnostic technologies such as dermoscopy and more recently of reﬂectance confocal microscopy, hasenriched profoundly our knowledge regarding the morphological variability of nevi in different stages of their evolution. In addition, signiﬁcant progress has been made in our understanding of genetic alterations and molecular pathways involved in the formation of melanocytic tumors. All this newly acquired knowledge increasingly questionswhether morphologically different nevi are also histiogenetically different. In this article, we intend to extract some ofthe salient points from published clinical and molecular studies on melanocytic tumors and attempt to assimilatethem into an integrative concept of nevogenesis.
I found this quite interesting. Night workers have an increased risk of cancers generally but not skin cancers. I wonder if it is due to reduced sun exposure or something else?
BOSTON, March 3 (UPI) — Working nights is linked to increased risk of some cancers, heart disease and diabetes, but workers may have less risk of skin cancer, U.S. researchers say.
Lead author Dr. Eva Schernhammer of the Channing Laboratory at Brigham and Women’s Hospital in Boston documented 10,799 incidents of skin cancer in 68,336 women in the Nurses’ Health Study over an 18-year period.
The study, published online in the Journal of the National Cancer Institute, found higher duration of working rotating night shifts was associated with a significantly lower risk of skin cancer.
Although the risk for each skin cancer — basal cell carcinoma, squamous cell carcinoma and melanoma — decreased, the strongest association was observed for melanoma, which was associated with a 44 percent decreased risk of melanoma after working shifts for 10 years.
Working night shifts has been linked to decreased production of melatonin, which is known to have cancer-protective properties.
Just wondering about whether there was any consensus or views about the following:
1. All suspected BCC’s need a biopsy to guide management
2. If you have a biopsy diagnosis of BCC, you should submit the treatment (curette or excision) specimen.
3. BCC’s can be treated without histological confirmation at any point.