CONTACT:
John O'Brien
(847) 330-0101, ext. 339
E-mail: [email protected]
or
Timothy Johnson, MD
(734) 764-2220
ADVANCES IN MELANOMA THERAPY IMPROVE TREATMENT OPTIONS FOR PATIENTS
NEW YORK, NY (April 29, 1998) -- Several advances in the evaluation of regional lymph nodes, adjuvant therapy and genetic immunotherapy for the treatment of malignant melanoma have improved the treatment options for patients, as well as the five year survival rate for many patients according to a study in the May issue of the Journal of the American Academy of Dermatology.
The improvement of treatment options and survival rates for melanoma patients is an important healthcare concern as melanoma is now the fifth most common type of cancer in the United States. The incidence rate of melanoma continues to rise faster than any other type of human cancer.
"The importance of advances in treatment for melanoma cannot be underestimated," said Timothy M. Johnson, MD, University of Michigan Comprehensive Cancer Center, the lead author of the study. "The current updates in melanoma therapies offer improved options for patients, but there is still much research to be done."
The evaluation of regional lymph nodes has proved to be an important predictor of the long-term outcome for a patient. In patients with nodal metastasis, the actual number of diseased nodes is the most important factor for the prognosis and overall survival. Currently, selective node dissection (which focuses on the main, or sentinel, node) is used to determine the condition of the entire group of nodes.
Another evaluation of the regional lymph nodes, intraoperative radiolymphatic mapping, uses an isosulfan blue dye in conjunction with different types of radiopharmaceuticals improve the accuracy of sentinel node mapping.
After the injection of a standard blue dye, a handheld gamma probe is used intraoperatively to identify the site of the radioactive sentinel nodes. The accuracy of identifying sentinel nodes increases to 99 percent when this form of node evaluation is used.
The benefits of many of the most common adjuvant therapies remain unclear for melanoma patients. The most promising adjuvant therapy to date involves interferon. There are two types of interferon: interferon gamma and interferon alpha. Interferon alpha appears to improve the long-term survival rates of patients while interferon gamma does not seem to have the same success. In recent clinical trials, the five year relapse-free survival rate improved by 42 percent ( 37 percent for the treatment group and 26 percent for the observation group) and the five year survival rate improved by 24% for the treatment group receiving interferon alpha (46 percent for the treatment group vs. 37 percent for the observation group).
The final advance, genetic immunotherapy, focuses on applications of gene therapy as it applies to immunotherapy based upon the understanding that melanoma appears to be an immunoresponsive disease. The concept is that immune cells are specifically sensitized against the tumor antigens. In a laboratory, these cells are replicated and then reinfused into the patient. One approach to gene therapy involves genetically modifying tumor cells to make them more immunogeneic. Another approach involves the injection of foreign genes directly into the tumor in an attempt to impact the immune response to the tumor.
The advances in the treatment of melanoma continue to generate interest among patients and healthcare providers alike. It has been estimated that more than $1 billion was spent on melanoma treatment in the United States in 1990. Assuming that the current 6% annual increase in melanoma treatment continues, the cost of melanoma treatment to Medicare alone may exceed $5 billion by the year 2010. The AAD is the world's largest organization of dermatologists representing 11,500 physicians that are experts in treating skin, hair, and nails.
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