MPIP: Melanoma Patients Information Page

The MPIP is the oldest and largest community of people affected by melanoma hosted through the Melanoma Research Foundation. It is designed to provide support and information to caregivers, patients, family and friends. Once you have been touched by melanoma—either as a patient or as a family member or friend of a patient—you become part of a community. It is not a community anyone joins willingly. But if you must be part of this group, you will find no better place to find the tools you need in your journey with this cancer, and the friends who can make that journey more bearable.

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Marker Could Predict Dabrafenib Response in Melanoma

 
By Leah Lawrence | August 18, 2013
 
 

The results of BREAK-2, a phase II clinical trial of dabrafenib, were recently published in the Journal of Clinical Oncology, showing that the BRAF inhibitor dabrafenib was effective in the treatment of patients with advanced melanoma with the BRAF V600E/K mutation, with a manageable toxicity.

Based on the results of this study, and the subsequent BREAK-3 phase III trial, dabrafenib was approved by the FDA in late May for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E mutation.

In addition to the drug’s efficacy, the researchers, led by Paolo A. Ascierto, MD, vice-director of the unit of melanoma, cancer immunotherapy and innovative therapy at the National Tumor Institute Fondazione G. Pascale, Naples, Italy, also found that circulating cell-free DNA could represent a possible predictive marker of response, if results are confirmed in a larger prospective study.

Ascierto and colleagues examined outcomes in 76 patients with stage IV BRAF V600E and 16 patients with stage IV BRAF V600K metastatic melanoma. All patients were assigned to receive 150 mg dabrafenib twice daily until progression, death, or unacceptable adverse events.

At the time of follow-up, 59% of patients in the BRAF V600E–mutated population had a confirmed response, including 7% with complete response. Of the patients with BRAF V600K–mutated melanoma, 13% had a partial response.

The researchers also looked at secondary endpoints of progression-free survival and overall survival. The progression-free survival in the V600E group was 6.3 months, and in the V600K group it was 4.5 months. The overall survival for V600E and V600K was 13.1 months and 12.9 months, respectively.

“The overall survival reached in the study confirmed the important role of the BRAF inhibitor in the treatment of advanced melanoma patients,” Ascierto said.

Overall the treatment was considered to be well tolerated. Twenty-seven percent of the group experienced a serious adverse event and 93% of patients experienced any adverse event. The most commonly occurring adverse events were arthralgia (33%), hyperkeratosis (27%), and pyrexia (24%).

“The evaluation of the circulating cell-free DNA showed a possible correlation between the baseline level of circulating cell-free DNA in the V600E population and progression-free survival and response rate, with higher value of baseline circulating cell-free DNA correlating with a reduced progression-free survival and overall response rate,” Ascierto said. “Of course, this finding should be confirmed in further studies.”

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http://www.cancernetwork.com/melanoma-skin-cancer/content/article/10165/2154519

Live 4 today. Thank God for all he has done for us. Looking forward to enjoying tomorrow.

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mark1101's picture
Replies 2
Last reply 8/22/2013 - 12:42am
Replies by: Tim--MRF, Richard_K

My dermatologist had a little spot (1 cm) on my face biopsied which came back squamous cell carcinoma.  I am scheduled for Moh's surgery in a few weeks to get it cleaned up.

I am starting my Ipi maintenance phase for Stage III melanoma next week.  Has anyone heard of the presence of a different cancer on the skin causing problems with continuing treatment of a melanoma?

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Roxy1453's picture
Replies 10
Last reply 8/23/2013 - 1:44pm

I haven't posted in quite awhile. I have been on here several times to see how everyone is doing though.
I have been doing so well and have been trying to put it behind me and live my life. I have had 4 months off and have been feeling as close to normal as I can. I had a PET Scan yesterday that shows a spot in my lung. It's in the scar tissue from my surgery to remove Mel in 2011. He says its on the edge of my lung and had probably gone to my pleura also. He's not for sure about any of it yet and has given me two choices. Wait 8 weeks and and have another scan and see if it grows or do a needle biaopsy which could deflate my lung. I don't know if I can wait 8 weeks and sit and worry that long. I also have two children getting married next May and July. If I had to have treatment I would rather get started now rather that 8 weeks from now. What are your thoughts? I'm stage 4 metastatic.

"I can do all things through Christ who strengthens me." Philippians 4:13

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Lisa - Aust's picture
Replies 12
Last reply 8/31/2013 - 5:03pm

Hi Everyone,
I visit often and luckily haven't had to post much - but unfort I have some questions! My husband Craig has been on Zelboraf for 2.5 years (complete response) - but we found out today that one of the lymph nodes he had at the beginning of the z trial has started growing again. The onc discussed merck anti PD1 as his next option. I am just looking for some info about it - stories, side effects, results etc - would love to hear from anyone experiencing it :)
Thanks so much
Lisa

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Anonymous's picture
Replies 18
Last reply 3/5/2014 - 7:22pm
Replies by: pigs_sty, Anonymous, benp, Peabody_58, POW

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nnhood's picture
Replies 11
Last reply 8/22/2013 - 2:44pm
Replies by: JerryfromFauq, Anonymous, nnhood, Janner, hbecker, sbrooks90, POW

 

About three months ago I had noticed a small dime-sized red mark on my right side / buttock area.  At first I simply dismissed it as a bug bite but noticed that it wasn't going away. It didn't grow, but didn't shrink either and looked harmless enough, it hadn't scaled over at all.  I scheduled an appointment with a dermatologist and they removed the lesion and did a biopsy. On the breslow scale it was only .48 in depth so they did not do any lymph node biopsies.

They called me back and told me it was a superficial melanoma and that it was very good that I caught it early. A few days later I went back in they surgically removed the recommended area around the original lesion. 

It required 10 stitches, but it was a painless procedure and it's now healing well. I had the top stitches taken out a couple weeks ago.

I will now be going back every three months for the time being to get a physical exam and skin examination.

I guess I'm just paranoid now, I'm not so much worried about every little mark on my skin, but I worry about aches and pains in other areas being cancer now.  Sort of the opposite of worrying about the surface lesion spreading, I'm starting to worry the cancer was somewhere else and showed itself on the surface by way of this melanoma...

Should I have any other tests done like CT or PET scans to be sure or is that just being a hypochondriac.  It doesn't help my mom always worked for doctors her whole life, I'm always trying to be proactive which is good, but not when you obsess over something.

Thanks,

Matt

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MattF's picture
Replies 4
Last reply 8/20/2013 - 9:36pm
Replies by: MattF, kathycmc, ecc26

So biopsy of lump on my right side of neck
about half an inch below my primary MM
WLE with clear SNB and marginsa Stage II
from Sept 2012 are in.

UCLA FNA confirmed Metastatic Melanoma
in the Salivary Gland on right side.

I meet with the Oncologist (Dr Bartosz
Chmielowski) tomorrow. I assume this is
moves me to stage III as it is not a "distant"
site. I expect PET, parotidectomy (sp),
possible neck dissection or lymphextomy (sp)
and probably some treatment.

Anyone with any info please feel free to
pass it on.

Matt

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bj63's picture
Replies 3
Last reply 8/31/2013 - 5:28pm
Replies by: Tina D, bj63, Richard_K

Just returned from the oncologist a little while ago.  I'm in my 10th month on Zelboraf and appear to still be responding to the drug.  The tumor activity appears to have remained dormant since my scan in February and all my blood work looks normal.

For now I appear to have adjusted to the drug pretty well.  I still have the sun sensitivity and have lost most of my body hair.  Though some has started growing back, it is very sparse whereas I used to be a fairly furry critter.  I still get some random aches and pains that appear to be related to the Zelboraf but they've become fewer.

So, for now at least, thing seem to be going well.  Sometimes no news is the best news of all.

bj63

Sometimes no news is the best news!

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Anonymous's picture
Replies 2
Last reply 8/20/2013 - 2:55pm
Replies by: JerryfromFauq, POW
Review August 15, 2013

Immunotherapy and the Concept of a Clinical Cure

 

Eur. J. Cancer 2013 Jul 25;[EPub Ahead of Print], AM Eggermont, G Kroemer, L Zitvogel

 

 
TAKE-HOME MESSAGE

The authors discuss their thoughts on the optimal way to continue the renaissance in cancer immunotherapy with the ultimate goal of achieving a complete cure for patients.

 
ABSTRACT

Immunotherapy has entered a new phase in its history, i.e. the phase of being broadly accepted as a key component of therapeutic strategies to control and cure cancer. Immune-modulation by checkpoint inhibitors have demonstrated to be capable of inducing long lasting tumour responses. Breaking tolerance by ipilimumab has been a crucial event in the past recent years, but PD-1/PD-L1 antibodies have forever changed the landscape in oncology in 2013. The most mature results have been obtained in advanced melanoma patients. High response rates of high quality with prolonged duration have been demonstrated in melanoma, renal cancer and in lung cancer. The broad potential is now being explored across a wide range of tumours. Importantly, synergy with ipilimumab has been demonstrated in melanoma, indicating a bright further future. Long term tumour control now seems achievable and thus the concept of a "clinical cure" is emerging. These antibodies bring immunotherapy to the forefront and indicate that immune-modulation will be a key component of therapeutic strategies from now on. All these observations indicate that "clinical cures" can only be achieved when the immune system is involved, and so the true renaissance of immunotherapy has arrived.

European Journal of Cancer
Immunotherapy and the Concept of a Clinical Cure
Eur. J. Cancer 2013 Jul 25;[EPub Ahead of Print], AM Eggermont, G Kroemer, L Zitvogel

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mark1101's picture
Replies 6
Last reply 8/21/2013 - 10:06am
Replies by: mark1101, Gene_S, ecc26, DeniseK

I am in the Ipi trial for Stage III.  I completed my infusion treatments on May 14 and am starting maintenance treatments this coming Monday, August 26.  I started experiencing a rash and itching a week after my second infusion.  We managed it with Prednisone.  Other than a few days prior to each infusion I have been taking Prednisone almost continuously since mid-April.  As of today, the itch and rash have cleared up and I am off Prednisone.  Wondering what I might expect after the maintenance treatment on Monday.  I have two questions regarding all of this:

1.  Does the tendency to have the itching and rash reaction abate at all as treatment goes on...ie will I become less sensitive?

2.  What long-term effects of Prednisone should I be aware of, and are there alternatives to Prednisone with less inherent toxicity?

My good news is that my last PET was on August 12 and I have been NED now since my last surgery at the end of January.

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SaveMySister's picture
Replies 8
Last reply 8/20/2013 - 4:18pm

My sister's battle barely got off the ground She was diagnosed July 22nd.  She was admitted to Moffit, where she stayed less than a week. They sent her home after 3 days of brain radiation. She received 2 more rounds as an outpatient.  But being that her spleen was so swollen and she could barely get any food or drink down her, she was rushed by paramedics to the ER 4 days later due to fever, nausea/vomiting and extreme pain. They admitted her to Tampa General where she stayed 5 days, missing the 5 supposedly critical brain radiation treatments on the agenda that week, because Moffitt didn't have a bed for her.  They moved her back there just before the weekend, gave her 1 brain radiation treatment on Monday, and then Tuesday she was told they were not going to give her the Zelboraf or the chemo, that they were discontinuing treatment and moving her to hospice that very day.  I spoke to her Tuesday for over an hour on the phone. By the time I got back down to see her Thursday morning, she was so much more incoherent.  She lost her last ability to interact with anyone by 2 AM Friday morning.  Friday evening she died at 9PM.  No one could save my sister.

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Anonymous's picture
Anonymous
Replies 1
Last reply 8/19/2013 - 5:08pm
Replies by: melissa ann

How Brett is doing?  she went by Sharmon

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vrswesley's picture
Replies 6
Last reply 8/19/2013 - 8:24pm

Im at the veru begining, I found a "something" that I susspect is a mole..I say susspect..because I cant really see it..its on my back. i can sorta see it in the mirror.. most of the info i have is what i can get from other people looking at it..driving me crazy.. I have a doc appt is in 3 weeks.

mine Ive been told, looks anything like a bad scratch that has bled and then scabbed over to a mole with a rough tecture and a thin red line srounding it. int about a short centimeter in lengther and roughly oval in shape.

my friend paul wants the doc to look at it RIGHT now-he had something simular once that was cancer.. others say its nothing.. others say 3 weeks is soon enough.. its driving me crazy that I cant see it.

 

I have alot of health problems, am on social seciurity disabilty, my husband JUST died.. Im depressed and...now SCARED.

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kwb's picture
Replies 4
Last reply 8/19/2013 - 2:02pm
Replies by: kwb, JerryfromFauq, Becky

Greetings....Diagnosed in late July with a recurrence of melanoma in my right lung (two small tumors).  I have c-Kit gene mutation and doctor wants to start me with Gleevec.  I've been doing a bit of research on my own, but I want to know if anyone in this "community" has any insights or experience with this drug.

Thanks.

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Replies by: Delores T., POW

This trial has been recommended for my niece.  Just wondering if anyone has any experience with this trial?  For background - my niece is stage IIC - diagnosed with a pink melanoma - 4.24mm deep, ulcerated with a mitotic rate of 9.  It seems like interferon is not a great choice.  I know it is controversial but wondering what the pros and cons might be of each treatment.  Thanks so much!

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