By Louise M Perkins, PhD
Chief Science Officer
There is no denying the transformative success of new treatments for melanoma ranging from molecularly targeted agents for BRAF-mutant melanoma to immunotherapies like anti-CTLA4 and anti-PD-1 drugs. Indeed, the treatment of BRAF-mutant melanoma is a prime example of Precision Medicine; that is, matching treatments to a patient’s specific disease.
Yet, despite the progress, about half of melanoma patients lack a BRAF mutation and treatment resistance to immunotherapy is far too common. New strategies for these patients cannot come quickly enough.
Expanding Precision Medicine in Practice
Since 2012, the SU2C-MRA Melanoma Dream Team has been working on one such strategy, a Precision Medicine approach – similar to what President Obama advocated just a few months ago – with joint funding by both the Melanoma Research Alliance (MRA) and Stand Up to Cancer (SU2C).
The first publication describing the pilot phase of the Melanoma Dream Team’s genomically guided therapy study appeared online recently in the journal Molecular Cancer Therapeutics. The team piloted its approach to ensure that state-of-the-art genomic information could be produced with biopsies from patients with melanoma that could be useful for treatment decision-making in a timely way. While this idea may sound simple, it is no easy feat, with many real-world logistical and technical challenges.
Teamwork is a key feature in overcoming many of these challenges, including starting and running a complex trial of this sort involving multiple centers and high-tech analyses. But state-of-the-art science is also needed. The team’s cutting-edge sequencing machines and expertise in genomics is critical to produce and analyze the genomic data. This genomic data can help spot tumor-specific mutations that might be susceptible to therapeutic treatment. Together, the teamwork, expertise and technology provide the means to unlock a better understanding of how to offer treatments tailored to the unique genomic features of one’s own tumor.
Sharing Lessons Learned
The important lessons learned in this pilot have already been shared widely in meetings with researchers to speed the startup of similar studies across cancers. And participants from programs like NCI-MATCH and LungMAP have been actively sharing information on this topic, too. It is gratifying to see the Melanoma Dream Team’s programmatic advances disseminated world-wide through this recent publication.
It is important to ask how well such a Precision Medicine approach works with larger numbers of melanoma patients, as the field continues its efforts to overcome resistance to available treatments and work toward wider adoption of Precision Medicine.
To that end, the Melanoma Dream Team has several sites around the country that are enrolling eligible patients with melanoma who have progressed on (or are ineligible for) approved immunotherapies and who lack a BRAF V600 mutation that would qualify them for molecularly targeted treatments.