Are We Winning the Fight Against Melanoma?
Jan. 11, 2016 -- When former President Jimmy Carter announced late last year that his advanced melanoma appeared to be in remission, family and followers of the 91-year-old humanitarian were overjoyed.
Some said it seemed nothing short of a miracle, since the skin cancer is often deadly in its advanced form. His doctors, though, pointed to one of the drugs prescribed to Carter as a major reason for his improvement.
Among other treatments, Carter took pembrolizumab (Keytruda), one of several new meds approved in the last 4 years by the FDA to treat melanoma. This explosion of new drug approvals in such a short time came after decades of stalled progress and glum outlooks for many diagnosed in advanced stages of this deadly cancer.
About 73,000 new cases of melanoma were expected in 2015, with about 10,000 deaths, according to the American Cancer Society.
Experts are hopeful the new drugs that have received the FDA's OK since 2011may change those death statistics. The meds fall into two categories. Immunotherapy treatments prime the immune system to fight the cancer. Targeted therapies take aim at common genetic mutations found in a small group of melanoma patients.
"Talk about game-changing," says Len Lichtenfeld, MD, deputy chief medical officer for the American Cancer Society. "All of a sudden you have researchers talking about half the patients getting benefits [for some of the drugs]." In years past, doctors gave people with advanced melanoma much less hope.
"These are incredible advances," Lichtenfeld says. "We now have something to offer where we had nothing."
The new drugs, for the most part, are only approved for stage IV melanoma or advanced disease, says Joseph Skitzki, MD, an associate professor of surgical oncology at Roswell Park Cancer Institute. Stage IV cancer means it has spread to other organs or parts of the body -- in Carter’s case, his brain.
When doctors spot melanoma early, removing it surgically produces a cure rate of 97% to 100%, Skitzki says.
But even with the new ''wonder'' drugs for advanced melanoma, the war isn't won, Skitzki and other experts say. The new medications don't work for everyone, and many unanswered questions remain.
"We aren't even certain" how long the benefits of the drugs will last for patients, Lichtenfeld says. "We are still very much learning" who the meds will help.
The drugs also come with breathtaking costs. The average Medicare patient will pay $60,000 of the $300,000 yearly costs for treatment with one combination of drugs. For other meds, experts predict annual costs could approach $1 million per patient.