CUH research hope for advanced melanoma patients

A clinical trial at Cork University Hospital (CUH), the first of its kind in the world, may offer fresh hope to patients with advanced melanoma, a form of skin cancer with a traditionally poor prognosis.

Those who sign up to the trial will receive a drug called Ipilimumab or ‘Ipi’ and electrochemotherapy. Ipi is the first in a line of new immunotherapies that prevent tumours from shutting down the patient’s immune system when it’s attacking the cancer.

Electrochemotherapy involves a process known as electroporation, where short bursts of electricity are delivered directly to the tumour making it porous, and dramatically increasing its absorption of the chemotherapy drug.

Researchers hope that combining Ipi and electrochemotherapy will make the immunotherapy treatment even more effective, enabling the patient’s immune system to respond against the cancer.

Principal Investigator and consultant oncologist Derek Power said Ipi has already shown its potential. “The scientific information on Ipi after 10 years follow-up of 5,000 patients worldwide is that about 18% to 20% are alive a decade later. These are people with advanced, incurable melanoma. That was unthinkable 10 years ago when about 50% of those with advanced melanoma died in less than 10 months,” Dr Power said.

There was also “early scientific data” to show the combination approach being taken in the Cork trial could further improve outcomes for patients, Dr Power said.

Bristol-Myers Squibb the manufacturers of Ipi, is partially funding the trial by covering the cost of the drug – €70,000 to €100,000 per treatment schedule per patient. A treatment schedule involves four doses of the drug over 12 weeks.

The trial, which has just commenced at CUH, has enrolled two patients to date and is open to patients around the country.

Dr Power said because the Cork/ Kerry/ Waterford seaboard is a skin cancer hotspot, as identified by the National Cancer Registry, about one third of advanced melanoma cases each year are in the region. He said not all patients with advanced melanoma will be suitable for the trial

There are other drugs, more advanced than Ipi, which may be more effective but patients could enrol in the trial and see how it worked out for them.

Doctors with patients who may be suitable for the trial should refer them to Dr Power of the Oncology Clinical Trials Unit in CUH or Declan Soden of the Cork Cancer Research Centre in University College Cork.

The centre is the pioneer of electroporation, announced the launch of the study yesterday entitled ‘Enhanced Malignant Melanoma Immunological engagement using sequential therapy with Ipilimumab and electrochemotherapy’. n For more on Cork Cancer Research Centre see www.ccrc.ie