Immunotherapy Has Potential To Cure Advanced Skin Cancer: Expert

New data shows that over half of melanoma patients on immunotherapy are alive and well at five to six years after treatment, says Dr Olivier Michielin at the World Cancer Congress 2022.

KUALA LUMPUR, Nov 3 – Recent advancements in immunotherapy drugs, which spur the immune system to attack tumours, have shown promising outcomes of curing skin cancer, including patients with melanoma, the most deadly of skin cancers.

While melanoma is usually curable with early detection, the skin cancer can become more difficult to treat and can be deadly if it has metastasised or spread deeper into the skin or other parts of the body.

“So clearly, cancer research is really active. We have had very important breakthroughs over the last few years. One of them is clearly immunotherapy. I am a physician treating melanoma patients, and I started with chemotherapy some years ago with absolutely little effect, if any. 

“Now, with immunotherapy, my goal, when I enter the room with a patient, is to get a cure, even if the patient is highly metastatic,” said Dr Olivier Michielin, chairman of the Department of Oncology at Geneva University Hospitals in Switzerland, at the World Cancer Congress 2022 press conference in Geneva last October 19. 

Dr Michielin said although success is not guaranteed, new data has shown that over 50 per cent of melanoma patients on immunotherapy treatment are alive and well at five to six years after the treatment. “So I think this infraction of the patient will be cured,” he said. 

Despite being less common than some other types of skin cancer, melanoma is one of the most serious types of skin cancer, as it is more likely to grow and spread. 

Melanoma starts in the melanocytes – cells which produce melanin (the pigment that gives the skin its colour) – and can develop anywhere on the body. 

Although melanoma develops in areas that have been exposed to the sun, the exact cause of melanoma is unclear. However, it has been proven that exposure to ultraviolet radiation from sunlight or tanning lamps and beds can increase the risk of a person developing melanoma. 

Dr Michielin said immunotherapy’s rising efficacy against melanoma has opened up the prospect of using immunotherapy to replace polychemotherapy in countries where the risk of infection is high, as immunotherapy might not carry the risk of infection. 

“Sometimes polychemotherapy can be very difficult to apply in some countries because of the risk of infections, and the immunotherapies might not suffer from this,” said Dr Michielin, when talking about the future of immunotherapy. 

Immunotherapy is a biological therapy treatment which uses substances made from living organisms to treat cancer. Polychemotherapy involves treatment with several chemotherapeutic agents all at once. 

Dr Michielin acknowledged, however, that immunotherapy’s application for cancer remains limited to only a few types of cancer and may “not work at all” for other cancers. Nonetheless, he stressed that immunotherapies are here to stay. 

“So, as we move towards cheaper drugs and generic formulation, maybe this could really be a path to follow in the years to come,” said Dr Michielin. 

To determine which patients will benefit from immunotherapy, Dr Michielin said “precision oncology programmes” are being developed across the world. 

“We have announced on Monday the creation of the Clinical Service of Precision Oncology at HUG (Geneva University Hospitals) with the aim to really find all the biomarkers that allow us to pinpoint those patients that need immunotherapy.

“And it’s very important because this selection mechanism could be deployed in many countries. So I think this type of research, hopefully, could also be useful, at some point, to really select the patients that really are in need of this or other types of immunotherapy.

“So clearly the research is going on and we have an absolute need to find solutions so that this can be deployed broadly in the years to come.”

Another area which has seen progress is chimeric antigen receptor (CAR) T-cell therapy.

“We also have a revolution in the cell-based therapies, where we can use engineered T-cells from the patients to really gain incredible control of some of the haematological malignancies.

“This is also an area of great interest with cure rates that are really interesting. Very expensive at the moment, but, again, the technology is evolving towards off-the-shelf CAR T-cell that could be used without the need of this extremely heavy logistics to get the cells from the patient and transform them,” Dr Michielin said.

CAR T-cell therapy is a way to obtain immune cells called T-cells from the patient to fight cancer. This is done by changing the cells in the lab through the addition of a gene for a receptor called the chimeric antigen receptor. 

This helps the T-cells attach to a specific cancer cell antigen, which is then given back to the patient where the cells then find and destroy cancer cells. 

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