The new anti-melanoma drug Keytruda, which the latest clinical studies say help prolong life in patients suffering advanced melanoma may open up new ways to treat many other forms of cancer, says Professor Rick Kefford, Co-Director of Research for Melanoma Institute Australia.
A study published today by the prestigious New England Journal of Medicine, and which included participants provided by the Westmead Institute of Cancer Research, says that Keytruda reduced the size of tumours in 70 per cent of patients and allowed 74 per cent of patients to survive for a year after diagnosis, a stunning leap forward compared to 58 per cent of patients treated with the other standard melanoma drug Yervoy.
Further than that, the drug encouraged “deep reduction” in tumours in 30 per cent of patients, a result, says professor Kefford, of the drug being able to block a key cancer receptor known as PD-1 (programmed death receptor 1).
“PD-1 is just one of a series of red flags that the tumour cell puts up that tells the immune system to ignore it and allow it to keep reproducing,” says Professor Kefford. “They actually inhibit the immune system from recognising it and from killing it off.
“These drugs bind to that flag and block from recognition by the immune system so that the immune system gets angry and attacks the tumour, which is what it is meant to do. The insidious nature of cancer is that it throws up these false signals that allows it to keep growing without an immune response to stop it.
“But the key factor here is survival and we can clearly see by the survival rates that this drug is contributing a major benefit to these patients. These drugs have only been examined for three years so we don’t have long-term data as yet but many oncologists around the world are confident that they contribute to cures for a group of people. We can’t say exactly how many but it could be more than 25 per cent.”
As such this is “one of the great leaps forward in cancer research”, he says. “There is no doubt about that,” he says. “People have talked about immune-therapy to treat cancer for years but it has been a series of disappointments so to finally have something that reliably and reproducibly restores immune attack on cancers is a majority jump forward that has absolutely gripped the entire oncology world.
“Researchers are already building on this to produce a whole new class of drugs that inhibit a whole range of other flags on tumour cells and combining them to gain massive benefits in survival and tumour control – its revolutionary.
“I have been working on melanoma for 30 years and the first 25 were desolate in terms of treatment. We had nothing with which to treat patients who had advanced melanoma and most of them died within two years.
So we never expected that melanoma would become the poster child for the future of cancer treatment but it has. And there are now trials being conducted in a range of cancers. This drugs has in quite a few other cancer types particularly lung cancer but also cancer of the head and neck, a number of different blood cancers – including leukaemia and lymphoma –and some types of breast cancer that have until now proved resistant to treatment.
The other attractive thing, professor Kefford says, there are very few side effects. “While these patients are using it they enjoy a very high quality of life with none of the onerous side effects that we typically associate with chemotherapy cancer treatments.”
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