Immune drugs hold hope of "clinical cure" for deadly skin cancer

Reuters

* New data on BMS drug show some patients survive 10 years

* Immunotherapy drugs arm immune system to fight tumours

* In some patients, disease held in check in "clinical cure"

By Kate Kelland

AMSTERDAM, Sept 27 (Reuters) - A new generation of drugsdesigned to trigger the immune system to fight cancer isoffering the prospect of a "clinical cure" for some melanomaskin cancer patients who until a few years ago were more likelyto be facing a swift death.

Cancer specialists gathering for a European conference atthe weekend said the so-called immunotherapy drugs, a class ledby Bristol-Myers Squibb's Yervoy, or ipilimumab, havetransformed an area of oncology in which until recently doctorsbarely had time to get to know their patients.

Stephen Hodi, assistant professor of medicine at theDana-Farber Cancer Institute in the United States, said he wascautious about using the term cure, but described recentadvances as a "paradigm shift".

At the least, he said, the success of this new generation ofmedicines means some melanoma patients would now be living witha chronic disease, rather than facing imminent death.

"This is a really amazing time ... A few years ago we couldnever have imagined using the C-word, cure, in melanoma," hesaid. "But we are headed that way."

"Ipilimumab opened a door, and now the field is movingextremely fast," he told Reuters at the European Cancer Congress(ECC) in Amsterdam.

Yervoy, approved by regulators in 2011, was hailed as abreakthrough treatment in melanoma after it became the firstdrug ever to extend survival in patients with advanced forms ofthe melanoma, the deadliest form of skin cancer.

A type of drug known as a human monoclonal antibody, itactivates the body's immune system to fight the cancer bytargeting a protein receptor called Cytotoxic T-LymphocyteAntigen 4, or CTLA-4.

On average, Yervoy added only about four months of life inpivotal trials, but around 20 percent of patients had animpressively durable response to the drug.

Hodi presented new data at the ECC from the largest andlongest study of overall survival for patients treated withYervoy which showed some of them can survive for up to 10 years.

Alexander Eggermont of the Institut Gustave RoussyComprehensive Cancer Center in France, who specialises in thetreatment of melanoma, said Hodi's results suggested somepatients could be effectively cured of their cancer - a conceptknown as a "clinical cure" - with the drug helping the immune tokeep the disease in check.

"Patients apparently can keep residual tumours under controlfor a long time when the immune system is properly 'reset', andthe concept of 'clinical cures' becomes a reality," he said in astatement to the conference.

And with a next generation of immunotherapy drugs - designedto disable proteins called PD1 and PDL1 that prevent the immunesystem from spotting and attacking cancer cells - already beingtested alone and in combination with Yervoy, there is"tremendous promise" in the treatment of melanoma, said Hodi.

Bristol-Myers Squibb is conducting late stage trials of itsnext-generation drug, nivolumab, in advanced melanoma, whilerival U.S. drugmaker Merck is developing a competitor,lambrolizumab, which in early-stage trials helped shrink tumoursin 38 percent of advanced melanoma patients.

Swiss drugmaker Roche's also has a leadingcontender - MPDL3280A - in this class.

"These (Yervoy) survival results could even double or triplewith anti-PD1/PDL1 monoclonal antibodies, and metastaticmelanoma could become a curable disease for perhaps more than 50percent of patients over the coming five to 10 years," Eggermontsaid.

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