shows benefit for melanoma in Phase III trial

Winship Cancer Institute melanoma specialist David Lawson, MD, helped bring to light encouraging news about advanced melanoma, typically one of the most difficult cancers to treat. Lawson, professor of hematology and medical oncology, was a co-author of a study published in June 2 in the New England Journal of Medicine showing that a therapeutic melanoma vaccine improves responses and progression-free survival rates when combined with Interleukin-2, an immunotherapy drug.

“It makes the point that you can add vaccine to Interleukin-2 and possibly improve response rates,” says Lawson.

No vaccine is yet available to treat melanoma, Lawson explains, and it could be years before one is available. But the study was significant because it marked the first vaccine study in melanoma to show clinical benefit in a randomized Phase III trial. While vaccines have been studied as a way to help the body fight cancer, none has been approved by the FDA for use in advanced disease.

Patients in the trial were randomized to receive high-dose IL-2 or IL-2 plus a vaccine, a peptide known as gp100. Those receiving the vaccine and IL-2 had a response rate of 16 percent, while those receiving only IL-2 had a response rate of 6 percent. Progression-free survival for the vaccine group was 2.2 months, compared with 1.6 months for the IL-2 group.

Double-team could block escape route for triple-negative breast cancers

drugs such as tamoxifen or Herceptin.

“Right now, there aren’t effective treatments for triple-negative breast cancer besides chemotherapy,” says Ruth O’Regan, MD. These aggressive tumors disproportionally affect African American women at a young age.

second class of drugs, mTOR inhibitors, may be able to block the cancer cells’ escape route.

Winship researchers are testing whether a combination of drugs can stop the growth of a hard-to-treat form of breast cancer. “Triple-negative” breast cancers get their name because they lack three biological markers that make other breast cancers vulnerable to

After researchers showed that lapatinib combined with rapamycin can stop growth in cell lines and in animal models, this approach is being tested in a clinical trial at Winship designed by O’Regan. The lab studies were published recently in Molecular Cancer Therapeutics

Although the molecule EGFR (epithelial growth factor receptor) is hyper-activated in many breast cancers, so far EGFR inhibitors such as lapatinib have not been effective by themselves in the clinic. O’Regan says that adding a

The rationale for the combination grows out of a concept called “enhanced oncogene addiction,” she says. The idea is that mTOR inhibitors such as rapamycin can make cells more dependent on a growth factor pathway like EGFR, an approach that was previously successful with Herceptinresistant breast cancers.

The clinical study is designed for patients with triple-negative breast cancer who have already been through first-line chemotherapy. O’Regan says the study includes biopsies, as part of an effort to understand what mutations and genetic signatures distinguish patients who have a better chance of responding.