Melanoma Diagnosis and Its More Effective Therapies

The fight against melanoma, skin cancer is particularly aggressive, now has new allies: early diagnosis that relies on new tools and a therapy that is enriched by innovative drugs that have been shown to stop the evolution of the disease even when it is in an advanced stage. On the occasion of the Congress of Italian melanoma Inter-group (Imi) presented the novelties, including Alexander Testori, outgoing President of Imi, speaks to Dica33.

 

Dr. Testori, starting with the diagnosis: what is new?

About two years ago has been introduced which allows confocal microscopic analysis of pigmented lesions without having to remove. The laser draws the profile of cells up to a thickness of 250 microns, i.e. the thickness of the epidermis. Is similar to a histological examination but requires the removal, and then allows you to select a more sophisticated who submit removal: intervene, for example, on early stage melanomas, or not, if the lesion is not suspected. It is a very important innovation to find out what are the most serious patients to follow

Then all suspects must be analyzed in this way?

This method is suitable if there are few injuries or to examine those previously selected with dermatology, another that detects among many, sometimes there are up to 300 in atypical in the same patient, to be sent to surgery. Confocal with the selection becomes even more pressing and undergoes surgery only those most at risk. Typically, when in many investigations are always a mapping of in, that is a digital recording of all those that the dermatologist sees. We must not forget that early diagnosis with melanoma is simple because just look at the patient.

On the front of the treatment have been made strides?

The biggest successes have always obtained by surgery, which remains the central pillar of the cure, but there are new drugs that are modifying the disease course with the goal is to make it chronic, i.e. not to advance. The two drugs are immutability and deafening. The first acts on the immune system and binds a receptor of T cells, blocking component that prevents the immune response. In essence, a kind of brake on the immune response and the patient with melanoma draws benefits with an increase in survival. Vemurafenib has another mechanism, as it inhibits the B-Raf gene that is altered in 60% of patients and is used only in these cases.

That results are obtained with these new drugs?

Both were designed with patients with metastasis with advanced disease. In recent, then trials rather with data collected within 2-3 years, it has been observed an increase in survival of 30%, this means that if patients lived an average of six months with the treatment allusiveness survival without progression of disease until 9-11 months. It is a matter of global media, which is played on large numbers, and this means that some patients could live much longer, even for 20 years without disease progression. Now the intention is to experience the two drugs in combination, with the assumption that their action mechanisms against cancer cells to be compounded.

Drugs are available in Italy?

No, have not yet been approved, although in the United States and Europe the approval procedure has already passed some passages. But it remains the problem of high costs which will have to face when they enter the market. Just to get an idea: four vials of ipilimumab, administered once every three weeks cost 84mila euro.