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By Daily Telegraph Reporter
DRUGS used to treat high blood pressure and costing less than 5p a day could reduce the death toll from skin cancer, scientists have discovered.
Beta-blockers cut deaths from malignant melanomas by around 13 per cent, researchers have found.
Scientists think the drugs, which ha been around for more than 50 years, may not necessarily stop people from getting skin cancer but instead prevent the disease from spreading to other vital organs.
The findings, by a team of American and Danish scientists, come just days after Cancer Research UK, Britain's biggest cancer charity, announced it was funding a leading investigation, involving 30,000 women, to see if beta-blockers top breast cancer spreading.
The drugs work by preventing stress hormones, such as adrenaline, from stimulating cells in heart tissue and increasing blood pressure.
Scientists from Ohio State University and Aarhus University Hospital in Denmark studied 4,000 skin cancer patients and analysed how many had been taking beta-blockers.
Each patient was followed up for almost five years to see who survived and who did not.
The results, published in the journal Cancer Epidemiology, Biomarkers and Prevention, showed 372 of the patients were coincidentally prescribed beta-blockers, for heart-related conditions, around the time of their cancer diagnosis.
When they looked at mortality rates in this group, they found that those on beta-blockers in the three months before they got cancer were 13 per cent less likely to die from their subsequent tumour than those who did not have the drugs.
From The Times
Mark Henderson Science Editor
Last updated June 6 2011 12:01AM
British patients with the deadliest form of skin cancer are to be offered a revolutionary drug after trials showed it to extend life among people with advanced malignant melanoma.
A “compassionate use” programme for vemurafenib is to be set up within weeks to provide access to the Roche drug after the announcement of landmark study results hailed as the biggest breakthrough for 30 years. Hundreds of patients are expected to benefit.
The international clinical trial of 680 patients found that those taking vemurafenib, which attacks a genetic mutation found in about half of all melanomas, were 63 per cent more likely to be alive after a year than those on standard chemotherapy.
The results, presented yesterday at the annual meeting of the American Society of Clinical Oncology in Chicago, also showed that vemurafenib stopped tumours from getting worse for 5.32 months on average, compared with 1.61 months for chemotherapy. Half of the patients on the new drug experienced significant tumour shrinkage, compared with about 5 per cent of the control group.
Doctors and scientists described the findings as a milestone in therapy for advanced melanoma, which has always been among the most difficult of all cancers to treat.
Melanoma, which is diagnosed in almost 12,000 people in Britain each year, is treatable with surgery if caught early, but only 10 per cent of patients survive for more than a year once it has spread.
The first results were so encouraging that it was deemed unethical to continue with the trial, as that would have involved denying an effective drug to the control patients.The research is also an advance for personalised cancer medicine, by which drugs are targeted at particulargenetic mutations that drive individual patients’ tumours. Vemurafenib is suitable only for patients whose melanomas carry a mutation called V600, in a gene known as BRAF.
“It’s a clear turning point, a landmark moment for melanoma without question,” said James Larkin, a consultant medicaloncologist at the Royal Marsden Hospital in London, who led part one British armof the trial, said“Melanoma is a disease that just isn’t sensitive to standard chemotherapy, which is why we’ve made almost no progress at treating it.”until now.: “We have seen very dramatic benefits in pretty much all the patients who were on the drug. in the trial.These patients often had severe symptoms, pain and other problems, and some felt better almost immediately, literally within hours. For melanoma, that is unprecedented.” It isn’t a cure, and resistance is a problem, but this is a major step forward.”
Professor Richard Marais, of the Institute of Cancer Research in London, whose work contributed to the drug’s development of the drug, said: “This is the biggest breakthrough in melanoma treatment in more than 30 years.” “The results demonstrate for the first time that a targeted therapy can work in melanoma and will change our approach to treating the disease.” It is an enormous advance in the field.”
Roche, which makes the drug, has applied for licences to sell it in both Europe and the US, which are expected to be granted later this year. Until then, the company will fund patients to receive the drug on a compassionate basis. , in a study that will also gather further safety data.
Dr Larkin said the UK scheme would begin within the next two weeks, and that patients could be referred for treatment by their oncologist or GP. He cautioned that not every patient with advanced melanoma is suitable for the drug: their tumours will have to test positive for the V600 BRAF mutation targeted by vemurafenib, and they cannot be too sick.
This scheme will operate only until the drug is licensed, after which the NHS will have to decide whether or not to fund it.
The trial results also demonstrate how quickly scientific discoveries about cancer genetics are now being translated in to effective smart therapies that target mutated genes. The V600 BRAF mutation was identified just nine years ago, by a team led by Professor Mike Stratton, of the Wellcome Trust Sanger Institute near Cambridge.
Dr Larkin said: “Once we understood that half of all melanomas were critically dependent on hyperactive BRAF, it was significant because we could develop a drug. We can very clearly see that once we begin to understand the biology of the disease it opens up whole new approaches to treatment.”
Vemurafenib, which was previously known as PLX4032 or RG7204, is generally effective only for a period of months before a patient’s cancer begins to become resistant to it. It is now being tested in combination with other melanoma agents, in the hope that such cocktails might prevent or delay this.
On Thursday, Roche announced a partnership with Bristol-Myers—Squibb to test a combination of vemurafenib and ipilimumab, which stimulates the immune system to fight melanoma. The company is also evaluating a combination therapy with an experimental drug called GDC-0973.
The Skin Cancer Research Fund: Department of Plastic Surgery, Frenchay Hospital, Frenchay, Bristol BS161LE
Secretary: Caroline Newton
Telephone: 0117 340 3130
e-mail: Caroline.Newton@north-bristol.swest.nhs.uk