The Melanoma trial of the future- the trials we want

GSK MEK inhibitor authorised in Europe!

The GSK MEK inhibitor (also Trametinib, now called Mekinist ® has been approved in Europe-  http://goo.gl/xoZwrN

So now we are waiting for the up-date of the BRAF/MEK combination versus BRAF mono therapy! The latest results as presented at ASCO surprisingly looked like that the GSK BRAF monotherapy (Dabrafenib) was actually better than initially assumed- much more in the league of the Novartis BRAF inhibitor which makes for quite some interesting thoughts in the light of the currently ongoing Novartis/ GSK deal, especially as Dabrafenib was priced at a *lower price* than Vemurafenib in the US- so who knows we might actually see the day where we get better drugs for lower prices, very much in line with the recognition of the Novartis CEO Jimenez that the endless stacking of expensive cancer therapies is not sustainable as published this April in Forbes.

These latest results are at odds with previous results that had shown that the BRAF/ MEK combo resulted in longer time to resistance and fewer side effects, in particular less joint pain, rash and new skin cancers forming than either mono therapy with a BRAF or a MEK inhibitor.

Because the REAL question is obviously going to be- who is going to pay for a drug that in mono-therapy is not as good as a BRAF inhibitor?

Benefit/risk assessment in patients- really good webinar!

This was a really good webinar organised by EMA, EFPIA and CASMI

http://vitaltransformation.com/2014/05/webinar-the-patients-understanding-of-benefit-risk/


The cancer community can learn a lot from the experience of the rare disease groups!

Watch the space- NIVO post-Ipi coming soon in Europe

For patients who have progressed on Ipi-

http://clinicaltrials.gov/ct2/show/NCT02156804?term=nivolumab&rank=17

Patient on intermittent MEK/ BRAF combo for 85 weeks

Absolutely worth reading!!

On/ off treatment of the BRAF/ MEK combo is possible and can lead to a long time on treatment- this patients has been on it for 85 weeks!

http://cancerdiscovery.aacrjournals.org/content/4/5/538.full?keytype=ref&siteid=aacrjnls&ijkey=u2VcPOYyTy11U

Unexpected MEK1 Mutations Not Cause of Potent Melanoma Drug Resistance

Not from ASCO but on my list of noteworthy!

The previously held belief (it was very much thought of the day when Peter was diagnosed with Melanoma) that resistance to BRAF inhibitors (like Dabrafenib or Vemurafenib) is caused by the acquisition of new mutations in MEK1 turns out not to be true as patients who have mutations both in BRAF and MEK1 from the beginning still respond to the drugs-

read the details here!

ASCO 2014

I am currently at ASCO - see the separate ASCO blog! Thanks to the great Masterclass from the European School of Oncology, I got to know many other advocates in other cancers- many of which are now here, too. It is good to learn from others' insights, Melanoma unfortunately doesn't have the organisation other cancers have- and the faster we learn and the better we get at advocating, the better for Melanoma patients!

Best regards from Chicago!
Bettina