The Canadian Melanoma Conference (CMC) took place February 19-21, 2016 in Whistler, British Columbia and was a uniquely Canadian perspective on the landscape of Melanoma as it is happening in Canada now. Attended by medical oncologists, dermatologists, pathologists, surgeons, radiologists, molecular biologists, industry partners and patient groups the Canadian Melanoma Conference is an opportunity to review and explore new therapies and to understand what’s coming next in the treatment of melanoma.
Here are some key takeaways from that conference:
We understood at the Society for Melanoma Research Congress (SMR) last November in San Francisco that LDH levels play an important role in response rates in both the BRAF mutant positive population and the wildtype, and while no long term data on overall survival is available yet in the ipilimumab + nivolimumab combination therapy, early findings suggest that patients with both high and low LDH levels are having the same response to this combination therapy. High LDH levels in patients, which correlate with aggressiveness of the tumour, demonstrated resistance to long-term response from targeted and immune therapies. Whereas patients with low disease burden are seeing great outcomes on therapy. To view the SMR report go here.
There are distinct gender differences in melanoma, including different tumour types and different tumour sites (men are more likely to develop melanoma on the backs and trunks whereas women are more likely to develop melanoma on the legs.) An epidemiology study of melanoma by Dr. Thomas Salopek identified that globally, women are twice as likely to have melanoma between the ages of 15-50 (during menstrual years) which have researchers asking what role estrogen plays in the development of melanoma. There is also a spike in incidence in men after the age of 50, there is not a clear understanding of why this is happening.
Resident Dr. Paul Kuzel presented on the epidemiology of pediatric melanoma in Canada from 1992-2010. Melanoma is the most common primary cutaneous malignancy diagnosed in patients under the age of 20. Unlike adult melanoma, pediatric (those under the age of 18) melanoma rates remain stable. Same distribution data between genders is seen in pediatric melanoma under the age of 15, after the age of 15 there are despairing differences in gender incidence of melanoma.
Melanoma patients are showing high rates of usage of mental health services in with use and rate of services depending on treatment administered. A study by Dr. Timothy Hanna showed a substantial burden on mental health services in advanced melanoma patients.
Sequencing was again a hot topic and data coming in the next year will provide treating clinicians more information on what to use and in what order when treating patients.
Standard of Care for the treatment of metastatic melanoma varies depending on what province you live in, with most patients having access to ipilimumab as a first line treatment, while doctors and patients in Québec are still on a regiment of dacarbazine (DTIC – chemotherapy). Dr. David Hogg expressed concern on the use of DTIC for the treatment of metastatic melanoma an felt that standard of care for the treatment of metastatic melanoma should be clinical trials (to find out more about clinical trials go here).
To here my thoughts on CMC go here
A full report on CMC will be available within the coming weeks.
Executive Director, SYSF