Your Genes, Your Melanoma – The Role of Precision Oncology in Advanced Melanoma Therapy
Jun 03, 2016
By Jeff Legos, Senior Vice President, Global Program Head, Novartis Oncology
In the 1970s, overall survival rates for advanced melanoma patients were approximately 6 to 8 months – a span of time that remained largely unchanged until 2011. However, advanced melanoma patients are now living three times longer largely in part to the advances made in scientific research, which have significantly improved our understanding of this disease. Advanced melanoma is the most serious form of skin cancer, and develops when the DNA in skin cells becomes damaged and causes these cells to abnormally multiply and form tumors. We now know that melanoma is not a single disease, but one that can vary from person to person due to genetic changes, often called mutations, which can exist in a melanoma tumor. In fact, melanoma is one of the cancers with the highest frequency of mutations.
Researchers have identified several mutations, that can be present in an advanced melanoma tumor, which commonly occur within the Mitogen-Activated Protein Kinase (MAPK) pathway – one of the pathways that controls cell growth. When something goes wrong at any step along the pathway, a mutation occurs and cancer cells such as melanoma can grow.
While the most common melanoma mutations include BRAF, NRAS, and c-KIT, there are instances in which a tumor may not test positive for a known mutation, in which case it is called Wild-Type. The BRAF mutation is the most common, and is found in about half of all advanced melanoma cases. Because of these various mutations, no two advanced melanoma tumors are the same.
Precision oncology addresses genetic differences. Treatment plans can be tailored to the characteristics of each person’s cancer, and are not one-size-fits-all.
For many, it can be difficult to stay up to date with all the recent advances. Two recent treatment options include targeted therapy and immunotherapy.
Treatment guidelines recommend genetic testing for all people with advanced melanoma because the type of mutation may play a key role in the development of a personalized treatment plan. Additional factors influencing treatment decisions are disease stage, as well as a person’s age and general health.
It is important to discuss all your treatment options, and their possible side effects, with your health care team to help determine which treatment best fits your needs.