Melanoma is the most serious form of skin cancer and the most common cancer in young adults. Around 13,000 new cases are diagnosed every year in the UK and around 3,000 patients will die from this disease. Melanoma is a public health problem, with incidence increasing faster than for any other type of cancer.
Melanoma is resistant to conventional treatment with cytotoxic chemotherapy and radiotherapy. In the last few years, research partnerships involving scientists, clinicians, patients and pharmaceutical companies have led to identification of new, effective drug treatments and genetic biomarkers predicting those likely to benefit from specific treatments.
The Cambridge melanoma specialists provide a regional and supra-regional research-based specialist service, offering patients entry into local, national and international trials and research studies, enabling access to state-of-the-art treatments and technologies designed to improve outcomes.
This is a CRUK-funded, national, multicentre randomised trial to evaluate the role of bevacizumab – a monoclonal antibody targeting vascular endothelial growth factor – as an adjuvant treatment for patients with resected melanoma at high risk of recurrence. AVAST-M is co-ordinated from Cambridge and is one of the largest adjuvant melanoma trials conducted to date.
Between 2007 and 2012, 1,343 patients were recruited and the interim analysis published in 2013 identified a statistically significant improvement in disease-free interval in the bevacizumab arm. The final overall survival analysis is expected in 2017. Analyses are currently being undertaken on tissue and blood collected from over 700 patients recruited to AVAST-M, to identify potential response biomarkers. The trial protocol is available here as a pdf.
This is a local collaboration involving the Cambridge Cancer Centre and the Wellcome Sanger Institute, investigating response and resistance to molecular targeted treatments using next generation sequencing of tissue and blood samples from patients prior to and on relapse from drug treatment. This collaboration is being extended to other sites including Oxford, Norwich, Mount Vernon and Zurich, Switzerland.
Current open trials in Cambridge
The table below lists the current open trials for melanoma coordinated by the Cambridge Cancer Trials Centre (last updated January 2016).
|Trial name||Trial description||Contact|
|An Open-Label, Phase 1, Dose Escalation Study of MLN2480 in Patients with Relapsed or Refractory Solid Tumors Followed by a Dose Expansion Phase in Patients With Unresectable Melanoma.||An Open-Label, Phase 1, Dose Escalation Study of MLN2480 in Patients with Relapsed or Refractory Solid Tumors Followed by a Dose Expansion Phase in Patients With Unresectable Melanoma.||Dr Pippa Corrie|
|EORTC 18081 - Adjuvant Pegylated Interferon in Ulcerated Melanoma||Adjuvant peginterferon alfa-2b for 2 years vs Observation in patients with an ulcerated primary cutaneous melanoma with T(2-4) bN0M0: a randomized phase III trial of the EORTC Melanoma Group.||Dr Pippa Corrie|
|MelResist: Investigating resistance to gene-targeted melanoma therapies||Melanoma is a highly aggressive cancer which invades and spreads early and is resistant to conventional treatments such as chemotherapy and radiotherapy. Around 50% of melanoma cells harbour a mutation in the BRAF gene. Despite some recent success with new cancer drugs targeting the BRAF pathway, drug resistance is a significant problem, so long term benefit remains uncertain. There is increasing evidence that genomic events are involved in the development of drug resistance in particular in the context of the new BRAF and MEK inhibitors currently entering the clinic. We will collect fresh tissue (both tumour and blood) from melanoma patients receiving new gene targeted drugs. The samples will be analysed to determine changes in genes thought to be responsible for drug resistance. The aims of the study are to investigate the mechanisms underlying resistance with the long term aim of developing new improved therapeutic strategies for melanoma. In addition, the study will explore the ability to identify tumour DNA in plasma of patients undergoing treatment for melanoma as a novel, non-invasive method to monitor patient outcome or tumour response.||Dr Pippa Corrie|
|SelPac||A Randomised three-arm, open label, Phase II study of continuous Selumetinib versus continuous or interrupted Selumetinib in combination with weekly Paclitaxel in Metastatic Uveal Melanoma||Dr Pippa Corrie|
|WBRT post local treatment in melanoma study||Whole Brain Radiotherapy following local treatment of intracranial metastases of melanoma – a randomised phase III trial||Dr Pippa Corrie|
If you would like further information about how to take part in any of the clinical trials listed here, please talk to your cancer specialist as patients usually need to be referred by their doctor.