President Nixon declared a "War on Cancer" in 1971, the
funding and will behind which paved the way for the establishment
of an autonomous National Cancer Institute (NCI).
In the coming months, the Journal of Drugs in Dermatology
(JDD) will provide more information on an “International Initiative
for the War Against Skin Cancer” between the International
Society for Dermatologic Surgery (ISDS) and the Skin Cancer
Foundation (SCF), with an initial meeting in Nicaragua.
This issue of JDD includes a special focus on skin cancer, which is
fitting, considering that the NCI estimates that there are about 11.4
million Americans alive today who have a history of cancer. Noting
the 1,529,560 new cancer cases that were predicted for last year, the
"good" news is that the five-year relative survival rate for all cancers
is 68 percent, which is up from 50 percent in the mid-to-late 1970s.
Skin cancer is the most common form of cancer in the United
States (U.S.), leading to over 3.5 million cases in two million
people diagnosed annually.
As we know, the most common form of skin cancer is basal cell
carcinoma (BCC), which affects approximately two million Americans
each year; more that one of three new cancers are skin
cancers—the vast majority of these are basal cell carcinomas.
Over 700,000 new cases of squamous cell carcinoma (SCC) are
diagnosed every year, making it the second most common skin
cancer. In terms of melanoma, the most serious form of skin
cancer, 120,000 new cases are diagnosed each year.
Hope is On the Horizon
What is encouraging is that BCC and SCC are almost always curable
when detected and treated early, although it is, of course,
best to prevent in the first place.
As far as melanoma is concerned, encouraging patients to
reduce their risk and to be alert for atypical moles is critically
important. For those patients who present with melanoma or
develop it, surgery is of course the main first-line treatment option;
for more advanced disease, chemotherapy, radiation and
immunotherapy are all part of our armamentarium.
Two new studies emphasize that patients at high risk for melanoma
benefit from a follow-up program that can detect the cancer early.
Recent clinical trial results suggest that an experimental drug
(RG7204, aka PLX4032) that targets a malfunctioning protein
produced by the B-RAF gene prolonged survival of patients
with metastatic melanoma.
To assess whether the drug prolonged lives, Roche/Genentech
(the manufacturer) was asked to compare survival on both
arms of the trial (B-RAF drug and conventional chemotherapy).
On January 19th, the FDA asked Roche/Genentech to conduct
the analysis sooner than scheduled initially so that patients on
the chemotherapy arm (dacarbazine) can cross over if the BRAF
drug is clinically superior.
The manufacturer has initiated a Patient Access Program (PAP)
at several cancer centers in order to make the drug available for
melanoma patients with previously untreated metastatic melanoma
who are not enrolled in the study.
In the meantime, a biologics license application (BLA) 125377
with the proposed trade name YERVOY (ipilimumab) was
submitted to the FDA by Bristol-Myers Squibb (BMS) for the
treatment of advanced melanoma in patients who have received
What may be encouraging to patients and dermatologists is that
the Oncologic Drugs Advisory Committee Meeting that had been
scheduled for February 9, 2011 was cancelled on December 30th
because "the issues for which the FDA was seeking the scientific
input of the committee have been resolved."
In addition, on January 25th, GlaxoSmithKline (GSK) announced
the roll-out of two phase 3 studies in advanced or metastatic melanoma
patients. These studies will assess the safety and efficacy
of two investigational agents, GSK2118436 and GSK1120212, in
stopping or slowing progression of skin cancer in patients whose
tumors contain a B-RAF V600 mutation.
Cancer is personal so our battle against it must be personal,
too, one we fight in our offices, in hospitals, in laboratories
and in operating rooms.
Our weapons are not only the latest pharmaceuticals and radiotherapies
but also the power of the human spirit, the battle for
our patients' hearts and souls that we will never, ever let this
Address for Correspondence
William Levis MDDepartment of Environmental MedicineNew York University Langone Medical Center57 Old Forge RoadTuxedo, NY 10987(845) 731-3661