Researchers at NYU Langone Health and the Perlmutter Cancer Center have discovered why many patients with melanoma are resistant to current treatments and how an existing drug class is effective in these patients. The study focused on a subgroup of melanoma patients with mutations in the neurofibromin 1 (NF1) gene. Of melanoma patients studied, 40% of those who did not respond to immunotherapy had NF1 mutations in their samples. Researchers found that the epidermal growth factor receptor (EGFR) was more active in melanoma cells with the NF1 mutation than in cells with other mutations of the melanoma gene. Previous research has shown that increased activity of EGFR is linked to abnormal cell growth in tumors and shorter survival with various cancers. Since drugs that inhibit EGFR are already used to treat some cancers, researchers tested two drugs in the class — cetuximab and afatinib — in cell cultures that had the NF1 mutation and those that did not. Both EGFR inhibitors were effective against cells and transplanted tumors with NF1 mutations. However, these drugs had no effect on melanomas without these mutations.
“While further tests are needed, our results support a novel approach of deploying EGFR inhibitors either alone or in combination with other immunotherapies for treatment of melanoma patients whose tumors harbor NF1 mutation,” said study co-senior investigator Markus Schober, PhD. Schober is an associate professor in the Ronald O. Perelman Department of Dermatology at the NYU Grossman School of Medicine and a member of the Perlmutter Cancer Center.
These results were published online in the journal Cancer Research.
PDT Access Gap Widens
A research letter published in JAMA Dermatology shows a widening gap in Medicare participants’ access to photodynamic therapy (PDT) between metropolitan and nonmetropolitan counties. Researchers from Yale School of Medicine and the University of Connecticut School of Medicine used Medicare data to analyze trends in use, accessibility, and cost. While use of PDT in this population increased across the board from 2012 to 2017, the density of dermatologists providing PDT in nonmetropolitan counties was less than half of that in metropolitan counties, and this difference widened during the time frame.
“With the incidence of nonmelanoma skin cancer (NMSC) is rising, photodynamic therapy could be important for prevention and treatment of some NMSCs while maintaining low costs,” wrote lead author Shayan Cheraghlou, and colleagues. “Strategies leading to more dermatologists offering PDT, such as recent increases to reimbursements, may, therefore, ultimately lower Medicare expenditures on skin cancer treatment, especially in nonmetropolitan areas, where our study suggests that PDT access is particularly lacking.”
Medical Student Creates App to Identify Skin Lesions
A University of Miami Miller School of Medicine student has developed an app that helps non-dermatologists identify potentially problematic skin lesions. The idea came out of Yasmine Mohseni’s experience shadowing at a Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery clinic.
“I thought there should be a way for melanoma patients to check in between their dermatologist appointments,” says Mohseni.
Mohseni formed a corporation, SkinSmart, and partnered with Motiv to design and build the SkinSmart app, which uses a custom-AI model to help assess skin lesions.
“We’re hoping this will help rural and underserved areas,” she says. “The app is in beta testing, and we’re submitting the IRB for a clinical trial this summer.”
