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Study led by Roswell doctor supports the treatment of melanoma with immunotherapy drug Keytruda

“The study reinforces the fact that immunotherapy can significantly extend the life of patients with melanoma and even lead to cures,” Dr. Puzanov says.
Credit: WGRZ
Roswell Park

BUFFALO, N.Y. — Medical Oncologist Igor Puzanov holds many esteemed positions locally in medicine, both at Roswell Park and the Jacobs School of Medicine. On Thursday, his long-term work to find treatments for cancer was published in JAMA Oncology, showing a hopeful future for melanoma patients being treated with immunotherapy.

Puzanov has been working on a study for 10 years, with 1,500 patients, to determine if an immunotherapy drug still benefited the survival of patients with advanced melanoma, even if they had a gene mutation in their tumor cells or previously used a targeted therapy.  

The study supported the use of the immunotherapy drug for advanced melanoma regardless of the gene mutation or previous use of a targeted therapy.

“The study reinforces the fact that immunotherapy can significantly extend the life of patients with melanoma and even lead to cures,” Dr. Puzanov says. “But importantly, we also still see a role for targeted therapies. Having both of these treatment options at our disposal has helped to drive incredible progress against in a cancer type that was almost universally fatal a decade ago.”

The immunotherapy Puzanov and his team focused on was Pembrolizumab, also known as Keytruda. 

Keytruda's website explains that the medication does not attack cancer, but rather helps the immune system recognize cancer cells. Sometimes, cancer cells use a pathway in the immune system cells to hide, so this medication blocks that pathway, so that the immune system can fight the cancer. 

Keytruda's website says that the medication is FDA approved for several types of cancer, however, Puzanov's study focused specifically on melanoma. 

What Puzanov hoped to answer was if mutation status of the cancer, or the previous treatment of the cancer with a targeted mutation therapy, would impact the treatment of advanced melanoma with the immunotherapy drug Keytruda. 

"Our findings confirmed the long-term, lasting benefits of pembrolizumab for patients with unresectable advanced melanoma and show that the effect is seen regardless of BRAF mutation status — and regardless of earlier treatment with a BRAF-targeting therapy,” says Dr. Puzanov.

Roswell Park says that some 40 percent of people with metastatic melanoma have BRAF mutations, which mean that a certain gene and protein in the tumor are modified.  

This study focused on the BRAF V600E/K mutation status, and the previous use of targeted mutation therapies called  BRAF inhibitor (BRAFi) therapy and/or MEK inhibitor (MEKi) therapy. 

“Our long-term view provides evidence to support giving immunotherapy early in a patient’s treatment, before turning to targeted therapies. This course of treatment is now the standard of care, but this is important affirmation for this approach, which was not standard at the time these patients were treated,” Dr. Puzanov notes.

Puzanov is the Director of Early Phase Clinical Trials and Chief of Melanoma at Roswell Park Comprehensive Cancer Center, as well as a Professor of Medicine at the Jacobs School of Medicine and Biomedical Sciences, at the University at Buffalo. 

You can read the study online by clicking here.