WCCS 2016

Dr Andtbacka meets with ecancertv at WCCS 2016 to discuss the use of oncolytic virotherapy (OV) in the treatment of melanoma. He discusses the OPTiM trials of T-VEC, a genetically modified herpes virus, including identifying which patients have the most durable response, and looks forward to potential combinations for T-VEC and other OVs.

Prof Lorrigan speaks with ecancertv at WCCS 2016 about the changing role of chemotherapy for metastatic melanoma. Given the emergence of alternative therapies, he considers which tumour types and patient subgroups may be more or less responsive, and how to take chemotherapy into a changing field of targeted and combination therapies.

Dr Forsea speaks with ecancertv at WCCS 2016 about the logistics and importance of data and research around melanoma, and the way that this affects diagnosis and treatment.

Dr Sherwood speaks with ecancertv at WCCS 2016 about metabolic regulation of melanoma cells under the control of wnt signalling pathways. She highlights the difference between canonical and non-canonical signalling, or B-catenin dependent and independent arms of wnt signalling pathways, and how these exert metabolic control through PTEN expression. Dr Sherwood describes PTEN melanoma cell lines as mitophagy addicted, with macroautophagy and mitophagy blocked, resulting in a changed metastatic potential.

Prof Nick Hayward talks to ecancertv at WCCS 2016 about the effect of ultraviolet light on underlying genes behind at-risk phenotypes. He describes how the concomitant risk of melanoma from UV exposure, especially from sunbed use, can be modulated by the genes responsible for phenotypes associated with increased susceptibility. Prof Hayward also highlights the genes responsible for telomere maintenance as a further influence on disease risk.

Dr Testori speaks with ecancertv at WCCS 2016 about the role of surgery in melanoma treatment. He describes techniques, such as limb perfusion, which can reduce the size and threat of tumours to a stage in which the tumour can be fully resected, with less severe impact on patient quality of life. Dr Testori also details how the treatment of in-transit metastases poses a challenge of local targets versus systemic therapy, and how novel drugs are moving treatment of stage IV disease away from a purely surgical domain.

Dr Grob speaks with ecancertv at WCCS 2016 about the timeline of adjuvant and neoadjuvant therapy for melanoma. He considers how advances in targeted molecules and immunotherapy could change the progression of treatments for melanoma treatment beyond surgery in the first instance, and how biomarkers could define the most at-risk patient populations.

Dr Schadendorf speaks with ecancertv at WCCS 2016 about coping with resistance to targeted therapies in melanoma. Looking at the survival rate of melanoma with current therapies compared to recent history, Dr Schadendorf highlights a greater understanding of which mutations confer resistance to targeted pathways as a necessary step to increase treatment efficacy. He also considers the challenges of diagnosis and treatment of rare mutational subgroups, which can exhibit unusual vulnerabilities to molecular therapy. Lastly, Dr Schadendorf discusses the patients from Checkmate 065 and 069 who discontinued therapy after a period of severe side effects; it appears a small group among those who received checkmate regulatory therapy exhibited an overall accelerated response and recovery.

Dr Duvic speaks with ecancertv at WCCS 2016 about mogamulizumab, an anti-CCR4 engineered antibody for treatment of cutaneous T cell lymphoma, also known as Sézary syndrome She reports on results from a phase I/II trial in which patient response rate reached 37%, and describes upcoming trials for mogamulizumab, with considerations of international approval and possible combination/complementary therapies.

Katharina Kober speaks with ecancertv at WCCS 2016 about modelling wnt secretion for CSCC. Highlighting the role of wnt in stemness of cells, she introduces an EVI-knockout mouse cell line which inhibits wnt secretion, resulting in proliferation-competent cultures, but reduced tumourigenesis in mice.

Dr Weber speaks with ecancertv at WCCS 2016 about checkpoint inhibitor therapy for treating melanoma. He outlines ongoing and upcoming trials of PD-1/PD-L1 based immunotherapy, as well as immune modulation via OX40 and 41BB antibodies. Dr Weber also highlights the therapeutic potential of combining immunotherapy with surgery, chemotherapy and most notably radiotherapy, in which radiation can be used to 'warm up' a 'cold' tumour, allowing the inflammation of radiation-damaged cells to recruit a greater immune response than immunotherapy alone.

Dr Larkin speaks with ecancertv at WCCS 2016 about developments in checkpoint immunotherapy. He discusses results from recent trials of single agent, combined and adjuvant immunotherapy compared to targeted therapies, with regards to overall survival, subgroups determined by biomarkers, and complementary mechanisms. With regard to public awareness of melanoma, Dr Larkin highlights successful international campaigns and the remaining need in some populations for preventative measures to limit UV exposure.

Dr Malvehy speaks with ecancertv at WCCS 2016 about skin cancer lesions arising in uncommon regions. He describes the criteria by which dermatologists might investigate and accurately diagnose early melanoma, depending on the presentation of a wide constellation of symptoms. Dr Malvehy outlines how clinicians can remain up to date with the latest in skin cancer diagnostics, and the promise of current research for patients in the near future.

Prof McArthur speaks with ecancer at WCCS 2016 about targetted medicine to reduce melanoma mutational burden, with specific focus on the BRIM trials of cobimetinib and vemurafinib. He outlines the expansion of personalised therapy and genotyping for improved duration and depth of response, considering the push from other quarters towards sequencing for all patients, and his hopes for the future of cancer vaccines. However, Prof McArthur notes that these results do not indicate clinical readiness, and highlights brain metastases in melanoma as an area in need of further research.

Dr Hauschild speaks with ecancertv at WCCS 2016 with updates from recent trials in checkpoint inhibition therapy. He discusses the Hedgehog inhibitor tested through the VISMO trial to treat basal cell carcinoma, and the BRIM trials of vemurafinib ± cobimetinib. Dr Hauschild also considers the the results of Checkmate and Keynote trials of PD1/PDL1 biomarkers presented as ASCO 2016 and the economic viability of these treatments across Europe.

Dr Marmol meets with ecancertv at WCCS 2016 to discuss the outcomes of the Euro Melanoma campaign to raise public awareness of the causes, symptoms, and prevention of skin cancer. Looking at data gathered from participating European countries regarding sun-bed use over the years, she describes an increased awareness and attendance of melanoma screening. In comparison to attitudes towards other behaviours associated with increased risk of disease, specifically smoking, Dr Marmol highlights the ongoing need for wider engagement with preventative measures.