It is hard to imagine how a simple spot on your skin could wreak such havoc if it turns out to be melanoma and spreads throughout the rest of your body. A recent series in the New York Times called “Target Cancer” clearly illustrates how this can happen. The development of a new drug called PLX4032 that is in clinical trials for skin melanoma is presented. We are given the chance to follow Dr. Keith Flaherty as he oversees the use of the drug and the lives of the patients involved in the study.
PLX4032 is a unique cancer drug. Unlike other cancer medications that affect the body’s entire immune system, PLX4032 targets a specific genetic gene called B-RAF that mutates and is responsible for certain types of skin melanoma. In 2002, British researchers found that a defective gene called B-RAF was present in more than half of those diagnosed with skin melanoma. It was then that Dr. Flaherty realized that if there was a targeted drug that blocked a protein produced by the defective gene then enormous strides could be made for patients whose cancer was caused by this defect.
Dr. Flaherty, who is a devoted, conscientious oncologist, believes that a new reformulated version of the drug is a patient’s best hope at halting the spread of this insidious disease. The first clinical trial to target the B-RAF gene failed to help patients; they simply could not absorb enough of the drug. He works tirelessly at the University of Philadelphia Melanoma Clinic along with a team of trial nurses and other oncologists.
The series chronicles melanoma patients who have reached the end of their chance for life. There is the 89 year old grandfather, the young woman who was diagnosed at 26, the family man from south Jersey and many others who are just like you and me. I can’t help but become emotional as I read how much they and their families have been affected by lives full of struggling with cancer and how hard it must be to know that they are receiving a drug that may be their last chance at survival. Admittedly, a drug with no past record, no known best dose to administer might just shorten what is left of their life if their body rejects it.
In 2009, there were approximately 70,000 cases of skin melanoma, almost 9,000 died and deaths usually happen within one year of contracting the disease. The NYT’s article showed one patient’s body scan scattered with dark spots everywhere the cancer has spread. PLX4032 effectively was able to shrink the black spots so that in some patients, Dr. Flaherty had difficulty even finding signs of tumors. However, PLX4032 is not able to reach tumors in the brain, it cannot pass the blood brain barrier and sadly the 89 year old grandfather developed tumors in his brain that took his life even though the rest of his body had responded.
Research into newer and better cancer drugs always brings controversy. Questions about how much will such a drug cost once it goes to market and who should be eligible to receive the drug are already in the minds of those reading the articles who posted in comments section. One poster felt that those who step up to participate in clinical trials who may not survive are like those who step up to a war knowing that their effort will benefit those who follow after them.
It would be a mistake to confuse discoveries that improve the treatment of diseases with the ethics of who should receive them. Our problem as a population is not in knowing how or why to treat—it is in knowing when it’s time to stop.
If you would like to read and view videos of the series in the New York Times, go to: http://topics.nytimes.com/top/news/health/series/target_cancer/index.html
In Feb. 2010, PLX4032 entered Phase 3 clinical trials for FDA approval.
Additional source:
www.skincancer.org/skin-cancer-facts/