'Personalised' skin cancer drug wins NICE approval

A skin cancer drug designed to be effective in patients whose
cancer is driven by a specific gene mutation has been recommended by the National
Institute for Health and Care Excellence (NICE) to treat patients with advanced
melanoma.

Dabrafenib,
which is marketed as Tafinlar by
GlaxoSmithKline, blocks the growth of cancerous cells containing
the BRAF V600 mutation, which has been linked to half of all aggressive
melanomas.

The mutation, which can be
triggered by ageing and overexposure to the sun, was confirmed in 2009 (see BioNews 503) as the first event in a cascade of genetic changes that
eventually lead to the development of melanoma.

In 2012, NICE recommended two BRAF V600
mutation-targeting drugs: vemurafenib and
ipilimumab (see BioNews 680), after they were shown to improve both quality and quantity of life for certain
patients with advanced melanoma in clinical trials (see BioNews 660).

Professor
Carole Longson, director of the
centre for health technology evaluation at NICE, said: 'Drugs like dabrafenib are thought to have very rapid
positive effect for patients, even in those who are very unwell or bedridden.
In some cases, it has enabled people to resume everyday activities'.

Malignant melanoma is the fifth most
common cancer among 15-to-34-year-olds in the UK and cases have increased by over 50 percent in the last decade. Early
melanomas can often be surgically removed, slowing or halting disease progression, however treatments for
advanced-stage melanoma remain limited.

Dabrafenib is being recommend for advanced-stage patients
who test positive for the mutation and where it is no longer possible to have
the cancer removed surgically.

'While the drug
does not provide a cure, it represents the progress made in our understanding
of biology in advanced skin cancer and how this can be used to develop
innovative treatments to treat the disease', Professor Peter Johnson, Cancer Research UK's chief clinician, told BBC News.

Although the trials of BRAF V600-targeting treatments confirmed
their effectiveness, drug resistance remains a concern in the long run.

Professor
Paul Workman, interim chief executive of the Institute of
Cancer Research in London, said: 'One drawback of dabrafenib and vemurafenib is that
although they are often initially very effective, cancers usually become
resistant to treatment within a year'.

'One very promising area of
our research is the design of so-called panRAF inhibitors, which are intended
to be effective against BRAF and other cancer mutations simultaneously. We hope
that this new type of targeted drug could further expand the currently very
limited treatment options for advanced melanoma'.