Melanoma is a type of skin cancer. Around half of melanomas will have changes to a gene called BRAF which has been known to increase the activity of the MEK/ERK pathway in the cells which causes growth and spread of cancer cells. The main sign of melanoma are changes to moles which can include changes in size, shape and colour of the mole and pain, bleeding or crusting of the mole. People who are most at risk of developing melanoma are those with genetic mutations (such as the BRAF mutation), those with fair skin who burn easily and those who are exposed to the sun or use sunbeds. In metastatic melanoma, the cancer has spread from the skin to other parts of the body.
The combination of atezolizumab (given by injection) and cobimetinib (given orally) is being developed specifically for metastatic melanoma. Atezolizumab works by activating immune cells to recognise and attack cancer cells and cobimetinib works by blocking the MEK/ERK pathway and so stops the cancer cells from growing. This combination has not been used together before in melanoma, but have shown potential to slow down the growth and spread of melanoma. If licenced atezolizumab and cobimetinib may provide a treatment option for people with metastatic melanoma who do not have BRAF mutations – known as BRAF wild-type metastatic melanoma.
Ixazomib citrate is a novel oral medicinal product that is already licensed in the UK for the treatment of MM in patients who have received at least one prior therapy (in combination with lenalidomide and dexamethasone). Ixazomib citrate offers the potential advantage over similar medicines in its class of being more effective in its anticancer activity, less toxic (reduced side effects) and more convenient to administer (through its weekly oral dosing). If approved as maintenance therapy following stem cell transplant in newly diagnosed MM patients, ixazomib citrate has the potential to improve the success rates of treatment by improving progression free survival and overall survival as well as presenting a more convenient way of administration that allows long term administration and improvement of patients’ quality of life.