Research – clinical trials

• See current melanoma trials

Research into new ways of treating melanoma is going on all the time.

When a new treatment is being developed, it goes through various stages of research. To begin with it will be looked at in the laboratory, and sometimes tested on cancer cells in a test tube. If the treatment seems as though it might be useful in treating cancer, it is then given to patients in research studies (clinical trials). These early studies are called phase 1 trials. They aim to:

• find a safe dose
• see what side effects the therapy may cause
• identify which cancers it might be used to treat.

If early studies suggest that a new treatment may be both safe and effective, further trials (phases 2 and 3) are done to answer these questions:

• Is it better than existing treatments?
• Does it have extra benefit when given together with existing treatments?
• How does it compare with the current best standard treatments?

Clinical trials take a long time. It usually takes some years from the time when a new treatment is first discovered (often with a lot of publicity in the papers and on TV) until the time when its true value is established.

You may be asked to take part in a research trial. There can be many benefits in doing this. You will be helping to improve knowledge about cancer and the development of new treatments. You will also be carefully monitored during and after the study.

It is important to bear in mind that some treatments that look promising at first are often later found not to be as good as existing treatments, or to have side effects that outweigh any benefits.

As part of research you may be asked by your doctors for permission to store some of the samples of your tumour or blood, so that they can be used as part of trials to find the causes of cancer.

Diagnosis trials  Research is being carried out into whether skin scanners can tell the difference between melanoma and non-melanoma skin changes. These may be able to diagnose melanomas without having to have a biopsy. Currently these scanners should only be used by experienced melanoma specialists, as part of research trials.

Combination treatments  Research is trying to find out which combinations of treatment are most helpful for melanomas that have spread.

Hormonal therapies  Trials are testing whether hormonal therapies can be a helpful treatment for people whose melanoma has spread.

Gene therapy  Gene therapy is a new technique that is being developed for the treatment of a number of different cancers. At the moment it is still very experimental and it will take many years to find out whether it can be helpful in the treatment of melanoma.

Gene therapy means putting genetic material (DNA) into cells so that the cells can produce proteins which they do not usually produce. These ‘foreign’ proteins may:

• cause the cancer cells to die or
• make the cancer cells more sensitive to toxic drugs or
• stimulate the body’s own defence system (the immune system) to attack and destroy the cancer cells.

Putting the DNA into the cancer cells may be done before removing the cancer or after the cancer cells have been removed from the patient and grown in the laboratory.

Vaccines  Researchers are vaccinating patients with melanoma cells to try to reduce the chance of the melanoma coming back after surgery. Vaccines are also being used in trials to try to control the growth of melanomas that have already spread. There are several different types of vaccine but they are produced in similar ways. Cells are taken from a biopsy of the cancer. They are grown in the laboratory and then treated with the genes needed to produce proteins which are part of the immune system of the body. The changed cancer cells are then treated with radiation so they cannot grow, and are injected back into the patient. This vaccine is intended to stimulate the immune system so that it destroys the untreated cancer cells in the body.

All the above tests and treatments are experimental at this time.