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Tamils

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      Tamils
      Participant

        Thomas Jefferson University in Philadelphia specializes in ocular melanoma, and Dr Takami Sato is well-known for his work in the area.  It is one of the only hospitals to specialize in treating metastatic ocular melanoma.  Most other hospitals, even those that are centers of excellence in melanoma, will treat OM no differently than regular melanoma.  I would recommend at least researching and calling them.

        Tamils
        Participant

          Thomas Jefferson University in Philadelphia specializes in ocular melanoma, and Dr Takami Sato is well-known for his work in the area.  It is one of the only hospitals to specialize in treating metastatic ocular melanoma.  Most other hospitals, even those that are centers of excellence in melanoma, will treat OM no differently than regular melanoma.  I would recommend at least researching and calling them.

          Tamils
          Participant

            Thomas Jefferson University in Philadelphia specializes in ocular melanoma, and Dr Takami Sato is well-known for his work in the area.  It is one of the only hospitals to specialize in treating metastatic ocular melanoma.  Most other hospitals, even those that are centers of excellence in melanoma, will treat OM no differently than regular melanoma.  I would recommend at least researching and calling them.

            Tamils
            Participant

              This has more detailed info:

              EU Likes Melanoma Therapy Injected Directly Into Lesions

              A new treatment for melanoma that is injected directly into the lesion has been recommended for approval in Europe.

              The product, talimogene laherparepvec (Imlygic, Amgen), described as the first oncolytic immunotherapy, is destined for use in adults with unresectable melanoma that is regionally or distantly metastatic (stage IIIB, IIIC, and IVM1a) with no bone, brain, lung, or other visceral disease, according to the European Medicines Agency (EMA).

              This product has also recently been recommended for approvalin the United States, where it will be marketed as T-VEC. A US Food and Drug Administration decision is due by October 27.

              Talimogene laherparepvec is a first-in-class advanced therapy medicinal product (ATMP), derived from a virus that has been genetically engineered to infect and kill cancer cells. The recommendation for approval was based on an assessment carried out by the Committee for Advanced Therapies (CAT), the European agency's expert committee for ATMPs.

              The EMA explains that the product is derived from a herpes simplex virus-1 that has been genetically engineered to infect and replicate within cancer cells and to produce the protein granulocyte macrophage colony-stimulating factor (GM-CSF). It is thought to work in two ways. It enters the tumor cell and uses the cell's energy stores to replicate, eventually overwhelming the cell and causing it to die. By producing the protein GM-CSF, it also stimulates the patient's immune system to recognize and destroy tumor cells. Once an infected tumor cell dies, copies of the virus are released into the patient's bloodstream to infect more tumor cells. Although the product can also enter healthy cells, it is not able to replicate in these healthy cells and so it does not kill them, the agency points out.

              The recommendation for approval is based on efficacy data that come from one randomized controlled trial (known as OPTiM) in adults with unresectable regionally or distantly metastatic melanoma. The study enrolled 436 patients, with 295 patients treated with talimogene laherparepvec compared with 141 patients treated with GM-CSF.

              Analysis of the subset of patients in the study whose disease had not spread to the lung or other internal organs (249 patients with stage IIIB, IIIC, and IVM1a disease) showed a benefit in patients treated with talimogene laherparepvec, with a durable response rate of 25% vs 1% with GM-CSF alone, according to the EMA.

              A durable response was defined as disappearance of the tumors or at least 50% reduction of tumors lasting at least 6 months, until patients' health declined or they required subsequent therapy, the agency noted.

              An exploratory analysis in these patients suggested improvements in survival in patients treated with talimogene laherparepvec, the agency noted, but it points out that "this is not yet fully clear." It addition, there are no comparative data with other approved therapies for melanoma, which have already been shown to improve overall survival.

              Overall, the expert committee considered that the product is relatively well-tolerated in patients with cancer and concluded that the medicine's benefits outweigh its risks, the agency stated.

              The OPTiM study was published in May in the Journal of Clinical Oncology (2015;33:2780-2788), as reported at the time. The data in the publication are a little different to what the EMA cites in its press release, as in the publication, the durable response rate with the product was reported as 16.3% vs 2.1% with GM-CSF. In addition, it reports complete responses in 10.8% of patients on the product, compared with <1.0% on GM-CSF.

               

              "Durable responses to T-VEC were seen across all disease stages tested, including in patients within each subset of stage IV disease," said the authors, led by Howard L. Kaufman, MD, FACS, from the Rutgers Cancer Institute of New Jersey in New Brunswick. Noting that T-VEC could potentially delay or prevent relapses or preclude progression to later disease stages, they add that it "represents a novel potential new treatment option for patients with injectable metastatic melanoma and limited visceral disease." Dr. Kaufman told Medscape Medical News at the time: "Despite all the advances in the field of melanoma, many patients do not respond to treatment."

              "Some patients are not able to tolerate some of the drugs for a variety of reasons, and so any agent that has some activity is important," he added.

              "Interestingly, I think one of the more important things in the data is that nearly 11% of the patients had a complete response…. We don't often see that in melanoma studies. I think that's very significant," he commented.

              Tamils
              Participant

                This has more detailed info:

                EU Likes Melanoma Therapy Injected Directly Into Lesions

                A new treatment for melanoma that is injected directly into the lesion has been recommended for approval in Europe.

                The product, talimogene laherparepvec (Imlygic, Amgen), described as the first oncolytic immunotherapy, is destined for use in adults with unresectable melanoma that is regionally or distantly metastatic (stage IIIB, IIIC, and IVM1a) with no bone, brain, lung, or other visceral disease, according to the European Medicines Agency (EMA).

                This product has also recently been recommended for approvalin the United States, where it will be marketed as T-VEC. A US Food and Drug Administration decision is due by October 27.

                Talimogene laherparepvec is a first-in-class advanced therapy medicinal product (ATMP), derived from a virus that has been genetically engineered to infect and kill cancer cells. The recommendation for approval was based on an assessment carried out by the Committee for Advanced Therapies (CAT), the European agency's expert committee for ATMPs.

                The EMA explains that the product is derived from a herpes simplex virus-1 that has been genetically engineered to infect and replicate within cancer cells and to produce the protein granulocyte macrophage colony-stimulating factor (GM-CSF). It is thought to work in two ways. It enters the tumor cell and uses the cell's energy stores to replicate, eventually overwhelming the cell and causing it to die. By producing the protein GM-CSF, it also stimulates the patient's immune system to recognize and destroy tumor cells. Once an infected tumor cell dies, copies of the virus are released into the patient's bloodstream to infect more tumor cells. Although the product can also enter healthy cells, it is not able to replicate in these healthy cells and so it does not kill them, the agency points out.

                The recommendation for approval is based on efficacy data that come from one randomized controlled trial (known as OPTiM) in adults with unresectable regionally or distantly metastatic melanoma. The study enrolled 436 patients, with 295 patients treated with talimogene laherparepvec compared with 141 patients treated with GM-CSF.

                Analysis of the subset of patients in the study whose disease had not spread to the lung or other internal organs (249 patients with stage IIIB, IIIC, and IVM1a disease) showed a benefit in patients treated with talimogene laherparepvec, with a durable response rate of 25% vs 1% with GM-CSF alone, according to the EMA.

                A durable response was defined as disappearance of the tumors or at least 50% reduction of tumors lasting at least 6 months, until patients' health declined or they required subsequent therapy, the agency noted.

                An exploratory analysis in these patients suggested improvements in survival in patients treated with talimogene laherparepvec, the agency noted, but it points out that "this is not yet fully clear." It addition, there are no comparative data with other approved therapies for melanoma, which have already been shown to improve overall survival.

                Overall, the expert committee considered that the product is relatively well-tolerated in patients with cancer and concluded that the medicine's benefits outweigh its risks, the agency stated.

                The OPTiM study was published in May in the Journal of Clinical Oncology (2015;33:2780-2788), as reported at the time. The data in the publication are a little different to what the EMA cites in its press release, as in the publication, the durable response rate with the product was reported as 16.3% vs 2.1% with GM-CSF. In addition, it reports complete responses in 10.8% of patients on the product, compared with <1.0% on GM-CSF.

                 

                "Durable responses to T-VEC were seen across all disease stages tested, including in patients within each subset of stage IV disease," said the authors, led by Howard L. Kaufman, MD, FACS, from the Rutgers Cancer Institute of New Jersey in New Brunswick. Noting that T-VEC could potentially delay or prevent relapses or preclude progression to later disease stages, they add that it "represents a novel potential new treatment option for patients with injectable metastatic melanoma and limited visceral disease." Dr. Kaufman told Medscape Medical News at the time: "Despite all the advances in the field of melanoma, many patients do not respond to treatment."

                "Some patients are not able to tolerate some of the drugs for a variety of reasons, and so any agent that has some activity is important," he added.

                "Interestingly, I think one of the more important things in the data is that nearly 11% of the patients had a complete response…. We don't often see that in melanoma studies. I think that's very significant," he commented.

                Tamils
                Participant

                  This has more detailed info:

                  EU Likes Melanoma Therapy Injected Directly Into Lesions

                  A new treatment for melanoma that is injected directly into the lesion has been recommended for approval in Europe.

                  The product, talimogene laherparepvec (Imlygic, Amgen), described as the first oncolytic immunotherapy, is destined for use in adults with unresectable melanoma that is regionally or distantly metastatic (stage IIIB, IIIC, and IVM1a) with no bone, brain, lung, or other visceral disease, according to the European Medicines Agency (EMA).

                  This product has also recently been recommended for approvalin the United States, where it will be marketed as T-VEC. A US Food and Drug Administration decision is due by October 27.

                  Talimogene laherparepvec is a first-in-class advanced therapy medicinal product (ATMP), derived from a virus that has been genetically engineered to infect and kill cancer cells. The recommendation for approval was based on an assessment carried out by the Committee for Advanced Therapies (CAT), the European agency's expert committee for ATMPs.

                  The EMA explains that the product is derived from a herpes simplex virus-1 that has been genetically engineered to infect and replicate within cancer cells and to produce the protein granulocyte macrophage colony-stimulating factor (GM-CSF). It is thought to work in two ways. It enters the tumor cell and uses the cell's energy stores to replicate, eventually overwhelming the cell and causing it to die. By producing the protein GM-CSF, it also stimulates the patient's immune system to recognize and destroy tumor cells. Once an infected tumor cell dies, copies of the virus are released into the patient's bloodstream to infect more tumor cells. Although the product can also enter healthy cells, it is not able to replicate in these healthy cells and so it does not kill them, the agency points out.

                  The recommendation for approval is based on efficacy data that come from one randomized controlled trial (known as OPTiM) in adults with unresectable regionally or distantly metastatic melanoma. The study enrolled 436 patients, with 295 patients treated with talimogene laherparepvec compared with 141 patients treated with GM-CSF.

                  Analysis of the subset of patients in the study whose disease had not spread to the lung or other internal organs (249 patients with stage IIIB, IIIC, and IVM1a disease) showed a benefit in patients treated with talimogene laherparepvec, with a durable response rate of 25% vs 1% with GM-CSF alone, according to the EMA.

                  A durable response was defined as disappearance of the tumors or at least 50% reduction of tumors lasting at least 6 months, until patients' health declined or they required subsequent therapy, the agency noted.

                  An exploratory analysis in these patients suggested improvements in survival in patients treated with talimogene laherparepvec, the agency noted, but it points out that "this is not yet fully clear." It addition, there are no comparative data with other approved therapies for melanoma, which have already been shown to improve overall survival.

                  Overall, the expert committee considered that the product is relatively well-tolerated in patients with cancer and concluded that the medicine's benefits outweigh its risks, the agency stated.

                  The OPTiM study was published in May in the Journal of Clinical Oncology (2015;33:2780-2788), as reported at the time. The data in the publication are a little different to what the EMA cites in its press release, as in the publication, the durable response rate with the product was reported as 16.3% vs 2.1% with GM-CSF. In addition, it reports complete responses in 10.8% of patients on the product, compared with <1.0% on GM-CSF.

                   

                  "Durable responses to T-VEC were seen across all disease stages tested, including in patients within each subset of stage IV disease," said the authors, led by Howard L. Kaufman, MD, FACS, from the Rutgers Cancer Institute of New Jersey in New Brunswick. Noting that T-VEC could potentially delay or prevent relapses or preclude progression to later disease stages, they add that it "represents a novel potential new treatment option for patients with injectable metastatic melanoma and limited visceral disease." Dr. Kaufman told Medscape Medical News at the time: "Despite all the advances in the field of melanoma, many patients do not respond to treatment."

                  "Some patients are not able to tolerate some of the drugs for a variety of reasons, and so any agent that has some activity is important," he added.

                  "Interestingly, I think one of the more important things in the data is that nearly 11% of the patients had a complete response…. We don't often see that in melanoma studies. I think that's very significant," he commented.

                  Tamils
                  Participant

                    For what it's worth, my then-76-year-old father had a craniotomy with a fairly easy recovery.  He was back in his own home living by himself within two weeks.  Besides being stage IV, he was in good health before the craniotomy, however.  My best wishes to you and your family, whichever choice you make.

                    Tamils
                    Participant

                      For what it's worth, my then-76-year-old father had a craniotomy with a fairly easy recovery.  He was back in his own home living by himself within two weeks.  Besides being stage IV, he was in good health before the craniotomy, however.  My best wishes to you and your family, whichever choice you make.

                      Tamils
                      Participant

                        For what it's worth, my then-76-year-old father had a craniotomy with a fairly easy recovery.  He was back in his own home living by himself within two weeks.  Besides being stage IV, he was in good health before the craniotomy, however.  My best wishes to you and your family, whichever choice you make.

                        Tamils
                        Participant

                          I'm sorry your son is going through this at such a young age, but what great news about the Keytruda.  Here's hoping NED for him!  My father had radiation to the spine, which stopped the spinal tumor in its tracks and took away his back pain.  On the minor downside, the radiation damaged a valve in his stomach, and he had trouble with heartburn thereafter.  He had to eat small meals and take some standard OTC heartburn meds.  Hope your son recovers without issue.

                          Tamils
                          Participant

                            I'm sorry your son is going through this at such a young age, but what great news about the Keytruda.  Here's hoping NED for him!  My father had radiation to the spine, which stopped the spinal tumor in its tracks and took away his back pain.  On the minor downside, the radiation damaged a valve in his stomach, and he had trouble with heartburn thereafter.  He had to eat small meals and take some standard OTC heartburn meds.  Hope your son recovers without issue.

                            Tamils
                            Participant

                              I'm sorry your son is going through this at such a young age, but what great news about the Keytruda.  Here's hoping NED for him!  My father had radiation to the spine, which stopped the spinal tumor in its tracks and took away his back pain.  On the minor downside, the radiation damaged a valve in his stomach, and he had trouble with heartburn thereafter.  He had to eat small meals and take some standard OTC heartburn meds.  Hope your son recovers without issue.

                              Tamils
                              Participant

                                Hi Scared,

                                I'm also a healthy person, but with a lot of moles and a family history of melanoma.  I have gone for annual checkups from a derm for the last three years.  On my first visit, she took one off because it looked a little different from my others (the 'ugly duckling' theory), just like your third derm did.  That one was found to be moderately atypical, but I was not told that made me at any higher risk.  On the second visit, none were removed.  On my third visit earlier this week, she removed a scary new very dark mole in the crease of my toe that I had never even noticed (and that hadn't been there on the last visit).  Luckily that did not turn out to be cancerous either.  

                                So from my perspective, your third and current derm seems the most reasonable, or at least, the closest to my experience.  Hope that helps, and probably the mole on your stomach will turn out to be nothing.  Best of luck! 

                                Tamils
                                Participant

                                  Hi Scared,

                                  I'm also a healthy person, but with a lot of moles and a family history of melanoma.  I have gone for annual checkups from a derm for the last three years.  On my first visit, she took one off because it looked a little different from my others (the 'ugly duckling' theory), just like your third derm did.  That one was found to be moderately atypical, but I was not told that made me at any higher risk.  On the second visit, none were removed.  On my third visit earlier this week, she removed a scary new very dark mole in the crease of my toe that I had never even noticed (and that hadn't been there on the last visit).  Luckily that did not turn out to be cancerous either.  

                                  So from my perspective, your third and current derm seems the most reasonable, or at least, the closest to my experience.  Hope that helps, and probably the mole on your stomach will turn out to be nothing.  Best of luck! 

                                  Tamils
                                  Participant

                                    Hi Scared,

                                    I'm also a healthy person, but with a lot of moles and a family history of melanoma.  I have gone for annual checkups from a derm for the last three years.  On my first visit, she took one off because it looked a little different from my others (the 'ugly duckling' theory), just like your third derm did.  That one was found to be moderately atypical, but I was not told that made me at any higher risk.  On the second visit, none were removed.  On my third visit earlier this week, she removed a scary new very dark mole in the crease of my toe that I had never even noticed (and that hadn't been there on the last visit).  Luckily that did not turn out to be cancerous either.  

                                    So from my perspective, your third and current derm seems the most reasonable, or at least, the closest to my experience.  Hope that helps, and probably the mole on your stomach will turn out to be nothing.  Best of luck! 

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