05/06/2016

The morning session started with a presentation firstly why you should treat with Adjuvant therapy and then the rebuttal as to why you shouldn’t. From my personal perspective when a patient is newly diagnosed in what are deemed to be early stage melanoma the shock of finding your self in that position is enormous and you want your medical team to do at least something to prevent re-occurrence. This is perfectly understandable emotional response. As is often repeated surgery at extremely early stage is your best weapon against melanoma re-occurrence. This is why as advocates we try to drum that message of Early Detection!! In patients that are classified as Stage 3 there are now more trials in operation as an alternative to the wait and see strategy which is extremely mentally challenging to patients, but there is a fear also that treating at too early a stage can lead to drug resistance whilst offering no preventative benefit which would affect overall survival rates and progression free survival in the long term. Data from these trials is emerging all the time and will give a clearer picture on which is best option for the patient.

When you sit in these sessions and listen to them talk an debate which treatment MIGHT be better and which treatment pathway MIGHT be better you understand this is not medicine as we think of it as patients, this is patients being treated by emerging science. The reason their have been so may developments in Melanoma research within the last few year’s is that Melanoma has become the first point of testing for treatment in all kinds of cancer. Melanoma contains an unprecedented number of tumor mutations so if a new treatment works on Melanoma there is a logic in the assumption, that it will also work on other types of cancer. This is why we are now seeing a crossover in treatment that started within the Melanoma community to other cancers such as Nivoloumab in non-small cell lung cancer. The majority of exciting new cancer developments have originated within the melanoma community of Research and Development. This is good news for Melanoma patients as it means research and development of new treatments and combinations of existing treatments will continue to be tested on our patients as a rule as the wider Cancer community continues to keep pace.

 

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Koen Van Elst Stiching Melanoom Holland, Me, Gilliosa Spurrier Melanome France, Iain Galloway Ocular MPNE

Of course it wasn’t all work and no play in Chicago it would be very difficult to get through such an intense program of lectures without a break every now and then and the patient Advocacy Lounge provided just such an oasis within the crowded confines of McCormick place. I felt we were really privileged to have such facilities available as patient advocates compared to those who had to endure the long ques for food and drink around the centre. We could visit the Patient Advocacy Lounge throughout the day where breakfast, lunch and beverages were provided free of charge along with a quiet place to sit or have meetings with fellow advocates or just to charge your phone and laptop it really made a huge difference to all the MPNE advocates who attended ASCO. The staff were always on hand to give advice be it about the conference or accomodation or transport nothing was too much trouble for Chrisy and Jeannine.

On Sunday afternoon their was a presentation on Developmental Therapeutics in Immunotherapy the conclusions of the session were that immunotherapy continues to show great promise in the treatment of Cancer. There are numerous potential targets for the use of this treatment, but building combinations of therapies should be based on and understanding of immune mechanisms and rational approaches. Better diagnostic tools that will help identify appropriate patients to treat will be required to ensure treatment is directed properly for optimum effects. There is reason to believe poorly responding disease such as Uveal Melanoma can respond to immunotherapy which is very encouraging for other types of rare cancers.

We are in a time of great change when it comes to the treatment of Cancer and Immunotherapy is causing a sea change in treatment choices for many this will lead to longer progression free survival and longer over all survival rates. Even with progression there is hope that the disease may now be managed in the long term even in the event that it is not eradicated, this is good news for patients, living longer with less side effects is the end goal when it comes to treatment and a long term remission for many patients too is now a real possibility.

In the evening myself Iain and Koen hopped on one of the many shuttle buses into the city on the way I ran into a oncologist I had randomly met while I sat on a bench the day before she was a professor at the University of Utah and had a special interest in Ocular Melanoma so it was a useful connection for Iain and they had a chat on the bus into the city I have learned its no use being shy and if someone sits beside you introduce yourself. If you get the opportunity to stand in front of a panel of experts in a crowded room and ask a question then just bite the bullet and do it, as  Koen from Dutch Melanoma reminded me nothing in life can be as scary as waiting for scan results!!

We had signed up to go to an Ancillary Education session not really knowing what to expect when we arrived it was obvious we had made the right choice we found a table near the front and followed the presentation with great interest even when the slides of dead lab mice made me wonder what kind of stomach’s Oncologists have that they could actually eat whilst watching. Two of the leading authorities in Melanoma presented their perspectives on advances in cancer immunotherapy for solid tumor. Questions were asked to be submitted from the audience and was I surprised when Jefferey Weber MD PHD chose mine to answer first we were really pleased with ourselves as out of a room of possibly two hundred people mine Iain and Koen’s questions were chosen from those submitted to be answered. We also fared pretty well in the multiple choice buzzer questions at end of session compared to some of the oncologists sitting around us 🙂

At the end of the session with nothing to lose we approached the podium and managed to have another chance to question Antoni Ribas MD PHD. I saw Dr Weber make a break for it and took my chance to follow him and ask him a few questions so he asked me to walk with him while he got something to eat from the buffet a slightly surreal moment I must say eventually he made his apologies and left but to say that experience left a lasting impression on the three of us is an understatement as the saying goes Fortune Favours The Brave!!!