Hopeful sign for new skin cancer treatment

A rarely observed cancer phenomenon has been confirmed in a Long Island patient who is helping medical scientists pave the way to a possible new treatment for others with advanced skin cancer.

Reporting in Thursday's New England Journal of Medicine, investigators at Memorial Sloan-Kettering Cancer Center in Manhattan say they have observed an example of the unusual occurrence known as the "abscopal effect."

The phenomenon occurs in advanced cancers following radiation therapy on a single tumor. Not only does the irradiated tumor disappear, but distant tumors -- metastases -- untouched by radiation disappear as well.

"We've learned that if you kill one tumor sufficiently and if the immune system is attracted to the debris of the dead tumor, the immune system can attack tumors elsewhere in the body," said medical oncologist Dr. Jedd Wolchok, who treated the patient.

The phenomenon was confirmed by a team of medical experts at the cancer center's Ludwig Center for Cancer Immunotherapy.

The patient, identified by Bloomberg News as Valerie Esposito, 41, a government clerical worker and single mother of three, was suffering from tumors that had spread throughout her body.

Wolchok said his first choice of treatment was the drug Yervoy, administered in September 2009.

The drug, Wolchok said, is designed to boost the immune system.

The immune system, under the drug's influence, is supposed to marshal its cellular forces to quash the cancer.

But by December 2010, Esposito was not improving and a tumor in her lung was pressing on her spine. Wolchok ordered radiation to shrink it.

Within three months of completing therapy, the tumors throughout Esposito's body began to disappear.

"The drug has some responsibility but by itself the drug was not controlling the disease," Wolchok said.

He theorizes the drug combined with radiation created a synergistic effect causing the boosted immune system to destroy distant tumors.

He has since followed the same steps with a second patient and has observed the same results.

Dr. Craig Devoe, an oncologist who specializes in melanoma at Monter Cancer Center in Lake Success, said the phenomenon is not a fluke.

"You have to suspect the drug somehow aided the response," said Devoe, an assistant professor of medicine at the Hofstra North Shore-Long Island Jewish School of Medicine.

Devoe said malignant melanoma is a tenacious cancer that is often difficult to treat.

"This is an important finding and may point to a new way to use the drug," he said.

Wolchok said he is designing a clinical trial to see if the strategy can be extended to other patients with malignant melanoma.