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Melanoma Is Rare in Black Men, But More Deadly

Melanoma is diagnosed less frequently in Black men, but Black men who have melanoma are 26% more likely to die from the disease than white men. That’s according to a study published in the Journal of the American Academy of Dermatology that analyzed more than 205,000 cases of melanoma from the National Cancer Database. The findings, reported July 11 in the Washington Post, noted stark differences in diagnosis patterns between Black and white men, finding 48.6% of Black men with melanoma were diagnosed at late stages compared with 21.1% of white men. Melanomas were generally found on the lower extremities in Black men and in areas not typically exposed to the sun—such as the soles of the feet, toes, toenails, fingernail beds and palms—while white men typically had the disease on their trunk or head and neck. In addition, more than 75% of white men live five years or more after a melanoma diagnosis, while 51.7% of Black men do. The study drives home the importance of increasing public education for doctors, who may not be aware that the disease shows up differently in Black men, and patients to be on the lookout for melanoma, says Jeremy Brauer, a dermatologist at NYU Langone Health in New York City, who was not connected to the study. “This disproportionate and unfortunate rate of death means we have to try to be much more preventative,” Brauer said in the Washington Post article.

CAR T-cell Therapy Provides Promising Option for Aggressive Lymphoma

People with diffuse large B-cell lymphoma whose cancer doesn’t respond to initial treatment with chemotherapy have historically faced uncertain and difficult options, including the prospect of more grueling chemotherapy and a stem cell transplant. However, only half of patients with this type of lymphoma are healthy enough to be candidates for an arduous stem cell transplant—and less than a quarter of those patients who tolerate it will be cured, a July 10 article published on Cancer Currents, a blog from the National Cancer Institute (NCI),noted. The article described a study that found CAR T-cell therapy is effective for patients with early relapsed or refractory large B-cell lymphoma. The findings, which were initially presented at the American Society of Clinical Oncology Annual Meeting in June and published in the New England Journal of Medicine, included results from 359 patients with early relapsed or refractory large B-cell lymphoma who received either the CAR T-cell therapy Yescarta (axicabtagene ciloleucel, axi-cel) or the standard of care, which included two to three cycles of chemoimmunotherapy, high-dose chemotherapy and an autologous stem cell transplant. Comparing the two treatments, investigators estimated that about 55% of patients in the study would still be alive four years after receiving Yescarta, compared with 46% of those who initially received the standard treatment for relapsed disease. Importantly, 94% of people in the Yescarta group received the CAR T-cell therapy, while only 36% of those in the standard-treatment arm were able to have a stem cell transplant, according to Cancer Currents. In addition, many who were not able to receive a stem cell transplant in the study crossed over to receive CAR T-cell therapy. Based on these results, Yescarta is now the preferred treatment for people whose diffuse large B-cell lymphoma has recurred quickly or proven resistant to standard initial treatment, according to Christopher Melani, a physician and staff clinician for the NCI’s Center for Cancer Research. For future studies, Yescarta “is now the benchmark upon which to improve with future treatments,” he said in the Cancer Currents article.

Rare Brain Tumor Responds to Targeted Treatment

Two drugs that are used to treat metastatic melanoma were able to shrink tumors in a rare type of brain cancer called papillary craniopharyngiomas (PCPs), according to a study published July 13 in the New England Journal of Medicine. The research included 16 patients who had not received prior radiation therapy for their cancer. These patients were given two cancer drugs—vemurafenib and cobimetinib—that had been approved for melanoma with a certain BRAF mutation. For the brain cancer patients, the targeted therapy resulted in a 91% reduction in tumor size at four months. The trial is an example of bench-to-bedside research where scientists in the lab who were studying the molecular drivers of PCPs discovered the BRAF gene was present in more than 90% of PCP tumors. The discovery led to the realization that BRAF and MEK inhibitors, already approved in melanoma for patients with the same BRAF mutation, could be effective in treating PCP. The current standard of care to treat PCP is surgery and targeted radiation—which can be effective but is associated with significant side effects “The results of this trial really do represent the highest response rate to date of systemic therapy in brain tumors. So we were very pleasantly surprised, and these types of responses are actually unprecedented,” noted Priscilla Brastianos, lead author of the study and director of the Central Nervous System Metastasis Center at the Mass General Cancer Center, in a STAT article. After the therapy had been discontinued, three patients in the study had disease progression, the journal article reported.