Current approaches to treating melanoma amount to Sisyphean work, Andrzej Slominski, MD, PhD, of the University of Tennessee Health Science Center (UTHSC), wrote in an editorial published in the April edition of Mayo Clinic Proceedings.
“Similar to Sisyphus, it will be problematic to reach the pinnacle where targeted cure is achieved,” wrote Dr. Slominski, who serves as a professor of Pathology and a professor of Medicine at UTHSC. That’s because the immunosuppressant characteristics of melanoma and the diverse characteristics and behaviors of tumor cell populations allow them to overcome the effect of current drugs in most cases.
Slominski was invited by the publication, one of the premier peer-reviewed clinical journals in general medicine, to comment on two papers about recent advances in the treatment of melanoma. The publication has a circulation of about 125,000.
The papers discuss the similarities between the mechanisms protecting metastatic melanoma from immune responses from its host, and those that protect a fetus from being rejected as a foreign body by the mother. Dr. Slominski wrote that studies of this aspect of melanoma in search of targeted therapies to get around immune modulation, “will secure the academic future for years to come.” They won’t, however, do much for patients in the present, because current treatments are able to prolong life for only a few months, before the disease relapses and death occurs. Current therapies are expensive and produce toxic effects as well, Dr. Slominski wrote.
Serious investment in melanoma research beyond mainstream approaches is warranted, he said. As oncology treatment moves toward targeted, personalized therapy, the major challenge is to find economical and effective treatments to inhibit melanoma’s ability to rewire itself to evade drug therapy, fool the immune system, and resist treatment.
In the meantime, Dr. Slominski suggested the use of melatonin and vitamin D, which have anti-cancer and protective properties, as adjunct treatment during any type of therapy for late-stage melanoma. Both are inexpensive, melatonin is non-toxic, and vitamin D is easily monitored for toxicity.
He said clinical trials with melatonin showed it improved survival and decreased toxicity of the cancer-fighting drugs. Still, he said, efficacy is not proven, but they are viable options, because they are low cost and not toxic with supervision. “We don’t know, but you don’t have anything to lose,” he said.