Defeat Melanoma: Radiation and Immunotherapy | News | Loyola Medicine
Monday, May 23, 2016

Combining Radiation with Immunotherapy Showing Promise Against Melanoma

MAYWOOD, IL – Combining radiation treatments with a new generation of immunotherapies is showing promise as a one-two-punch against melanoma, Loyola Medicine researchers report in a review article.

Radiation kills cancer cells by damaging their DNA. Immunotherapies work by harnessing a patient's immune system to attack and kill cancer cells. When combined, the two therapies appear to have synergistic effects, according to the article by James S. Welsh, MD and colleagues in the Journal of Radiation Oncology. The article summarizes the latest research in how radiation can be integrated with immunotherapy in the treatment of melanoma.

Dr. Welsh is a professor in the department of radiation oncology of Loyola University Chicago Stritch School of Medicine.

Melanoma is one of the most aggressive forms of skin cancer. Among patients with Stage 4 metastatic melanoma, in which the cancer has spread to other organs, one-year survival rates range from just 33 percent to 62 percent. This year in the United States, about 76,000 patients will be diagnosed with melanoma and about 10,000 people are expected to die of the disease, according to the American Cancer Society.
 
On rare occasions, melanoma patients can spontaneously go into remission. More common are partial spontaneous regressions of melanoma lesions. While scientists aren’t certain what causes these effects, evidence points to the immune system mounting an attack on cancer cells.
 
A key observation that supports the role of the immune system in melanoma is the abscopal effect.This rare phenomenon occurs when a localized treatment such as radiation not only shrinks the targeted tumor but also stimulates the immune system to mount a systemic attack on cancer cells throughout the body. Dr. Welsh saw the abscopal effect firsthand when he gave radiation treatment to a patient who had melanoma that had spread to his liver and bones.The radiation was intended merely to shrink a tumor in the patient’s thigh bone, to relieve his pain and reduce the risk of fracture. But three months later, a CT scan found no trace of cancer anywhere.
 
Many new immunotherapies for melanoma are being tried, some with notable results. One such example is a new generation of “checkpoint inhibitors.” These are drugs that, in effect, remove the brakes that normally prevent the immune system from attacking cancer cells.
 
Radiation increasingly is being used alongside checkpoint inhibitors and other immunotherapies, with encouraging results, Dr. Welsh and colleagues write.
 
Despite the recent successes of radiation and immunotherapy, not all patients are able to mount an effective immune system response to fight melanoma. So it is important to discover proteins or other biomarkers that can predict whether a patient will respond to immunotherapy. Such biomarkers also could help quantify how well experimental therapies are working, Dr. Welsh and colleagues write.
 
Their paper is titled “The integration of radiation therapy and immunotherapy in melanoma management.”
 
In addition to Dr. Welsh, co-authors, all from Loyola’s department of radiation oncology, are Kyle Stang, MD (first author), Scott R. Silva, MD, PhD and Alec M. Block, MD.

About Loyola Medicine and Trinity Health

Loyola Medicine, a member of Trinity Health, is a quaternary care system based in the western suburbs of Chicago that includes Loyola University Medical Center (LUMC), Gottlieb Memorial Hospital, MacNeal Hospital and convenient locations offering primary and specialty care services from 1,877 physicians throughout Cook, Will and DuPage counties. LUMC is a 547-licensed-bed hospital in Maywood that includes the William G. and Mary A. Ryan Center for Heart & Vascular Medicine, the Cardinal Bernardin Cancer Center, a Level 1 trauma center, Illinois's largest burn center, a certified comprehensive stroke center and a children’s hospital. Having delivered compassionate care for over 50 years, Loyola also trains the next generation of caregivers through its teaching affiliation with Loyola University Chicago’s Stritch School of Medicine and Marcella Niehoff School of Nursing. Gottlieb is a 247-licensed-bed community hospital in Melrose Park with 150 physician offices, an adult day care program, the Gottlieb Center for Fitness, the Loyola Center for Metabolic Surgery and Bariatric Care and the Loyola Cancer Care & Research at the Marjorie G. Weinberg Cancer Center at Melrose Park. MacNeal Hospital is a 374-bed teaching hospital in Berwyn with advanced inpatient and outpatient medical, surgical and psychiatric services, advanced diagnostics and treatments. MacNeal has a 12-bed acute rehabilitation unit, a 25-bed inpatient skilled nursing facility, and a 68-bed behavioral health program and community clinics. MacNeal has provided quality, patient-centered care to the near west suburbs since 1919.

Trinity Health is one of the largest multi-institutional Catholic healthcare systems in the nation, serving diverse communities that include more than 30 million people across 22 states. Trinity Health includes 94 hospitals, as well as 109 continuing care locations that include PACE programs, senior living facilities and home care and hospice services. Its continuing care programs provide nearly 2.5 million visits annually. Based in Livonia, Mich., and with annual operating revenues of $18.3 billion and assets of $26.2 billion, the organization returns $1.1 billion to its communities annually in the form of charity care and other community benefit programs. Trinity employs about 133,000 colleagues, including 7,800 employed physicians and clinicians. Committed to those who are poor and underserved in its communities, Trinity is known for its focus on the country's aging population. As a single, unified ministry, the organization is the innovator of Senior Emergency Departments, the largest not-for-profit provider of home health care services—ranked by number of visits—in the nation, as well as the nation’s leading provider of PACE (Program of All Inclusive Care for the Elderly) based on the number of available programs.