PracticalDermatology

Therapeutics Focus: Skin Cancer

STARVING CELLS TO TREAT MELANOMA

Research from Sydney's Centenary Institute and the University of Sydney suggests melanoma could be treated by cutting off its food source. Researchers previously showed they could starve prostate cancer, and now a further discovery opens up the prospect of a new class of drugs that could work across a range of cancers including melanoma. Melanoma and other cancer cells rely on the amino acid glutamine to divide and grow—amino acids, especially leucine and glutamine, are important for tumor cell growth, survival and metabolism. Thus, in order to fuel their rapid growth, cancer cells need to pump glutamine into their cells. New research published in the International Journal of Cancer has found that not only do melanoma cells have more glutamine pumps on their surface, but that blocking these pumps stops their growth. The work was led by Dr. Jeff Holst, who heads the Centenary Institute's Origins of Cancer Research Group, together with post-doctoral fellow Dr. Qian (Kevin) Wang. “We've shown that if we starve melanoma of these essential nutrients, we can stop the cancer from growing,” says Dr. Holst. “This involves blocking the protein pumps that move glutamine into tumor cells, which successfully slowed the growth of the tumors in cell cultures.”

“This work is leading a new wave with potential to develop cancer therapeutic agents,” says Centenary Executive Director Mathew Vadas.

—Int J Cancer. 2014 Feb 17. [Epub ahead of print]

VISMODEGIB SAFETY AND EFFICACY CONFIRMED IN EXTENDED ACCESS STUDY

Vismodegib, a first-in-class Hedgehog pathway inhibitor, was FDA approved for advanced basal cell carcinomas (BCCs) based on a single, nonrandomized, Phase II trial. In an effort to assess efficacy and safety of vismodegib, while providing early drug access to patients with advanced BCC and limited treatment options, researchers recently conducted an open-label, multicenter study in patients with advanced BCC that was inappropriate for radiotherapy or surgery. Patients received 150mg vismodegib daily until disease progression or intolerable toxicity. Tumor response was assessed via Response Evaluation Criteria in Solid Tumors version 1.0. A total of 119 patients with advanced BCC took vismodegib for a median of 5.5 months. Objective responses occurred in 46.4 percent of locally advanced BCC and 30.8 percent of patients with metastatic BCC. Response was negatively associated with prior systemic therapy in patients with locally advanced BCC (P = .002). Mean follow-up for safety was 6.5 months, with muscle spasms (70.6 percent), dysgeusia (70.6 percent), alopecia (58.0 percent), and diarrhea (25.2 percent) as the most common adverse events.

Read more in Oncology Watch, p. 57.

—J Am Acad Dermatol. 2014 Jan;70(1):60-9.

MELANOMA EPIDEMIOLOGY TRENDS

A recent review article in the British Journal of Dermatology assessed trends in melanoma incidence and mortality and outlined established and newly investigated risk factors and disease associations. Noting that cutaneous melanoma is one of the most rapidly growing cancers worldwide, the authors found that despite early detection of primarily thin melanomas and improved survival rates observed in several countries, the rate of thick melanomas has remained constant or continues to increase. The authors predict the ongoing trend of rising melanoma incidence rates in most white populations will continue over the next two to three decades, and note this rise is accentuated in older people aged > 60 years and has lately been observed in younger age groups, possibly marking the effects of an increased recreational indoor tanning exposure. The authors call for continuous surveillance and rigorous prevention programs, particularly in high-risk patients. Current considerations in the epidemiology of melanoma, according to the authors, focus on the observed survival benefit of females vs. males, the contributing role of indoor tanning, and the diverse effect of sun exposure. Well-known risk factors, such as skin, hair, and eye pigmentation and melanocytic naevi have been validated in large-scale studies, and other lifestyle factors and iatrogenic exposures, such as immunosuppressive agents and nonsteroidal anti-inflammatory drugs are being investigated. In addition, the authors explain, genome-wide association studies have revealed genetic loci that underlie the genetic susceptibility of melanoma, some of which are related to known risk factors. The authors write, “It is now evident that the epidemiology of melanoma is a multifaceted issue reflecting the complexity and heterogeneity of the disease itself. It is hoped that the recent advances in the biology and genetic basis of melanoma that have ushered in the exciting era of targeted treatment for patients with advanced disease will further elucidate the pathogenesis of the disease, generating more efficient and personalized approaches in the diagnostic and preventive setting.”

—Br J Dermatol. 2014 Jan;170(1):11-9.

New Products

REPLENIX RESTORATIVE NIGHTTIME BIO- THERAPY FROM TOPIX PHARMACEUTICALS

Topix Pharmaceuticals, Inc., introduced Replenix Restorative Nighttime Bio-Therapy cream, a moisture-boosting, rich night cream formulated to attract, hold, and distribute moisture through a system of ceramides, humectants, and emollients. The formula is infused with antioxidants, stem cells, and a peptide. The night cream features a multi-targeted system of ingredients to hydrate the skin and repair the skin's barrier. Replenix night cream is ideal for all skin types, including retinoid patients and sensitive skin patients, the company says. It is paraben-free, hypoallergenic, and fast absorbing. It minimizes the appearance of fine lines and wrinkles in mature skin, they say, and soothes and nourishes dry skin back to optimum health and combats environmental damage with skin protective antioxidants. topixpharm.com

XERACALM A.D LIPID-REPLENISHING PRODUCTS FROM AVÈNE

Avène introduced new XeraCalm A.D Lipid-Replenishing products. The XeraCalm A.D Lipid-Replenishing Cream for face and body is formulated to treat very dry skin prone to itching, atopic dermatitis and/or eczema. XeraCalm A.D Lipid-Replenishing Balm for face and body is a richly textured product formulated to treat severe dry skin prone to itching, atopic dermatitis and/ or eczema. The cream and balm are both clinically proven to significantly reduce itching, significantly and rapidly decrease dryness, repair the skin barrier, and boost the skin's natural defense system. XeraCalm A.D Lipid-Replenishing Cleansing Oil is a gentle, daily hygiene product for bath and shower formulated to treat moderately dry to very dry skin prone to itching, atopic dermatitis and/ or eczema. The soap- and fragrance-free oil has a physiological pH and is clinically proven to have very high skin, eye, and gynecological tolerance. Key to the efficacy of all products in the new XeraCalm A.D range is a biotechnological active based on discovery of an ancient microorganism, Avène says. Discovery of Aqua. dolomiae, found only in ATSW, led to 12 years of dedicated multidisciplinary research that resulted in the development of I-modulia, an original, patented biotechnological active. The active is proven to reduce pruritus, decrease inflammation, and increase the skin's innate immunity, the comapny says. aveneusa.com

MD COMPLETE FROM MD PROFESSIONAL

MD Professional launched MD Complete, created by dermatologist Dr. Brian Zelickson and backed by 20 years of research. MD Complete was born from Dr. Zelickson's desire to make dermatologist-level skincare broadly accessible, according to the company. MD Complete's propriety ingredient delivery system makes it possible to easily access and use professional levels of skincare ingredients for healthy, radiant, and youthful looking skin. Originally developed for pharmaceutical skincare of compromised or sensitive skin, this delivery system macro encapsulates ingredients in a protective shell to enable higher levels of ingredients to be absorbed by the skin, unique and more effective combinations of ingredients that could not have been formulated together in the past, and the creation of multitasking three-in-one treatments. MD Complete offers 11 products to address a broad spectrum of skin concerns in two product lines—one targeted at skin clearing and the prevention of breakouts and the other focused on anti-aging concerns. MDCompleteSkincare.com

NEW TRIPLE PROTECTION FACTOR BROAD SPECTRUM SUNSCREEN SPF 50+ FROM ELIZABETH ARDEN

Elizabeth Arden, Inc. unveiled Triple Protection Factor Broad Spectrum Sunscreen SPF 50+, or TPF 50. TPF 50 was developed based on a unique combination of protective and restorative ingredients including a DNA enzyme complex, a potent protein protection antioxidant complex, and broad spectrum SPF 50+ sun protection, the company says. Elizabeth Arden collaborated with US CosmeceuTechs, LLC and its CEO Joe Lewis. After years of research and development, in collaboration with Signum Biosciences, Lewis and the Elizabeth Arden report that the three components working together in TPF 50 are more effective in reducing the risks associated with premature signs of aging and skin cancer. TPF 50 is designed to maintain radiant, glowing skin, with a universal tint designed to work with all skin tones. TPF 50 is the first of a comprehensive new skincare line, Elizabeth Arden Rx, designed for exclusive distribution in physician offices. elizabethardenrx.com