1 News from American Society of Clinical Oncology Meeting June 2011 (Lung and Skin) Paul Donnellan Consultant Medical Oncologist Galway University Hospitals

Common causes of cancer death in the United States, 2008 Rudin C M et al. Clin Cancer Res 2009;15: ©2009 by American Association for Cancer Research

4 Melanoma: Mortality

Tsao, H. et al. N Engl J Med 2004;351: Clinical Images of Pigmented Lesions

7 Metastatic Melanoma Young age at onset Dismal prognosis –1yr survival 25%; –2yr survival 10% (Korn et al JCO 2008) Chemotherapy ineffective –Dacarbazine (DTIC) response rates 10% median survival < 8 months Never shown to improve survival

High Dose Interleukin-2 16% respond (6% completely and for median duration 10 yrs) 16% respond (6% completely and for median duration 10 yrs)

Immune ERU…

. Kirkwood J M et al. JCO 2008;26:

Kaplan–Meier Curves for Overall Survival and Progression-free Survival in the Intention-to- Treat Population Hodi FS et al. N Engl J Med 2010;363:

Intracellular Signaling Pathways in Melanoma Known to Be Important in the Response and Resistance to Targeted Therapy. Smalley KS, Sondak VK. N Engl J Med 2010;363:

Targeting Treatment to a Specific Variant in the Melanoma Gene. McDermott U et al. N Engl J Med 2011;364:

Best Tumor Response for Each Patient. Chapman PB et al. N Engl J Med DOI: /NEJMoa

McMullan, D. M. et al. N Engl J Med 2006;354:397 A 72-year-old man presented for evaluation of progressive dyspnea and cough

Smoking image

Lung Cancer

Tarceva Tablet once a day Few side effects If have the target mutation, the responseto treatment is 5 times higher than withchemotherapy! 55% vs 11%

Crizotinib Tablet once a day Targets EML4-ALK (5% on NSCLC) Few side effects Dramatic response in patients who havefailed chemotherapy 90% patients respond Randomised Clinical Trial UCHG