Title: Pathology: Patient: Melanoma Descriptio...Image via Wikipedia

There are three cancers that make my heart sink when someone calls asking for information on them; pancreatic, advanced lung cancer and malignant melanoma.  Why?  Because patients typically have a poor prognosis and don't do very well.  It's a sharp reminder that for all the good news out there, we still have a long way to go for thousands of cancer patients.

My interest was thus piqued when I found a press release this week from Zymo Genetics suggesting that it's agent in development for malignant melanoma, IL-21, appears to shrink the tumour.  You can read more about it here.

IL-21 or Interleukin-21 is a cytokine.  Within the body, endogenous IL-21 is a potent regulator of key classes of immune cells,
including cytotoxic T lymphocyte cells and natural killer cells, which play critical roles in eliminating malignant and virally
infected cells from the body.  IL-21 also is important in boosting
antibody response. 


The combined biologic actions of IL-21 suggest that it may be an
effective immunotherapy in the treatment of cancer, either alone or in
combination with other anti-cancer drugs.  The preclinical and
early clinical trial data suggest that IL-21 could potentially be better tolerated
and more efficacious than other currently marketed immunotherapies for
cancer, such as interleukin-2 (IL-2) and interferon-alpha.

What of the data then?  Well, essentially, the company reported that:

"Interleukin 21
(IL-21) demonstrated an impressive overall response rate in the
treatment of metastatic melanoma. In interim Phase 2 results from 24
patients, 29 percent showed a partial response, with an additional 33
percent of patients showing stable disease in this difficult to treat

The compound, which they are looking to outlicense, also demonstrated that to date, 7 of the 24 patients (29%) had a partial response (5 confirmed
by RECIST criteria).  Eight patients (33%) had stable disease.  The most
common adverse events reported were mild or moderate fatigue and rash.

Two cancers in particular that are immune sensitive include melanoma and renal cell carcinoma, so it was no surprise to learn that Zymo Genetics are testing recombinant IL-21 in combination with Nexavar®
in a Phase 2 clinical trial in patients with metastatic renal cell
carcinoma, as well as a Phase 2 clinical trial in collaboration with
the National Cancer Institute of Canada to test IL-21 as a single agent
in patients with metastatic melanoma.

It will be interesting to see how this novel approach pans out with further research.

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