Therapy Analysis - Psoriasis and Skin Cancer
Immunotherapy
A number of successful immunotherapeutics are now under development; however, the majority are primarily in the early stages (Graph 3). Well known biological therapy interferon α-2b is the only US-approved systemic drug to improve survival of stage III melanoma patients, but one promising, naturally occurring substance under development as a therapeutic agent is the antiviral tumour necrosis factor. Additional forms of experimental immunotherapy for stage IV patients include lymphokines such as the immune stimulant, interleukin-2 (IL-2). One of these is Proleukin, which is registered in the US, a high-dose IL- 2-only regimen for the treatment of stage IV melanoma. Several experimental melanoma vaccines are also being tested in clinical trials in stage III and IV patients. Unlike a preventative vaccine, these are given to prevent disease from worsening, and to promote longterm survival. The choices are certainly varied, but the optimal regime for improving survival, whether it is treatment with vaccines, interferon-α or surveillance for early detection and treatment, remains to be found. Interferon-α for instance, may decrease relapse rates, but it does not appear to impact overall survival rates, and there are severe adverse events in 10-75% of patients.
..the optimal regime for improving survival, whether it is treatment with vaccines, interferon-α or surveillance for early detection and treatment, remains to be found..Gene therapy frequently makes the news, due to novelty, controversy and the wide range of illnesses it is being tested against. However, this form of treatment is in the very earliest stages of research, and its effectiveness is yet to be proven (Graph 4). One method is based on altering melanoma cells by removing samples from the patient, growing these outside the body and genetically modifying them to stimulate granulocytes and macrophages. The more recognizable melanoma cells are returned to the patient's body to stimulate the immune system response to the metastatic disease. Research into treatments for skin conditions is steadily increasing - in some areas more than others - but rapid development will always be hampered by a perception that low rates of fatality make this field a low priority, despite the potentially enormous impact on individuals.
Skin conditions can be painful and distressing, as well as having the potential to severely disrupt a person's psychological wellbeing. And for more variable, chronic conditions which have complex underlying causes, there are greater difficulties in developing effective, long-term treatments, compounded by low prioritisation due to the cost and time investment required for drug development.
However, the importance of our appearance, in our skin, in perceiving the people we interact with on a daily basis, cannot be underestimated; neither can the difficulties encountered by sufferers of disfiguring skin diseases.
Alix Biancardi
Pharmaprojects Analyst
