Dr John Thompson Discusses Screening and Diagnosis, Immunotherapy, and Biomarkers

While at the National Comprehensive Cancer Network’s 21st Annual Meeting, John A. Thompson, MD, co-director of the Melanoma Clinic at the Seattle Cancer Care Alliance, discussed screening and diagnosis of melanoma, immunotherapy, and biomarkers.

Transcript (slightly modified)

What have been some of the recent improvements in screening and diagnosis of melanoma?

Screening and diagnosis really is a matter of education of patients and this is probably an area of importance to all disciplines of medicine: primary care physicians, specialists, and public health doctors. We need to get the word out to patients that melanoma is on the rise, there’s an increasing incidence of melanoma, and help patients work with physicians to identify changing moles or suspicious lesions.

How does immunotherapy have the potential to transform cancer care?

We’ve witnessed a lot of change in the treatment of melanoma is one example over the past 5-10 years. I’ve given this lecture at the NCCN several times, and years ago I had very few treatment options for patients with melanoma. Now I have a list that’s longer than 10 of active agents; many of them are immunotherapy agents. And we’re now seeing that some of the original positive results seen in melanoma are now being observed in the treatment of lung cancer, head and neck cancer, bladder cancer, and other types of cancer.

While the PD-1 and PD-L1 checkpoint inhibitors have developed very promising results in patients with melanoma and non-small cell lung cancer, what is your take on the lack of a strong biomarker expression-based response?

Well, everyone would like a biomarker that would tell us exactly which patients are destined to respond to PD-1 inhibitors and which ones are not. That’s the goal, of course. And we’re moving in that direction. There’s work by a number of researchers to develop tumor biopsy-based assays, for instance PD-L1 expression, that may allow prediction of response, and hopefully there will be even easier assays in the future that will be blood-based.