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A Home-grown Team Battles Melanoma

  Drs. Deborah Wong, John Glaspy, Bartosz Chmielowski and Antoni Ribas
 

(From left) Drs. Deborah Wong, John Glaspy, Bartosz Chmielowski and Antoni Ribas.
Photo: Grace Cherry

The four physicians on the UCLA melanoma medical oncology team completed some part of their medical training at UCLA. John A. Glaspy, MD, MPH, graduated from medical school in 1979, completed his residency in 1982 and his fellowship in 1985; Antoni Ribas, MD, PhD, completed his fellowship in 2001; Bartosz Chmielowski, MD, PhD, completed his fellowship in 2008; and Deborah J.L. Wong, MD, PhD, completed her residency in 2009 and fellowship in 2013. They are at the forefront of the fight against a cancer that has been notorious for its resistance to most therapies. But exciting new advances are leading to improved therapies. (See “Turning the Tables,” U Magazine, Spring 2015.)

The treatment of patients with advanced melanoma, the most aggressive form of skin cancer, has recently undergone one of the most remarkable changes in any field of medicine. In a short period of time, it has gone from anecdotal responses to having an array of effective treatment options. The four physicians in the UCLA melanoma oncology clinic have made major contributions to these advances.

In the 1990s, if anything worked for a patient with advanced melanoma, it was a lucky strike. That is the time when Dr. Glaspy started the UCLA clinic, primarily to care for patients who were referred by melanoma surgeon James S. Economou, MD, PhD, UCLA vice chancellor for research. At that time, few medical oncologists wanted to work in melanoma, a disease that tended to affect patients at the prime of life and for which there were no effective treatments. In the early 2000s, when Dr. Ribas joined Dr. Glaspy, they started testing treatments aimed at turning on the immune system against melanoma. These treatments had low response rates, but they gave the first glimpse at the prospect of having durable tumor responses (lasting years) in patients who otherwise had a life expectancy measured, at best, in months. They built upon these initial observations by developing more active immune-system therapies and also by bringing to the clinic treatments that specifically blocked mutations present in melanomas.

By the early 2010s, the melanoma clinic had expanded with multiple clinical trials, and it attracted patients from all over the world. The research done at UCLA has contributed to the recent approval by the Food and Drug Administration of five new effective treatments for this disease. With the increased demand, Drs. Chmielowski and Wong joined the clinic. During their fellowship training, they had conducted laboratory research in melanoma, and they went on to apply their expertise to patients at a time when the promise of effective treatments became a reality.

Now, when patients with metastatic melanoma are seen at the UCLA melanoma clinic, Drs. Glaspy, Ribas, Chmielowski and Wong can discuss the benefits of treatments based on the BRAF gene and other specific inhibitors that disable prevalent mutations that drive melanoma growth. They also can discuss releasing the brakes of the immune system to enable the body’s own defenses to attack the cancer anywhere in the body. Their work to advance the science, which has led to improved treatments, has been published in leading medical journals, including the New England Journal of Medicine, The Lancet, Nature, Cancer Discovery, Proceedings of the National Academy of Sciences, Journal of Clinical Oncology, Clinical Cancer Research, Molecular Cancer and other prestigious publications.

 





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