Immunology Treatments Providing Hope for Late-Stage Melanoma Patients
The most common form
of cancer in the United States is skin cancer, and melanoma is the deadliest variety.
Yet when high school math teacher Trey Simmons of Fleetwood, North Carolina,
was diagnosed with melanoma in 2013, he didn’t flinch.
“I had done research
knowing it might be cancer and at the time I knew that with melanoma, they
could cut it out and it would be gone,” Simmons said. “And that’s exactly what
happened – at first.”
By 2015, however,
Simmons was not feeling well, even though the screenings he had every three
months following his original diagnosis and treatment had not indicated any
problems. He returned to Wake Forest Baptist Medical Center in Winston-Salem for
a PET scan, a type of imaging that studies metabolic changes in an organ or
tissue at the cellular level.
The scan revealed
that the melanoma had returned in several places in Simmons’ body, eliminating
surgery as an option. He was at stage IV, the most advanced cancer stage, with
melanoma under his collarbone, in his hip and in his lymph nodes.
But Simmons, 56, has since
been treated at Wake Forest Baptist with therapies that are giving new hope to
late-stage melanoma patients.
In December, Simmons began
an immunotherapy regimen – intravenous doses of ipilimumab, a drug that helps
bolster the body’s immune system to limit the growth of cancer cells, and
injections of a clinical-trial drug called HyperAcute Melanoma (HAM) vaccine, which
is designed to help the immune system attack cancer cells.
These days, Simmons
is feeling much better and doesn’t at all look like a patient with stage IV
“I’ve been extremely
fortunate,” he said. “Other than fatigue and a rash, I haven’t suffered any
Joyce Fenstermaker, a
registered nurse at Wake Forest Baptist who sees Simmons for the HAM trial,
said improvements in melanoma treatment over the past few years have been
“Patients who have
tumors that can’t be removed surgically often respond to immunotherapy and can
work and live a very good life taking these agents,” she said.
new cases of melanoma are diagnosed in the United States each year. In 2015,
former President Jimmy Carter brought heightened attention to both the disease
and recent advances in treating it. Carter announced in August that he had
metastatic melanoma that had spread to his brain and liver. But in December,
after undergoing surgery, radiation and immunotherapy treatment, he revealed that
he was cancer-free.
occurs on the skin, where it is easily noticed. Dr. Pierre Triozzi, a Wake
Forest Baptist hematologist and oncologist who specializes in melanoma, said
surgery has always been the best treatment option for the disease. When it is caught
early, the prognosis for recovery is excellent.
By stage III,
however, melanoma is in the lymph nodes, and at stage IV it has spread to other
organs. At that stage, Triozzi said, chemotherapy and radiation directly
targeting cancer cells can produce some shrinkage of melanomas, but neither
therapy is known to prolong survival.
immunotherapy has made an impact.
“It’s not treating
the cancer, but focusing on the host,” Triozzi said. “The immune system kills
viruses foreign to the body.”
doesn’t work for many cancer patients because cancers are “of the body” and not
necessarily seen as foreign by the immune system. Immunotherapy has proven
effective, however, against certain types of cancer, especially melanoma.
Studies suggest that sun
exposure and ultraviolet light, the typical causes of melanoma, damage cells in
such a way that they appear foreign to the body’s immune system. That, in turn,
makes the immune system’s response likely to be more effective when boosted by existing
drugs and clinical-trial medications such as HAM, Triozzi said.
“Most of the time in
the past when you had melanoma at an advanced stage, there were not a whole lot
of options,” Triozzi said. “Now, with all the new treatments available, there
is reason for optimism. It may be too soon to speak the word cure, but with these
new treatments we are seeing people even in stage IV cured of their melanoma.”
Simmons said that when
the HAM trial was suggested to him, he didn’t hesitate to sign up.
“I said if I qualify,
I’ll be glad to,” he said. “Even if it doesn’t help me, maybe it would help
publicly about his cancer at a Relay for Life event a few weeks ago, and
willingly shares his story with his students at Ashe County High School in West
“I have two or three
students going through cancer. We talk a lot,” he said. “Maybe they can gain a
boost from me.”