Using Immunotherapy to Fight Deadly Melanoma

Immunotherapy has radically transformed outcomes for some patients with cancers deemed universally lethal just five years ago. Now these patients are living years in remission, and some ultimately may be cured. Currently, 20 percent of patients respond to immunotherapy, thanks in part to the work of UCSF physician-scientists like Adil Daud, MD, who is revolutionizing melanoma cancer treatment. 

Daud has led the development of PD1 antibodies, which have been approved for treatment of melanoma, the most dangerous – and one of the most common – forms of skin cancer. More than 76,000 Americans are diagnosed with melanoma each year, and 9,000 die. Immunotherapy is one of the newest innovations Daud and his team at UCSF employ to stop cancers that no longer respond to conventional therapy. 

“With targeted therapies, the risk is that a cancer tumor will build resistance over time, find a way around the treatment, and continue to grow,” Daud explains. “But with an immunotherapy response, a patient’s immune system will continue to fight that tumor’s resistance forever.” 

Daud believes that certain immune-system cells called T cells possess an immune “memory” with the ability to proliferate and kill any future cancer cells they detect. He and his team also think they have found some new molecules that will serve as next-generation immunotherapies for different cancers in different organs. He has led clinical trials that showed so much promise, the US Food and Drug Administration accelerated approval for their use in treating metastatic melanoma. 

Treatment using immunotherapy can include a single drug or two in combination. Combination therapy is extremely expensive and highly toxic, but Daud and his colleagues discovered a novel biomarker that can predict who is most likely to respond well to combination immunotherapy treatments for melanoma. The goal: Protect patients whose tumors won’t respond from enduring a lot of extra risk and discomfort. 

Daud’s work revealed that patients who had lower levels of T cells within their tumors benefited most from receiving two immunotherapy drugs in tandem. He and his trailblazing team are now exploring why woman have fewer T cells – and in turn, a diminished response to single immunotherapy drugs.