Physicians, researchers, lawmakers and advocates are constantly making strides in the skin cancer space, and 2018 was an especially busy year. We saw the FDA approve a groundbreaking drug, companies debut new technology to help increase our awareness of dangerous ultraviolet (UV) rays and lawmakers pass indoor tanning legislation. Here, we look back at some of the most significant skin cancer news of the year.
New Hope for Patients With Advanced Skin Cancer
When caught and treated early, skin cancer is usually curable. If a cancerous tumor is detected at a later stage, however, treatment becomes more complicated. Thanks to continuous innovation by researchers and pharmaceutical companies, more options than ever exist for patients whose skin cancer has metastasized. On September 28, 2018, the U.S. Food and Drug Administration (FDA) approved Libtayo (cemiplimab-rwlc) for the treatment of patients with metastatic cutaneous squamous cell carcinoma (CSCC) and for patients with advanced local CSCC who are not suitable candidates for surgery or radiation.
Though fewer people develop CSCC than basal cell carcinoma (BCC), CSCC has a higher risk of becoming locally advanced or metastatic — and approximately 15,000 people in the U.S. die of CSCC every year. Cemiplimab, an immune-oncology drug that is administered intravenously, works by harnessing the power of the body’s own immune system to fight cancer. FDA approval of the drug was based on a phase 2 clinical trial, where 46 percent of patients responded to the cemiplimab and an earlier phase 1 trial with a combined 47 percent of patients responding to the drug. Since therapies for patients with advanced CSCC have been limited so far, the approval of cemiplimab is an important step forward for CSCC patients and immunotherapy skin cancer treatment as a whole.
Addressing the Skin Cancer Gender Gap
The skin cancer gender gap is unfortunately nothing new. We know that the majority of people diagnosed with melanoma are white men over age 55, and from ages 15 to 39, men are 55 percent more likely to die of melanoma than women in the same age group. A study presented at the 2018 NCRI Cancer Conference in November brought more grim news for men: The rate of men dying from malignant melanoma has risen around the world, while rates for women are generally steady or falling.
Dorothy Yang, MD, a junior doctor at the Royal Free London NHS Foundation Trust, UK, and the presenter of the research, said additional studies would be needed to explore the factors causing these trends. She pointed out that evidence suggests men are less likely to use sun protection than women, and are less likely to engage with melanoma awareness and prevention campaigns. Future research would focus on seeking out possible biological influences affecting the difference in mortality rates between men and women, among other factors.
Protecting Teens From Dangerous Tanning Devices
The U.S. has made slow but steady progress in the fight to keep teens out of UV tanning beds. While The Skin Cancer Foundation’s ultimate goal is to see tanning beds banned completely, stopping those under 18 from patronizing UV tanning salons is a good place to start.
Today, 17 states plus the District of Columbia ban tanning for minors, and in 2018 Rhode Island and New York joined the list. Similar laws are being considered in Arizona, Connecticut, Indiana, Michigan, Mississippi, Missouri and Nebraska. The Foundation supports any effort to curb indoor tanning, considering the serious consequences associated with the practice, especially for minors. People who first use a tanning bed before age 35 increase their risk for melanoma by 75 percent.
Options Limited for Effective Sun Protection
In July 2018, Hawaii became the first state to ban the sale and use of sunscreens containing the ingredients oxybenzone and octinoxate, which filter out the sun’s UV rays. Stemming from concerns that these ingredients harm coral reefs, the law will go into effect on January 1, 2021, and will remove access to a significant number of sunscreen products. Later in the year, Palau — a country of over 500 islands in the Pacific Ocean — became the first country to enact a similar law. Smaller territories have also implemented bans, including the Caribbean island of Bonaire and several parks in Mexico’s Riviera Maya.
These bans are of special concern since oxybenzone is one of the few UV filters available in the U.S. that provides effective broad-spectrum protection against the sun’s shortwave UVB rays as well as long-wave UVA rays. In a statement addressing the ban, The Skin Cancer Foundation recommended that locals and visitors alike should choose from whatever products are available, looking for a water-resistant, broad-spectrum, SPF 30 or higher sunscreen, in addition to seeking shade during peak sun hours and covering up with clothing, hats and sunglasses.
Looking forward, the Foundation supports innovation in sunscreen that would ultimately lead to more ingredients that protect against UVA rays being available in the U.S. Several of these ingredients are available in other countries but have been stuck in FDA review for nearly two decades. The legislation in Hawaii should send a strong message to the FDA: We need more sunscreen choices, and reviewing new ingredients should be a top priority.