And now, a "breakthrough" in melanoma treatment is giving patients more of it.
University of Otago pathology researcher Prof Mike Eccles said more than 7000 melanomas were diagnosed each year in New Zealand, and nearly 300 people died from the disease every year.
Immunotherapy treatment, particularly Keytruda (anti-PD1 therapy), was the main frontline medicine used to treat it.
However, only about 30%-40% of melanoma patients responded to it effectively, underscoring the need for biomarkers to predict treatment success.
Prof Eccles led new research which identified key epigenetic differences — specifically in DNA methylation and gene expression — that correlate significantly with melanoma patient responses to Keytruda treatment.
It meant doctors might be able to determine if a patient could be successfully treated with the drug.
"This breakthrough offers the potential for more precise and effective melanoma treatment, which would enable clinicians to tailor therapeutic strategies based on each patient’s individual genomic profiles.
"Biomarkers are urgently needed to help treat melanoma patients. The potential to predict personalised treatment strategies is a major step forward in improving patient outcomes."
If a patient was not going to respond to that treatment, doctors would be able to save time and immediately explore other options.
It meant the patient would not be wasting time by taking Keytruda if it was not going to work as effectively as another drug.
"At the moment, I think that there are other targeted therapies, such as BRAF inhibitors.
"Clearly, time is pretty important ... If you have a tumour growing and becoming potentially more resistant or more aggressive, potentially more metastasis could happen if you’re not on the right treatment.
"The sooner you can get on to a treatment that’s working, the better for the patient. They won’t be wasting time, but also, they would be avoiding potential toxicities."
The new test might also allow doctors to consider additional immunotherapies, which could be added to the treatment regimen.
"In overseas countries, they have an additional therapy which can be added on top of Keytruda, which can sometimes increase the chance of a patient responding."
The research formed the core of lead author Dr Mehbuba Hossain’s PhD research.
Following completion of her PhD, Dr Hossain continued the work through a postdoctoral fellowship, which she undertook in Prof Eccles’ laboratory.
The research, published in the international journal Cancer Letters, was jointly funded by the Health Research Council of New Zealand, the Maurice Wilkins Centre for Molecular Biodiscovery, the Maurice and Phyllis Paykel Trust, a University of Otago Doctoral Scholarship and the NZ Institute for Cancer Research Trust.
