Q&A With Michael A. Postow, MD: What’s Next For Melanoma Research at Memorial Sloan Kettering

At Dr. Dennis Gross Skincare, melanoma research and awareness is really important to us (after all, our founder was a melanoma researcher before becoming a dermatologist). We are proud to support Memorial Sloan Kettering Cancer Center and the groundbreaking research they are pioneering to ultimately find a cure for melanoma. 

In 2023, Dr. Dennis Gross Skincare donated $25,000 to help fund ongoing melanoma research at Memorial Sloan Kettering Cancer Center (MSK) led by Michael A. Postow, MD. We sat down with Dr. Postow who gave us an inside look at the amazing new therapies on the horizon for advanced melanoma treatment. 

Note: Dr. Postow is a physician at MSK. The views expressed are his own.

How did you become interested in melanoma research? 

I was inspired by my mentors who were doing this research at the time I joined Memorial Sloan Kettering in 2010. Seeing people in this field pushing immunotherapies forward in melanoma was very exciting for me when I was getting into the field of oncology research.

I could sense there was a huge wave about to come of immunotherapies success in melanoma and potentially other cancers too. I wanted to be a part of that immunotherapy revolution. So far, it has been a wild ride. In the last decade, we have seen survival rates go from 10% to 50%. 

Everything that comes out is a little bit better. The next drug is a little bit better, the next combination therapy is a little better, and so on. The hope is that we will continue to see these types of results. 

We have been making big strides in this disease where historically, treatment had not been very successful. I wanted to not only be part of those initial successes but also really grow into them and help continue to push the field forward. 

MSK has been at the forefront of melanoma treatment options. What does the next frontier of breakthrough treatments look like? 

We have long been interested in ways that you can manipulate the body’s immune system to seek and destroy cancers. Melanoma has been a pioneer type tumor – we’ve figured out how to do things in melanoma first and then apply those strategies to other cancers. 

There has been success in using antibodies to boost immune responses in patients to fight their melanoma. What is new is that now, we are actually using immune cells themselves to fight melanoma. 

This is a huge new area that we have been very involved in pioneering – using cells in our own immune system to treat melanoma cancers is hopefully going to be the next big thing. 

This type of treatment is expected to get approved for melanoma sometime in 2023 which is very exciting. 

How do these treatments differ from existing immunotherapy treatments and why are they important?

Melanoma on the skin is normally cut off by a dermatologist or surgeon, however if left untreated, it can spread to other parts of the body, becoming advanced melanoma.

To treat advanced melanoma, traditionally we would give drugs intravenously to patients to boost their immune system. But now what we can do is take cells from the patient’s tumor and engineer them in the laboratory to make them better melanoma-fighting cells. It’s like boosting the army’s ability to fight melanoma before you reinfuse them back into the patients.

Ten years ago, patients with advanced stage 4 melanoma had a 5-year survival rate of about 10%. With the new immunotherapies that have come out, patients have a 50% survival rate which is a huge improvement. However, that leaves one in two stage 4 melanoma patients that aren’t served well with existing treatments. We need to do better for that large proportion of patients until we have 100% of people alive and doing well at 5 years – and hopefully long thereafter. 

This is why testing new treatment approaches is so important. Even with all of the big wins in the last decade to get from 10% to 50%, there is still work to do. We can’t stop at 50%. 

What excites you most about this research?

I am excited most by knowing that we can actually raise the bar – we can actually do better. We can win. We’ve seen survival rates increase from 10 to 50 percent so are hopefully on the verge of getting that next 50%.

Research, investment, drug development, and working with different companies, patients, and clinical trials have been able to improve long term survival for patients for whom this disease was unfortunately almost always fatal.

Why does existing treatment work on some people and not on others?

In general, melanoma is a tumor type that is pretty sensitive to immunotherapies, but we are starting to uncover clues as to why some patients with melanoma are more sensitive to immunotherapies than others. There are a lot of reasons why people might be more sensitive. For example, it might have to do with how foreign the melanoma looks to the immune system so it can destroy it like it destroys bacteria or viruses in the body. Other factors are the metabolic states of the melanoma, how the immune system can access parts of the melanoma and destroy it, and what the immune system looks like in general. 

That is one area we are specifically interested in: before we get the immune treatments, what does the immune system look like? To unlock this, we are doing a number of clinical trials where we are testing new ways of imaging the immune system and what it looks like in a patient before they start treatment. The hope is that this can guide some of our interventions.

I would credit Dr. Dennis Gross Skincare for giving us funding to support the clinical trial that is ongoing. The idea is that you can look at the CD8 cells which are parts of the immune response in tumors and they will help you better understand who is likely to respond or not to the immune stimulating treatment. 

What is the ultimate goal of your research?

The ultimate goal is to cure advanced melanoma. If we can’t cure it, the secondary goal would be to give people their life back who have this disease. Maybe they have it as a chronic disease that they need to live with, but they live well with it and can continue doing all of the things they love doing. 

How do we get there? It is developing new drugs for people who immunotherapy does not work for, and understanding why immunotherapies work for some people and not others so we can service those other patients with new approaches and hopefully continue serving as a model for other tumor types in oncology research. 

How can people get involved and/or support your continued research?

Being an advocate in every possible way is the goal, whether that’s interpersonally supporting friends, family or loved ones by raising melanoma awareness or reducing risk behaviors like tanning or excessive burning in the sun. Of course, financial support is always welcome and is so critical to the research engine because there are a lot of questions that we want to answer. The kind of gasoline to drive that car comes from generous donors, organizations, collaborations with the pharmaceutical industry and research grants. 

I’m very grateful for the support Dr. Dennis Gross Skincare has given. One of our current trials is co-supported by the Melanoma Research Alliance and is testing new imaging agents looking at the CD8 cells. 

The existing funding was insufficient for what we wanted to do with the trial so Dr. Dennis Gross Skincare really helped fill the gap in some of the areas where we needed extra funding to accomplish the maximum learning from the clinical trial that we could. The study is still ongoing. 

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