[Melanoma Network of Canada]

Yukon has approved funding for Adjuvant therapy.

The Yukon has listed dabrafenib (Tafinlar) + trametinib (Mekinist) for Adjuvant Treatment of Stage III-IV BRAF-Mutated, Fully Resected Melanoma” under their “ PEB programs” (Yukon Pharmacare Plan, Extended Health Care Benefits program, Chronic Disease and Disability program and the Children’s Drug and Optical program) effective April 15, 2020

Please note that the Yukon follows the BC Cancer Drug Benefit List /Systemic Therapy Program guidelines for treatment and utilizes the CAP process, however do their own contracting and have a separate, unique reimbursement system.

Eligibility criteria:

Cutaneous melanoma stage IIIA to IV NED (AJCC 8th edition).
Disease metastasized to the regional nodes (if stage IIIA and only one node involved then metastatic deposit > 1 mm), in-transit metastases or distant metastases must be completely surgically resected.
Brain metastases must be completely resected (or definitively treated with stereotactic radiation)
BRAF mutation (all BRAF V600 mutations)
Adequate baseline hematological, renal and liver functions
A Compassionate Access Program (CAP) approval is required prior to the initiation of treatment (please refer to https://cap.phsa.ca/).

Additionally:

Patients can receive one year of either adjuvant nivolumab OR combination dabrafenib/trametinib.
Patients with BRAF mutated melanoma who are unable to tolerate up to a 3-month trial of combination dabrafenib/trametinib due to toxicities can apply for adjuvant nivolumab and complete a total of one year of therapy.
A switch to combination cobimetinib/vemurafenib is not funded.
May have subsequent BRAF/MEK inhibitors if relapse > 6 months after end of USMAJDT
More details can be found on the below links:

Use Protocol:

http://www.bccancer.bc.ca/chemotherapy-protocols-site/Documents/Melanoma/USMAJDT_Protocol.pdf

Preprinted Order:

http://www.bccancer.bc.ca/chemotherapy-protocols-site/Documents/Melanoma/USMAJDT_PPPO.pdf

Patient Handout:

http://www.bccancer.bc.ca/chemotherapy-protocols-site/Documents/Melanoma/USMAJDT_Handout.pdf

BCC Monograph:

http://www.bccancer.bc.ca/drug-database-site/Drug Index/Trametinib_monograph.pdf

http://www.bccancer.bc.ca/drug-database-site/Drug Index/Dabrafenib_monograph.pdf

[Melanoma Network of Canada]

A big week for Adjuvant therapy funding approvals!
New Brunswick approved Nivolumab (Opdivo) for the adjuvant treatment of adult patients with completely resected stage IIIA (with lymph node metastases greater than 1mm) IIIB, IIIC, IIID and stage IV melanoma, based on the 8th edition of the American Joint Committee on Cancer melanoma staging system. Disease must be completed resected including in-transit metastases; however, presence of regional lymph nodes with micrometastases after sentinel node biopsy alone is allowed. 

Alberta has listed Dabrafenib (Tafinlar) + trametinib (Mekinist)  for Adjuvant Treatment of Stage III BRAF-Mutated, Fully Resected Melanoma” on the Alberta Health Services Outpatient Cancer Drug Benefit Program effective April 10, 2020.
Alberta Health Services Criteria and Listing Details

• This reply was modified 3 years, 1 month ago by Melanoma Network of Canada.

[Melanoma Network of Canada]

Great news for Ontario – Cancer Care Ontario has a New Drug Funding Program effective January 29, 2020 – for Nivolumab – Adjuvant treatment for completely resected stage III or IV melanoma

for information on the program click here

[Melanoma Network of Canada]

ADJUVANT THERAPY APPROVED IN BC
BC has approved adjuvant nivolumab for stage III melanoma as of Nov 1 and indication is for every 2 or 4 weeks as per patient choice or physician recommendation

BC Cancer Patient Hand Out View Now
BC Cancer Protocol Summary

[Melanoma Network of Canada]

First of all, thank you for reaching out and I commend you for being so diligent for your entire family. The statistics prove that family and patients are the best line of defence and for catching these things.
I am sorry to hear that he has yet another melanoma – and around his eye. That is such a vulnerable area as the skin is so thin and delicate around the eyes and lips. I am not a doctor and so am unable to advise, but can share my thoughts. That it presented as another brown spot likely indicates that it is a second new primary and not a recurrence. Change is a good indicator that something should be removed, and I hear this so very often unfortunately. Sometimes melanomas are hard to diagnose, but given his history of skin cancer, melanoma and a changing elevated spot, that should be a concern and if viewed by a doctor trained in the use of dermoscopy.

It is something to ask the oncologist or surgeon, but what you describe sounds like a new one. Also, generally if it is a recurrence they don’t report on necessarily all these details. It is early stage, which is good, but head and neck cancers are always a bit more of a concern due to location. Low mitotic rate and no ulceration is also generally good. They may have to do some additional surgery or radiation to get clear margins – something I am sure you will discuss with the doctors. It is quite likely he will need a SNB to rule out potential spread as it indicates .8mm – they will discuss that with you likely as a recommendation. Sox-10 is a stain used to show melanocytes present to confirm melanoma. It does not confirm metastatic disease.

I am hoping you will be able to read through our melanoma booklet, perhaps before you go to you next appointment, which may help prepare you with questions to ask. If you need any support during this stressful time, we are here to help. We may be able to answer some questions for you, provide some peer support or direct you to a local support group. Let us know.

Annette Cyr

[Melanoma Network of Canada]

Speakers

Information and updates on the latest in treatment therapies and support related to Melanoma.

Dr. Marcus Butler

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Expanding Horizons in Melanoma Treatment:
Reaching for the goal of long term survival.

Marcus Butler, MD.
Medical Oncologist, Princess Margaret
Hospital, University Health Network

Dr. Rinat Nissim

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The Psychosocial Care of Patients with Melanoma:
Coping with the fear and anxiety of a cancer diagnosis

Dr. Rinat Nissim, Ph.D., C. Psych.
Psychologist, Department of Supportive care
Princess Margaret Cancer Centre, University Health Network

Niall McGee

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Patient Story

Reporter, The Globe and Mail

For more information and to register, please visit http://www.melanomanetwork.ca/patienteducation

[Melanoma Network of Canada]

I would like to register for the education session for Dec 3rd.

I had very bad reactions from the high dose interferon treatment in 2007 as well as a reaction to the heparin used to flush my pic line.

If I ever have a reoccurance I would be unable to use interferon as a result of my complications.

Thanks,
Janet

[Melanoma Network of Canada]

What causes skin cancer and what are the effects? Well, I am 13, and I have gotten two severe sunburns this past month. My mom said they were pretty bad, and they can cause skin cancer in the future. Is this really true? If not what are the real causes of skin cancer? What are the effects?

[Author]

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