Masterton Man's Trial Story
The New Zealand Herald
New drug rids former soldier of melanoma
5:00 AM Saturday Jan 24, 2015
Granddad given six months to live gets new lease on life
Bob Hill, diagnosed with melanoma in 2013, says he is now clear.
Bob Hill was told he would probably die within six months from incurable melanoma - but that was before he entered a clinical trial of one of the new drugs that is revolutionising treatment of the disease.
Now, more than a year later, the national vice-president of the Returned and Services Association is clear of the skin cancer that had spread to his lungs and liver and caused re-growth of a large tumour in the wall of his chest.
The 72-year-old former regimental sergeant major, who served in Southeast Asia, has found a new zest for life and has even composed a "bucket list" of high adventure and strenuous activities.
Otago University cancer specialist Dr Chris Jackson said that after 40 years of advanced-melanoma drugs that were not very effective, the new immune system therapies were remarkable. "It really is a revolution."
Some patients were surviving five to 10 years.
In April 2013, Mr Hill, a grandfather from Masterton, had surgery to remove a lump causing severe pain in his chest wall.
It was diagnosed as a secondary melanoma tumour, although no primary was found. By the following October it had grown back to the size of an apple.
A surgeon judged the disease incurable, but Mr Hill's family doctor suggested he look into a trial of the melanoma drug pembrolizumab, made by Merck Sharp and Dohme (MSD).
He was accepted into the study, making him one of more than 20 patients in New Zealand to receive the drug through international clinical trials.
After some preliminary treatment, he began receiving three-weekly infusions of the medicine at Wellington Hospital last January. CT scans soon found the tumours were shrinking and eventually they disappeared.
"Around the 17th of September I went in and it showed I was completely clear. There were no cancer lesions on my lungs, my liver and nothing on my chest wall. All gone."
He had two more infusions, continues to have CT scans and is still clear of cancer.
Mr Hill accepts he is well short of the standard five-year cancer "cure" mark, but said: "One thing I do know: I'm alive and healthy today and I would like to think I was given an extension. I still feel the same as I did at 45 or 50 and I have got a lot of things I would like to do.
"You realise how lucky you are."
Pembrolizumab has shown such promise that the United States Food and Drug Administration last year gave it fast-track approval as a "breakthrough therapy".
MSD expects to seek regulatory approval in New Zealand this year, followed by an application to Pharmac for state funding, although the agency last year declined a request to fund ipilimumab, an earlier immunotherapy for advanced melanoma, partly because of the cost.
A study published in the Lancet found an overall response rate of 26 per cent to pembrolizumab among 173 patients with advanced melanoma.
Other data show that after taking the drug, 62 per cent of patients were still alive at 18 months.
In the US, the drug costs about US$150,000 ($199,788) per patient.
• NZ has one of the world's highest rates of melanoma, the most serious form of skin cancer
• About 2,200 new cases and more than 300 melanoma deaths are recorded each year
• Risk factors include sunburn as a child and using a sunbed
• Current survival rate is about 15 per cent at five years if the disease has spread around the body before diagnosis
• Costly new drugs are revolutionising advanced melanoma care
Bob Hill's bucket list
• Huka Falls jetboat ride (done)
• SkyJump off Auckland's Sky Tower
• Take part in September's centennial re-enactment of World War I departing soldiers' march over Rimutaka Hill from Featherston to Trentham