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Speaker 1: Farmac's looking at funding two new melanoma drugs though benefit

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Speaker 1: patients with late stage melanoma, saving the health system around

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Speaker 1: one thousand and fusion hours a year. They are out

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Speaker 1: for consultation. Doctor Gareth Rivland is with US medical oncologist

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Speaker 1: and melanoma specialist.

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Speaker 2: Good morning, all, very much, good to have you here.

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Speaker 1: What did these drugs do.

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Speaker 2: So over the last fifteen years or so, Not that

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Speaker 2: we don't want to take you back too far, but

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Speaker 2: there's been a real change in the way we treat melanoma.

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Speaker 2: So we don't use traditional chemotherapies. What we use are

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Speaker 2: these immunotherapy drugs where we try to get the patient's

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Speaker 2: own immune system to recognize the cancer cells and attack them.

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Speaker 2: And so these two drugs are in that group, and

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Speaker 2: one of them effectively unmasked the cancer to allow the

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Speaker 2: immune system to see it, and the other drug effectively

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Speaker 2: cuts the tax on the immune system if you like,

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Speaker 2: to allow it to run a lot harder, faster, earlier

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Speaker 2: and treatment. And so these two medications have been around

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Speaker 2: for a while, but the real change for us now

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Speaker 2: we can use them before someone has surgery to allow

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Speaker 2: the immune system to see these cancer cells. Really early

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Speaker 2: and try to kill them off even before the surgeons

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Speaker 2: get there.

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Speaker 1: And they must be used. Therefore they must be used together.

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Speaker 1: You need to fund them both.

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Speaker 2: Yeah, well, this is where the state of the art is.

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Speaker 2: Really this is the best combination. So this is what

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Speaker 2: we'd say is the global gold standard treatment. So when

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Speaker 2: you use this combination, you can do two treatment cycles

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Speaker 2: before surgery, so that's six weeks of treatment and about

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Speaker 2: sixty percent of people will have the cancer completely killed

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Speaker 2: off before surgery. So this is quite a change and

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Speaker 2: it really is better than any other combination or any

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Speaker 2: other single drug that has been tested around the world.

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Speaker 1: Do they still need surgery?

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Speaker 2: Oh, well, that's where we're going next. You know, that's

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Speaker 2: where the trials are heading at the moment. We need

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Speaker 2: the surgery to be able to tell how well the

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Speaker 2: pavement's work. So, as I said, sixty percent of people

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Speaker 2: in these trials look like that have what we call

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Speaker 2: a complete pathologic response. That means that when the pathologists

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Speaker 2: look at the slides, there's no cancer cells left. But

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Speaker 2: that does leave forty percent who don't get that sort

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Speaker 2: of response, and we need that understanding of what's happened

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Speaker 2: on the microscopic level to decide what sort of treatment

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Speaker 2: they might need sort of after surgery.

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Speaker 1: I had a look at this this morning. It looked

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Speaker 1: to me like these are being funded in Australia since

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Speaker 1: twenty eighteen. Is that I mean it sounds like revolutionary here,

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Speaker 1: but is that true?

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Speaker 2: Well, the original trials where we were looking at doing

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Speaker 2: treatment around surgery was in twenty eighteen. The treatment prior

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Speaker 2: to surgery, where effectively you leave the tumor in place

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Speaker 2: to you know, what you're is allowing the immune system

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Speaker 2: to see these cancer cells really early. That's a later development.

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Speaker 2: They probably had that treatment in Australia only over the

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Speaker 2: last two or three years. The combination, as I say,

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Speaker 2: which is the state of the art and was funded

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Speaker 2: in August last year in Australia, and in fact it

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Speaker 2: isn't funded in the UK or Canada. I think are

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Speaker 2: in the process of rolling it out, but it's not

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Speaker 2: quite there. So actually we're a little ahead of the

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Speaker 2: curve on this one, which is unusual for FARMAC.

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Speaker 1: First first time I've ever heard any doctor tell me that. Gareth,

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Speaker 1: I appreciate your time this morning, doctor Garethrivaland who's a

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Speaker 1: medical oncologist and melanomas specialist for.

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