Richard Murphy: Beating Stage IV Mucosal Melanoma Thanks to Immunotherapy
When I was diagnosed with metastatic melanoma, there were very few treatments to choose from, and after standard treatment failed to control my disease, I took part in two clinical trials. I wasn’t able to finish either trial, but the medication I received through the second one, an anti–PD-1 immunotherapy, worked anyway and my tumors are gone. I’ve been stable for two years. The experimental immunotherapies changed my life and allowed me to look further down the road. After I was diagnosed, I just hoped I’d see my youngest daughter go to kindergarten. Now maybe I can see her get married.
It began in 2008, when my nasal passages were blocked. The ENT [ear, nose, and throat] doctor looked and said, “You've got a golf ball up there.” He did a biopsy and called a week later with a diagnosis of mucosal melanoma.
I’d never heard of it, but I soon learned that it’s very rare, accounting for only about 1 percent of melanoma cases. Unfortunately, the prognosis is usually not good. The treatment was to remove the tumor and then treat the area with radiation, five days a week for 10 weeks.
A year later, a tumor showed up in my lung, and the doctors removed it. I remember sitting with my wife, saying, “All right, this is not that bad—I can manage it if every couple of years I have to go under the knife.” Unfortunately, the situation did not stay that way. The cancer spread to my spine and midsection, and scans showed that I had cancer in 15–20 sites.
My oncologist did everything he could, but finally he said, “There is no more conventional medicine that can help you. We should consider clinical trials.” For me, it was an easy choice because there wasn’t anything else to do.
In February 2011, I started in a trial for ipilimumab, which allows the T cells in your body to attack your cancer. After several infusions of the drug, scans showed that my tumors had shrunk by 20 percent. That was the first good news we’d had since 2008. During my time in the trial, the FDA [U.S. Food and Drug Administration] approved the drug and it was marketed as Yervoy, so my last couple of doses were not through the trial. Ipilimumab worked well for a while, but then the tumors grew again and the doctors took me off the drug ahead of schedule.
My doctor told me that new drugs called anti–PD-1 immunotherapies were coming out. PD stands for “programmed death,” which isn’t a great name, but the drugs that target it basically restore the natural ability of the immune system to go after cancer cells.
I was turned down for one trial but was accepted into another sponsored by Merck, with an anti–PD-1 drug then called MK-3475. I started on March 1, 2012. It was an all-day infusion every three weeks. But after only five infusions, the doctors thought I was going into renal failure. So they put me in the hospital for three days and took me off the drug. That was a tough time.
The doctors then did an ultrasound of my kidneys. My doctor called me to say they couldn’t figure out what was going on with my kidneys, but the ultrasound showed some of the tumors, and they were all shrinking. A few weeks later, I had a full set of scans, and the tumors had shrunk by 50 percent. A few months after that, all they could see was shadowing, which means that something was there once but it really isn’t there anymore. It has stayed that way, nothing there, after only five infusions. It’s amazing.
The reality is that without cancer research, I wouldn't be here. I want to help the next person and keep the cause going, so I give speeches to support more funding for research. My wife and I also participate in triathlons to raise money for research: I swim for money. Our team, Tri-ing for a Cure, has raised over $100,000.
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