In 2008, a new drug then known as PLX4032 was under study for metastatic melanoma—the malignant mole. Melanoma, when widespread, was almost invariably fatal, and there had been no drug that really worked in this condition, although the standard treatment is a drug called dacarbazine, approved years ago by the FDA. Frankly, everyone who has cared for patients with melanoma and treated them with dacarbazine knows it really doesn’t work.
PLX4032, on the other hand, was producing startling results. Part of a new wave of targeted treatments now being developed, PLX4032 was a drug that, for the first time in my memory as an oncologist who treated advanced melanoma patients for 40 years, produced good quality responses in most patients who got it. The majority of patients responded to it, and a substantial number went into complete remission. And it was safe—much safer than dacarbazine. No one had seen a drug do this before in melanoma. It was prolonging survival and providing a better quality of life with few of dacarbazine’s side effects. (You might ask why dacarbazine was approved in the first place. At the time, it showed promise, but not much. Yet because there was nothing else, it was approved. But unless someone figures out a new way to use dacarbazine that makes it effective, it has had enough years of testing to indicate that, by itself, it is nearly worthless.)
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