#MelanomaHeroes: The Researcher
As a Medical Director in Roche’s clinical development team, Dr Nicholas Choong leads the research and development of a new treatment for melanoma. Dr Choong is passionate about helping patients through his work and, one day, finding a cure. Here he talks about life at the forefront of the fight against the disease, what inspired him to work in this area and what it means to be a Melanoma Hero.
What does your job involve?
I’ve worked in clinical development at Roche for three years on a research project investigating the use of targeted treatments in combination to extend the lives of patients with metastatic melanoma. I was responsible for the initial clinical study where we combined two targeted therapies in an attempt to stop the cancer from growing for a longer period of time. The initial study had positive results in terms of both safety and efficacy, which gave us encouragement to pursue a phase III study. Conducting a phase III study is a big undertaking and I have since been overseeing this research and working with regulatory authorities in order to bring this combination treatment to patients.
What made you want to work in melanoma research?
I was first introduced to clinical research during my oncology training and, subsequently, in my five years of clinical practice in a university-based clinic, I was actively participating in clinical studies.
I came to realize the immense effort that goes into developing treatments against cancer and a lot of potential new drugs that were tested failed in clinical trials. It really made me want to help and make a difference. That’s when I decided to work for Roche. Here, I have the chance to be at the cutting edge of research into new and improved treatments, in a company that is committed to the field of oncology. The studies I’ve been working on at Roche have involved more than 600 patients and, whilst I don’t now work directly with patients, because I’m behind the scenes overseeing the studies, I do know that my work could make a difference to their lives.
What have been the most interesting developments in melanoma?
For 30 years, not a lot happened in this disease area. Many melanoma drugs were studied but failed to benefit patients with metastatic melanoma. The discovery, in 2002, of the BRAF gene mutation and its role in the development of melanoma was one of the catalysts for change.1 In a very short time, a targeted treatment was developed to inhibit the mutation’s negative effects and, on average, extend patients’ lives by about a year, with some patients surviving for five years or longer. The pace of development - from the initial discovery of the BRAF mutation in melanoma, to finding a drug to treat it and to understanding why the drug sometimes stops working - was amazing. All of this formed the scientific basis for developing the next treatment for melanoma, to further control the cancer and again to understand why it does not work in everyone or stops working after a certain period of time. I find it amazing where science can lead you - answering one question leads to many more questions.
What stands out about the melanoma community?
We tend to think of cancer patients as elderly but metastatic melanoma is indiscriminate of age. It hits people in the prime of their lives and for many of them it’s a death sentence. But the good news is that, nowadays, there’s more hope of prolonging patients’ lives than ever before.
What are your hopes for the future?
Two things: that everyone, no matter who or where they are, adopts good sun protection habits; and that those with metastatic melanoma live longer and better lives. Ultimately, I want there to be a cure.
What changes would you like to see?
We must focus on taking care of patients and on giving them treatments that improve their quality of life – ensuring that the time they have is meaningful, for them and their families. I’d like to see new medications, more treatment options and dependable social support systems for those in need.
What advice would you give someone diagnosed with melanoma?
It depends on the stage of diagnosis but it’s a never a bad idea to get a second or even third opinion from a specialized treatment centre. Melanoma is not uncommon but there’s usually a greater level of technical and multidisciplinary expertise in centres that treat high volumes of patients with the disease, as well as the opportunity to participate in potentially transformative clinical studies.
Who do you think are the real #MelanomaHeroes?
Undoubtedly it’s the care-takers of patients. They constantly support their loved ones and endure the hardship of the disease with them. But they also have to live their own lives. Care-takers bear a similar emotional burden to patients but often suffer in silence. I believe they’re the real unsung melanoma heroes.
What gets you out of bed in the morning?
My two kids jumping into bed with me! But from a professional perspective, it’s the desire to make a real difference to patients’ lives – now and in the future.