Melanoma Institute Australia has dozens of research projects going at any one time. These are just a few of note.
Brain metastases trial forges new ground
A world-first clinical trial led by Melanoma Institute Australia has opened that may benefit patients with advanced melanoma, specifically melanoma tumours that have metastasised to the brain.
Half of all patients diagnosed with stage 4 melanoma will develop brain metastases at some point during their illness, and 20–25% will already have brain metastases when first diagnosed with stage 4 melanoma.
Sadly, most patients with brain metastases die within four months and they have limited treatment options available. This is a significant unmet need and one that the clinicians at Melanoma Institute Australia (MIA) are passionate to do something about.
Historically, patients with brain metastases are excluded from clinical trials unless they have been completely treated and stable for a long time. However, because of the incredibly poor prognosis with brain metastases, this is difficult to attain and until recently they have only been treated with local treatments such as surgery or radiotherapy. Systemic chemotherapy historically has shown little effect in brain metastases and so patients with brain metastases have been excluded from these trials.
The trial is being run at MIA in North Sydney, and will also be in collaboration with a number of other research centres along the Eastern seaboard.
“The outcome of this trial may well change the treatment paradigm for how doctors treat melanoma patients with brain metastases,” says Dr Long.
This new MIA-led clinical trial is investigating the use of an experimental new therapy called anti-PD-1. This immunotherapy trial is the first in the world to investigate the anti-PD-1 drug, nivolumab, and nivolumab plus ipilimumab specifically in patients with active brain metastases.
“Being able to test the activity of an immunotherapy in the brain is an exciting avenue of research. It offers potential hope not only to the patients who are on the trial but if it proves successful, this has implications for patients around the world,”
Funding from this trial was passionately raised by the community through Melanoma March 2014 and 900KMFORACURE – an event that saw 2 melanoma survivors walk from Sydney to Melbourne to raise melanoma awareness and $160,000 for this trial. A research grant has also been generously provided by Bristol Myers Squibb (BMS), which enabled this trial to proceed. Thanks also to BMS for providing the drugs that are used in the trial at no cost.
As strict inclusion criteria apply, patients interested in going on the trial should speak with their oncologist.
Saving Our Next Generation
Postdoctoral Fellow, Dr James Wilmott is hoping to help by searching for early-detection genetic markers and treatment options that are specific to this age group.
“New drugs that target genetic mutations specific to a patient’s melanoma look extremely promising. But young patients have been largely overlooked in this kind of research. This study will address that gap by characterising all the gene mutations in blood and melanomas from young people with melanoma.”
The study is the first of its kind in the world. Data benefitting a range of research groups will be made available in Australia and abroad, bringing together pathologists, oncologists, surgeons, epidemiologists, computational biologists and researchers to focus on youth melanoma.
The goal is to identify the best genes for new drugs to target and uncover genetic mutations that predispose young patients to melanoma. It’s a unique and inventive way to detect melanoma in young people. And it will have the side benefit of helping them understand the benefits of sun safe behaviour and regular skin checks to reduce their risk of melanoma.
The data generated by the project will ensure that young melanoma patients are not left behind in innovations in personalised medicine, making a real difference to people in the prime of their lives.
Melanoma Genome Project
In August 2012 Melanoma Institute Australia launched the Melanoma Genome Project to map the DNA of 500 tumours stored in our BioSpecimen Bank. It’s an ambitious idea that seeks to change how melanoma is diagnosed and treated by identifying the common genetic mutations that lead to melanoma. The ultimate goal is to enable doctors to personalise each patient’s treatment.
The project is using DNA analysis to unravel the disease's genetic secrets. Secrets like why melanomas that look similar can behave so differently. Some melanomas have a greater chance to recur after surgery or respond differently to drug treatment, and we don’t know why. Answering questions like this will help develop new treatments and create tests that show which patients are most at risk.
“We would be astonished if this work does not, over time, translate into a major extension of life for thousands of people worldwide with melanoma.”
It’s the largest melanoma research effort ever undertaken in Australia, with a national coalition of researchers from Melanoma Institute Australia, The University of Sydney, Westmead Millennium Institute, Royal Prince Alfred Hospital and the Queensland Institute of Medical Research working together.
Our Melanoma Genome Project team recently played a crucial role in a global study that discovered cutaneous melanoma has four distinct subtypes. The breakthrough helps pave the way for more tailored individual, ‘personalised’ medicine for melanoma patients. Samples from our BioSpecimen Bank made up close to a third of the global contributions to ‘The Cancer Genome Atlas’ (TCGA), a five year study of tumours from over 300 patients.
In addition, our Melanoma Genome Project was endorsed by the International Cancer Genome Consortium early in 2015 and first results are soon to be published.