Our knowledge of cancer is always expanding. Researchers and healthcare professionals take the knowledge gained from research studies and use it to develop better practices that will help prevent, detect and treat melanoma, as well as improve the quality of life of people with melanoma.
The following information is a selection of research showing promise for melanoma.
Risk reduction
Risk reduction strategies may reduce the chance of developing cancer.
Noteworthy research includes:
- Calcium and vitamin D may reduce the risk of melanoma in women who have a high risk of developing the disease. Results from the Women’s Health Initiative trial showed that calcium and vitamin D supplements reduced the risk of melanoma by almost 55% in women with a history of non-melanoma skin cancer (Journal of Clinical Oncology, PMID* 21709199).
- Nonsteroidal anti-inflammatory drugs (NSAIDs) reduce the risk of melanoma. Two studies showed that long-term use of NSAIDs, especially aspirin (ASA), was associated with a decreased risk of melanoma (The Journal of Investigative Dermatology, PMID 19587697, PMID 21390049).
Diagnosis
A key area of research activity involves developing better ways to diagnose and stage melanoma.
Noteworthy research includes:
- Health Canada recently approved the Verisante Aura, which is a device that visually scans a mole or lesion to determine if it is cancerous. The Aura device is non-invasive. It uses Raman spectroscopy to analyze chemical reactions in the skin, providing immediate and accurate results. It can be used by healthcare professionals to detect both melanoma and non-melanoma skin cancers. Cancer agencies and dermatologists are being encouraged to use Aura, but family doctors can purchase the device as well. It may not be available at all centres. The device could reduce the number of biopsies performed on lesions that turn out to be benign. It may also reduce wait times for surgery for skin cancer (Conference Proceedings: Annual International Conference of the IEEE Engineering in Medical and Biological Society, PMID 19163364).
- Studies are looking at using a protein marker, called insulin-like growth factor-II messenger RNA (mRNA)-binding protein-3 (IMP-3), to help diagnosis melanoma. Researchers have found that melanoma cells produce increased levels of IMP-3 (Journal of Cutaneous Pathology, PMID 19788446).
- Several studies are investigating the most accurate way to determine lymph node involvement to more accurately stage melanoma, better predict prognosis and plan treatment. Currently, sentinel lymph node biopsy is the most accurate way to assess microscopic lymph node involvement in the absence of clinical evidence (Seminars in Cutaneous Medicine and Surgery, PMID 21277537). Researchers are studying the potential of using ultrasound to assess lymph nodes in both staging (Journal of Surgical Oncology, PMID 21858829) and follow-up (American Journal of Roentgenology, PMID 20173153).
Prognostic factors
Prognostic factors that may help determine the outcome of the disease are being studied in melanoma. They can be used to predict the chances of recovery or of cancer coming back. Doctors may also use prognostic factors to help them make treatment recommendations.
Noteworthy research includes:
- Researchers are studying S100B, a biomarker of cell growth, as a potential prognostic tool for melanoma. Studies have shown that people with high levels of S100B have a less favourable prognosis (European Journal of Cancer, PMID 21087856). S100B may also be a useful tool in follow-up to measure disease progression (BMC Cancer, PMID 21810220).
Treatment
Researchers are looking for new ways to improve the treatment of melanoma. Advances in cancer treatment and new ways to manage the side effects related to treatment have improved the outlook and quality of life for many people with cancer.
Noteworthy research includes:
- Targeted therapy targets specific molecules (usually proteins) that cause cancer cells to grow. Recent studies are looking at drugs that target changes in the BRAF gene (Seminars in Cutaneous Medicine and Surgery, PMID 21051014; Anti-cancer agents in medicinal chemistry, PMID 21426297). About half of all melanomas have changes in the BRAF gene. These changes cause the BRAF gene to produce an altered BRAF protein that makes melanoma cells grow and divide. A drug called vemurafenib (Zelboraf) acts against the altered BRAF protein. Vemurafenib is being used to treat advanced melanoma in clinical trials in Canada. It has been approved by the Food and Drug Administration (FDA) for treatment of advanced or metastatic melanoma and is currently being reviewed by Health Canada.
- The biological therapy drug ipilimumab (Yervoy) is a monoclonal antibody being used in clinical trials in Canada to treat advanced or metastatic melanoma. Ipilimumab has been approved by the Food and Drug Administration (FDA) for treatment of metastatic melanoma. Ipilimumab is a type of monoclonal antibody that works by targeting cytotoxic T lymphocyte antigen-4 (CTLA-4), a protein that blocks the T cell immune response, which may be involved with melanoma cell survival. Researchers are now looking at developing other biological therapy drugs that target CTLA-4 (Melanoma Research, PMID 19952852). Researchers are also looking into the possibility of using these novel anti-CTLA4 biological therapy drugs along with targeted therapy to treat melanoma (Cancer Immunology, Immunotherapy, PMID 21847631).
- Angiogenesis is the growth of new blood cells. Researchers have identified this process as a potential target for melanoma treatment. Some angiogenesis inhibitors, such as bevacizumab (Avastin), have shown promise in early studies for treatment of melanoma in both adjuvant and metastatic melanoma trials (Clinical Cancer Research, PMID 21030496; Therapeutic Advances in Medical Oncology, PMID 21789148; Journal of Clinical Oncology, PMID 22124101; Annals of oncology, PMID 21527587).
- Researchers are looking at cancer vaccines to treat melanoma. One trial is looking at a treatment called OncoVEX (GM-CSF) for people with advanced melanoma that cannot be surgically removed (Future Oncology, PMID 20528232). This treatment uses a form of the cold sore virus (the herpes simplex virus) to boost the immune system to fight cancer (Drugs, PMID 21770473; Expert Opinion on Biological Therapy, PMID 20515292).
- Electrochemotherapy involves using high-intensity electric pulses to help a tumour take up (absorb) chemotherapy drugs. Several studies have investigated electrochemotherapy as a novel treatment for melanoma and skin metastasis (Dermatologic Therapy, PMID 21054709; Dermatologic Surgery, PMID 21605245; Acta Oncologica, PMID 21574833).
Supportive care
Living with cancer can be challenging in many different ways. Supportive care can help people cope with cancer, its treatment and possible side effects.
Noteworthy research includes:
- Researchers are studying new methods of skin reconstruction to improve both function and cosmetic outcome following surgery for melanoma. Modified auricular composite grafts have shown good results for reconstructing the nose (Facial plastic surgery, PMID 21567343). Revolving-door flap showed good results for reconstructing the ear (anterior auricular conchal defects) (Journal of Plastic, Reconstructive and Aesthetic Surgery, PMID 19357009).
*PMID is the National Library of Medicine PubMed abstract identity number.
Find out more about the research process.