The primary objective of Project III is to forge new approaches to the surgical management of cutaneous melanoma, by continuing the clinical and translational studies of lymphatic mapping and sentinel node biopsy (SNB) that were developed and initiated under this Program Project. The focal point of Project III is its two Phase III, internatjonal randomized trials of SNB. The first Multicenter Selective Lymphadenectomy Trial (MSLT-I) examines the accuracy and clinical efficacy of SNB as a staging alternative to complete lymphadenectomy (CLND) in patients with clinical stage I melanoma. MSLT-I has completed accrual of 2001 subjects, who are now being followed to determine the long-term survival benefit of immediate CLND for sentinel node (SN) micrometastses versus delayed CLND for nodal recurrence after wide excision alone. Since most patients with micrometastases have no other tumor-involved nodes, CLND may not be necessary in all patients with tumor-involved SN. We are investigating this hypothesis in a second multicenter randomized trial (MSLT-II). Serum and tisue specimens from both trials will be used to evaluate new molecular biomarkers (with Project II) and to investigate histopathologic markers relating to SN tumor burden, architecture and microenvironment (with Project I). These markers should enable us to determine the likelihood of metastasis beyond the SN and thereby identify candidates for CLND and adjuvant therapy. In related Phase l/II trials with Projects I and II, we will continue to study the, biology and pathophysiology of the regional lymphatics and SN, will examine SN immunosuppression as a predisposing factor for establishment of nodal metastasis, and will assess the prognostic relevance of endogenous immune response as a systemic marker of disease status. Thus, the aims are: 1) continue follow-up of subjects in MSLT-I;2) continue screening, enrollment and randomization in MSLT-II;3) investigate the biology and pathophysiology of the SN;4) develop molecular and immunologic markers for detection of occult systemic metastases;and 5) determine the impact of endogenous immune resonse on prognosis and clinical course.

Public Health Relevance

This project focuses on minimally invasive surgical techniques for staging the regional lymph nodes, highly sensitive immunohistopathologic/molecular techniques for examining these nodes, and serum assays for monitoring tumor markers. Results of this multidisciplinary research will improve outcomes for patients with melanoma and help to establish an internationally standardized approach to early-stage solid malignancy.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Program Projects (P01)
Project #
4P01CA029605-30
Application #
8340136
Study Section
Special Emphasis Panel (ZCA1-RPRB-J (M1))
Project Start
1997-07-01
Project End
2014-08-31
Budget Start
2011-09-01
Budget End
2012-08-31
Support Year
30
Fiscal Year
2011
Total Cost
$2,105,174
Indirect Cost
Name
John Wayne Cancer Institute
Department
Type
DUNS #
556074458
City
Santa Monica
State
CA
Country
United States
Zip Code
90404
Jones, Maris S; Lee, Jihey; Stern, Stacey L et al. (2017) Is Pregnancy-Associated Melanoma Associated with Adverse Outcomes? J Am Coll Surg 225:149-158
Faries, Mark B; Thompson, John F; Cochran, Alistair J et al. (2017) Completion Dissection or Observation for Sentinel-Node Metastasis in Melanoma. N Engl J Med 376:2211-2222
Ozao-Choy, Junko; Nelson, Daniel W; Hiles, Jason et al. (2017) The prognostic importance of scalp location in primary head and neck melanoma. J Surg Oncol 116:337-343
Karakousis, Giorgos; Gimotty, Phyllis A; Bartlett, Edmund K et al. (2017) Thin Melanoma with Nodal Involvement: Analysis of Demographic, Pathologic, and Treatment Factors with Regard to Prognosis. Ann Surg Oncol 24:952-959
Jones, Maris S; Torisu-Itakura, Hitoe; Flaherty, Devin C et al. (2016) Second Primary Melanoma: Risk Factors, Histopathologic Features, Survival, and Implications for Follow-Up. Am Surg 82:1009-1013
Faries, Mark B (2016) Intralesional Immunotherapy for Metastatic Melanoma: The Oldest and Newest Treatment in Oncology. Crit Rev Oncog 21:65-73
Ono, Shigeshi; Oyama, Takashi; Lam, Stella et al. (2015) A direct plasma assay of circulating microRNA-210 of hypoxia can identify early systemic metastasis recurrence in melanoma patients. Oncotarget 6:7053-64
Wang, Jinhua; Huang, Sharon K; Marzese, Diego M et al. (2015) Epigenetic changes of EGFR have an important role in BRAF inhibitor-resistant cutaneous melanomas. J Invest Dermatol 135:532-541
Cochran, Alistair J; Huang, Rong-Rong; Su, Albert et al. (2015) Is sentinel node susceptibility to metastases related to nodal immune modulation? Cancer J 21:39-46
Marzese, Diego M; Huang, Sharon K; Hoon, Dave S B (2015) In Situ Sodium Bisulfite Modification of Genomic DNA from Microdissected Melanoma Paraffin-Embedded Archival Tissues. Methods Mol Biol :

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