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Welcome to the July issue of the Clinical Research Connection. We value the partnership we have with our affiliate network and hope this newsletter will provide an opportunity for enhanced communication and interaction, and advance our collective strength in the area of oncology research.
Please send your feedback and suggestions to Vera Jackson at affiliates@northwestern.edu.
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The Melanoma Research Program (MRP) at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, created in 2001, focuses its research efforts into understanding the development of melanoma, improving tools for the diagnosis of melanoma, and in a related vein, more accurately determining the prognosis for patients with skin-only manifestations, and ultimately find new treatment approaches for both melanoma and atypical moles.
The MRP is committed to ensuring that high-quality evidence-based care is provided to patients with melanoma of all stages, and to advancing the care of these patients through outcomes research and participation in clinical trials. The clinical research of the MRP is focused on achieving thorough understanding of melanomas, and, based on its biological features, personalizing treatment.
Prevention and Early Detection The MRP includes investigators representing several departments of Northwestern's Feinberg School of Medicine, including dermatology, medical oncology and surgical oncology. Through multidisciplinary Patient Management and Research Conferences, the MRP strives to provide optimized diagnostic reviews to patient care, and recommend the latest therapeutic techniques through our clinical trials.
Current research accomplishments include:
- Documenting outcomes and quality of care in patients with melanoma. By querying the National Cancer Database, the MPR has documented the underutilization of completion nodal dissection after a positive sentinel node biopsy. Working with collaborators from Johns Hopkins University, we also documented disparities in the utilization of sentinel lymph node biopsy by age, socioeconomic status and geographic location within the United States. Dr. Jeffrey Wayne, Associate Professor of Surgery at the Northwestern University Feinberg School of Medicine and Chief of Melanoma and Sarcoma Surgical Oncology at Northwestern Memorial Hospital, is a member of the American College of Surgeons / Commission on Cancer Expert Panel that defined a set of formally developed quality indicators to study the care rendered to patients with melanoma in this country.
- Dr. Pedram Gerami, a dermatologist and dermopathologist and Assistant Professor in the Department of Dermatology at the Feinberg School of Medicine, initiated the molecular diagnostics lab at Northwestern University, which is one of the few labs internationally using fluorescence in situ hybridization (FISH) as a routine diagnostic tool in the evaluation of melanoma. This method can be applied to help render more definite diagnoses on melanoma and melanocytic tumors when there is some level of equivocation using standard pathology methods. In addition, it can be used to identify signature changes in the DNA of a tumor, helping to better classify the tumor as benign or malignant. Dr. Gerami integrates his clinical, microscopic and research expertise, all focused on melanoma, to enhance the potential for optimal diagnostic accuracy. He consults and speaks internationally about the use of novel methods for the detection, diagnosis, and classification of melanomas and atypical melanocytic tumors.
- New imaging techniques that provide a noninvasive method of detection of dysplastic nevi (atypical moles whose appearance is different from that of an ordinary mole) and melanomas are the research focus of Dr. Mary Martini, Director of the Pigmented Lesion and Melanoma Clinic and an Assistant Professor of Dermatology at the Feinberg School of Medicine. She also serves on the NCCN Melanoma Panel that outlines the current therapeutic guidelines for melanoma therapy as well as the Melanoma Prevention working Group of ECOG and the American Academy of Dermatology Melanoma Task Force. Dr. Martini has studied the effectiveness of Stokes polarimetry (a technique using polarization of light) in imaging pigmented lesions. This imaging system allows the clinician to visualize the margins and melanocytic nesting patterns in benign and atypical moles. Dr Martini has also worked on the melafind study. This imaging system captured dermoscopic images of moles and melanomas with varied wavelengths of light. This system has been highly successful in detecting difficult early melanomas. Currently Dr. Martini is conducting a study on pigmentary changes during pregnancy. The hormonal changes associated with pregnancy effect both the growth and color of moles, as well as pigmentary changes in facial and body skin. These changes may also vary based on skin color (the amount of melanin pigment in the skin). Pregnant patients recruited from all skin color types will be monitored throughout their pregnancy for these changes.
- The Division of Hematology/Oncology leads the therapeutic effort for patients with high-risk locally-advanced disease or for patients with metastatic disease. The research focus of Dr. Timothy Kuzel, Professor of Medicine at the Feinberg School of Medicine and Director of the Clinical Research Office at the Lurie Cancer Center, has been novel drug development with a targeted focus, or exploiting over expressed proteins or underlying molecular perturbations to facilitate a targeted approach. Recent trials have included therapeutic efforts to utilize Vitamin D based therapy approches, targeted approaches against melanomas with high probability of over expressing c-kit, and methods to reduce endogenous immunosuppression to enhance outcomes with immuno-stimulatory compounds, such as Interleukin-2. Dr. Kuzel is also working to better identify optimal treatments for patients with melanomas arising from unusual locations, such as ocular melanomas or mucosal/vaginal melanomas. Vaccine studies have included trials for both adjuvant high-risk patients or patients with metastatic disease.
- In her role as the Research Clinical Nurse Specialist for the Melanoma Research Program, Mary Callaghan, RN, MN, serves as a critical link for patients participating in clinical trials. She monitors and educates patients about a trials' requirements, possible side effects and follow-up, and serves as the point person for questions and clinical concerns. Contact Callaghan at 312-695-1396 or m-callaghan@northwestern.edu.
Active clinical trials include:
- Multicenter Selective Lymphadenectomy for Melanoma Trial II: A Phase III Multicenter Randomized Trial of Sentinel Lymphadenectomy and Complete Lymph Node Dissection versus Sentinel Lymphadenectomy Alone in Cutaneous Melanoma Patients with Molecular or Histopathological Evidence of Metastases in the Sentinel Node . This trial is a phase III, multicenter, randomized trial of sentinel lymph node biopsy and complete lymph node dissection versus sentinel lymph node biopsy alone in cutaneous melanoma patients with molecular or hispopathological evidence of metastases in the sentinel node. The overall purpose of the research is to find out if melanoma which has metastasized to a sentinel lymph node can be treated by removing only the sentinel node from a lymph basin (called a sentinel node biopsy), or if all lymph nodes in a lymph basin must be removed (called a complete lymph node dissection).
To see more clinical trials for melanoma patients at the Lurie Cancer Center, click here
Program Members:
Pedram Gerami, MD
Joan Guitart, MD
Timothy M. Kuzel, MD
Mary Martini, MD
Amy Paller, MD
Nilda Reyes
June Robinson, MD
Jeffrey Wayne, MD
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