Melanoma

Melanoma is a potentially fatal cancer that usually arises from the skin’s pigment cells (melanocytes) that give skin its colour. Melanomas appear as moles or freckles that change colour, size or shape, or more rarely as non-healing sores. Although less common that other types of skin cancer, melanomas are more dangerous because of their tendency to metastasize to other parts of the body if not treated early before deeper skin invasion.

People who live in Queensland have the highest rates of melanoma in the world. Over 12,000 cases of melanoma are diagnosed each year in Australia.1  Globally it is the third most commonly occurring cancer in men (after prostate and colorectal cancer) and women (after breast and colorectal cancer).2 The treatment of advanced melanoma has been revolutionised in the last decade, substantially prolonging lives of those with metastatic disease, though costs of new therapies are very high. Despite this melanoma remains a material cause of death including in younger age groups. Each year in Australia more than 1400 die from the disease.3

Like most cancers, the earlier melanoma is diagnosed and treated, the better the chance of preventing it from spreading throughout the body and causing serious illness or death. Even more importantly, melanoma of the skin is largely a preventable cancer: an estimated 65% of melanomas in Australia can be attributed to the high levels of ambient ultraviolet (UV) radiation in our sunlight, and at least 10-15% are preventable through sun protection measures such as regular use of sunscreen.4

For those melanomas that do not arise on the skin, which are not caused by ultraviolet light exposure, the environmental agent associated with their development is unknown, hence preventive measures to reduce their incidence cannot yet be implemented.

Mutation targeted therapy and immunotherapy for melanoma has changed the way this cancer is treated when advanced. In particular, immune checkpoint inhibitors (eg. against PD1/PD-L1 and CTLA4) are responsible for the increasing survival rate for patients with metastatic melanoma. Despite the recent advancements in FDA-approved melanoma therapies, many advanced metastatic melanoma patients still face a significant mortality risk. The aggressive nature of this disease sustains an urgent need for earlier intervention (eg. immunotherapy pre-surgery) and more successful, effective melanoma immunotherapies that overcome mechanisms of treatment resistance that we are discovering.

RESEARCH FOCUS

  • conducting the largest prospective study of melanoma in Queensland, QSkin
  • predicting risk of melanoma
  • identifying targets for melanoma immunotherapy
  • understanding the genetic risk of melanoma
  • estimating the costs of prevention and treatment of melanoma
  • investigating personal, clinical and tumour-related factors associated with metastatic spread of localised skin melanoma after it is treated
  • determining the main molecular drivers of each of the different melanoma subtypes
  • understanding mechanisms of resistance to melanoma immunotherapy
  • understanding the melanoma microenvironment

 ASSOCIATED LABS

 SOURCES

  1. Whiteman DC, Green AC, Olsen CM. The Growing Burden of Invasive Melanoma: Projections of Incidence Rates and Numbers of New Cases in Six Susceptible Populations through 2031. J Invest Dermatol. 2016; 136: 1161-71.
  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018; 68: 394-424.
  3. The Australian Institute of Health and Welfare (AIHW). Cancer Data in Australia; Australian Cancer Incidence and Mortality (ACIM) books: melanoma of the skin. Cancer Incidence and Mortality (ACIM) books, at https://www.aihw.gov.au/reports/cancer/cancer-data-in-australia/ (2018).
  4. Olsen CM, Wilson LF, Green AC, Bain CJ, Fritschi L, Neale RE, Whiteman DC. Cancers in Australia attributable to exposure to solar ultraviolet radiation and prevented by regular sunscreen use. Aust N Z J Public Health. 2015; 39: 471-6.