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 than 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 the lives of those with metastatic disease, though the 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 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 the 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 increased 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.