Patients diagnosed with metastatic melanoma were, until recently, faced with a very grim prognosis. The advent of BRAF and MEK inhibitors as well as the more recent immune modulatory therapies has resulted in improved patient survival. Despite these advances there is still a need for predictive biomarkers of response and development of resistance.
The Melanoma Biomarkers Project is an in-house research initiative of the Peter MacCallum Cancer Centre with the aim of establishing a database and tissue resource from Stage IIIb, IIIc and IV melanoma patients with unresectable disease and who are receiving systemic therapy. Patients undergo serial FDG PET imaging, tissue biopsy and blood sampling throughout their treatment phases including: pre-treatment, during treatment, disease progression and next new systemic therapy.
The resource will enable/facilitate research projects to evaluate whether administration of systemic therapies such as cytotoxic chemotherapy, immunotherapyor targeted therapeutic agents produce biological, histological, immunological, imaging and/or molecular changes within the tumour that can serve as biomarkers of anti-tumour activity or treatment resistance to enhance our understanding of underlying mechanisms. Gaining a better understanding of the key mechanisms and oncogenic drivers in melanoma will enable more effective treatment strategies for patients.
To date, approximately 120 patients have been consented, many of whom have been followed across two or more systemic treatments including: BRAF inhibitors with or without MEK inhibition, anti-CTLA4 and anti PD-1 monoclonal antibodies. The database and tissue resource, which is now over 2 years old, is currently being utilised in projects including whole exome sequencing, evaluation of circulating tumour DNA and correlation of FDG PET with treatment response. Preliminary data, including genomic analyses, will be presented.