Sydney Cancer Center - Melanoma Group

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Melanoma Group

Group Leader:
Professor John Thompson

Members:
Professor Peter Hersey
Dr Angela Hong
Dr George Hruby
Professor Stan McCarthy
Dr Rajmohan Murali
Associate Professor Jonathan Stretch
Dr Michael Quinn
Dr Robyn Saw
Dr Kerwin Shannon
Associate Professor Andrew Spillane
Professor Richard Scolyer
Professor Roger Uren

Research Overview

Melanoma and skin cancer research is carried out by the Sydney Melanoma Unit and the Department of Dermatology.

2008/2009 Highlights
The Sydney Melanoma Unit and its affiliates have been conducting multidisciplinary research into the causes, diagnosis and treatment of melanoma for several decades. As the largest dedicated melanoma treatment centre in the world they have been wholly or partly responsible for a number of important developments in the diagnosis and care of melanoma. The research program of the SMU has recently been boosted through major funding by way of program grants from both the Cancer Institute of NSW and the NHMRC.

With its critical mass, the SMU can ensure strategic direction in clinical and translational melanoma research to achieve the following key objectives:

To determine the most reliable prognostic factors in early melanoma:
To establish the optimal surgical treatment of early melanoma.
To verify whether regional or systemic chemotherapy has a role in the management of advanced melanoma.
To establish the efficacy of novel agents and immunotherapy approaches.
To develop protocols for the identification of persons at high risk of melanoma.

The nucleus of the Sydney Melanoma Unit is the SMU database. This unique database was initiated in the mid sixties and has captured comprehensive clinical details of more than 25,000 melanoma patients. This invaluable research resource is used world wide to establish best practice in diagnosis, causes and care of melanoma patients. It was utilised extensively in formulating the NHMRC Guidelines for the Management of Cutaneous Melanoma and was critical to the development of the new melanoma staging system introduced by the American Joint Committee on Cancer in 2001, and its ongoing revision.

The SMU also has an established bio-specimen bank with more than 500 tumour specimens. Given that the tumours can all be married with a comprehensive patient record, this resource will provide a unique tool for future research.

A recent benefaction to the Sydney Melanoma Unit to commission a comprehensive outpatient clinical care and research centre at its Northern Campus will complement the molecular biology research program by providing more satisfactory infrastructure for extensive bio-specimen banking. This in turn will allow better use to be made of the bio-specimen resources which the SMU is able to procure from its prodigious clinical case load. In addition, the current SMU database will, as part of this Northern Campus development, be transformed into a cancer care informatics system which will include bio-specimen logging.

Current research and clinical trials include:

MSLT II (Evaluating of a specific surgical treatment for melanoma)
PV10 Trial (Assessing intratumoural drug injection)
TEAM (Analysing the short term effects of antimelanoma drugs)
Chemosensitivity study (Correlating tumour characteristics with drug)
Whole Brain Radiotherapy trial (for patients with resected brain metastases)
Ludwig NY-ESO-1 vaccine study (Designed to reduce recurrence in patients with resected metastatic disease)
Adjuvant Radiotherapy trial (for patients with resected lymph node disease)

There are currently over 40 other trials, projects and research papers in progress

Sydney Melanoma Unit 2008 – 2009 Publications

1. Amersi FF, Terando AM, Goto Y et al. Activation of CCR9/CCL25 in cutaneous melanoma mediates preferential metastasis to the small intestine. Clin Cancer Res 2008; 14: 638-645.

2. Balch CM, Morton DL, Gershenwald JE et al. Sentinel node biopsy and standard of care for melanoma. J Am Acad Dermatol 2009; 60: 872-875.

3. Beasley GM, Kroon HM, Ross MI et al. Isolated limb infusion for melanoma. In Balch CM, Houghton AN, Sober AJ et al. (eds): Cutaneous Melanoma, Edition 5th. St Louis: Quality Medical Publishing 2009; 541-553.

4. Beavis A, Dawson M, Doble P et al. Confirmation of sentinel lymph node identity by analysis of fine-needle biopsy samples using inductively coupled plasma-mass spectrometry. Ann Surg Oncol 2008; 15: 934-940.

5. Becker TM, Haferkamp S, Dijkstra MK et al. The chromatin remodelling factor BRG1 is a novel binding partner of the tumor suppressor p16INK4a. Mol Cancer 2009; 8: 4.

6. Chen JY, Hruby G, Scolyer RA et al. Desmoplastic neurotropic melanoma: a clinicopathologic analysis of 128 cases. Cancer 2008.

7. Cochran AJ, Thompson JF. Lymphatic mapping and sentinel node biopsy: The data unclouded by speculation. Arch Dermatol 2008; 144: 687-688.

8. Collinson FJ, Lam TK, Bruijn WM et al. Long-term survival and occasional regression of distant melanoma metastases after adrenal metastasectomy. Ann Surg Oncol 2008; 15: 1741-1749.

9. Dhomen N, Reis-Filho JS, da Rocha Dias S et al. Oncogenic Braf induces melanocyte senescence and melanoma in mice. Cancer Cell 2009; 15: 294-303.

10. Doubrovsky A, Scolyer RA, Murali R et al. Diagnostic accuracy of fine needle biopsy for metastatic melanoma and its implications for patient management. Ann Surg Oncol 2008; 15: 323-332.

11. Francken AB, Accortt NA, Shaw HM et al. Follow-up schedules after treatment for malignant melanoma. Br J Surg 2008; 95: 1401-1407.

12. Francken AB, Accortt NA, Shaw HM et al. Prognosis and determinants of outcome following locoregional or distant recurrence in patients with cutaneous melanoma. Ann Surg Oncol 2008; 15: 1476-1484.

13. Francken AB, Shaw HM, Thompson JF. Detection of second primary cutaneous melanomas. Eur J Surg Oncol 2008; 34: 587-592.

14. Francken AB, Thompson JF, Bastiaannet E, Hoekstra HJ. [Detection of the first recurrence in patients with melanoma: three quarters by the patient, one quarter during outpatient follow-up]. Ned Tijdschr Geneeskd 2008; 152: 557-562.

15. Gallagher SJ, Thompson JF, Indsto J et al. p16INK4a expression and absence of activated B-RAF are independent predictors of chemosensitivity in melanoma tumors. Neoplasia 2008; 10: 1231-1239.

16. Gershenwald JE, Balch CM, Soong SJ, Thompson JF. Prognostic factors and natural history of melanoma. In Balch CM, Houghton AN, Sober AJ et al. (eds): Cutaneous Melanoma, Edition 5th. St Louis: Quality Medical Publishing 2009; 16-64.

17. Gershenwald JE, Thompson JF, Mozzillo N, Balch CM. Intraoperative mapping and sentinel node technology in patients with melanoma. In Balch CM, Houghton AN, Sober AJ et al. (eds): Cutaneous Melanoma, Edition 5th. St Louis: Quality Medical Publishing 2009; 415-446.

18. Gershenwald JE, Uren R, Mariani G, Thompson JF. Sentinel lymph node biopsy in melanoma. In Mariani G, Giuliano AE, Strauss H (eds): Radioguided Surgery, Edition New York: Springer 2008; 92-110.

19. Haferkamp S, Becker TM, Scurr LL et al. p16INK4a-induced senescence is disabled by melanoma-associated mutations. Aging Cell 2008; 7: 733-745.

20. Haferkamp S, Scurr LL, Becker TM et al. Oncogene-Induced Senescence Does Not Require the p16(INK4a) or p14ARF Melanoma Tumor Suppressors. J Invest Dermatol 2009.

21. Hare D, Burger F, Austin C et al. Elemental bio-imaging of melanoma in lymph node biopsies. Analyst 2009; 134: 450-453.

22. Ho Shon IA, Chung DK, Saw RP, Thompson JF. Guidelines for imaging in cutaneous melanoma. Nucl Med Commun 2008; 29: 877-879.

23. Ho Shon IA, Chung DK, Saw RP, Thompson JF. Imaging in cutaneous melanoma. Nucl Med Commun 2008; 29: 847-876.

24. Kam PC, Thompson JF. Pharmacokinetics of regional therapy: isolated limb infusion and other low flow techniques for extremity melanoma. Surg Oncol Clin N Am 2008; 17: 795-804.

25. Karim RZ, Scolyer RA, Li W et al. False negative sentinel lymph node biopsies in melanoma may result from deficiencies in nuclear medicine, surgery, or pathology. Ann Surg 2008; 247: 1003-1010.

26. Karim RZ, van den Berg KS, Colman MH et al. The advantage of using a synoptic pathology report format for cutaneous melanoma. Histopathology 2008; 52: 130-138.

27. Kasparian NA, Butow PN, Meiser B, Mann GJ. High- and average-risk individuals' beliefs about, and perceptions of, malignant melanoma: an Australian perspective. Psychooncology 2008; 17: 270-279.

28. Kroon HM, Lin DY, Kam PC, Thompson JF. Safety and efficacy of isolated limb infusion with cytotoxic drugs in elderly patients with advanced locoregional melanoma. Ann Surg 2009; 249: 1008-1013.

29. Kroon HM, Lin DY, Kam PC, Thompson JF. Isolated limb infusion as palliative treatment for advanced limb disease in patients with AJCC stage IV melanoma. Ann Surg Oncol 2009; 16: 1193-1201.

30. Kroon HM, Lin DY, Kam PC, Thompson JF. Efficacy of repeat isolated limb infusion with melphalan and actinomycin D for recurrent melanoma. Cancer 2009; 115: 1932-1940.

31. Kroon HM, Lin DY, Kam PC, Thompson JF. Major Amputation for Irresectable Extremity Melanoma After Failure of Isolated Limb Infusion. Ann Surg Oncol 2009.

32. Kroon HM, Moncrieff M, Kam PC, Thompson JF. Outcomes following isolated limb infusion for melanoma. A 14-year experience. Ann Surg Oncol 2008; 15: 3003-3013.

33. Kroon HM, Moncrieff M, Kam PC, Thompson JF. Factors predictive of acute regional toxicity after isolated limb infusion with melphalan and actinomycin D in melanoma patients. Ann Surg Oncol 2009; 16: 1184-1192.

34. Kroon HM, Thompson JF. Isolated limb infusion: A review. J Surg Oncol 2009.

35. Kroon HM, Thompson JF, Hoekstra HJ. [Isolated infusion effective in melanoma and sarcoma. Good alternative for regional isolated cytostatic perfusion]. Ned Tijdschr Geneeskd 2009; 153: 508-514.

36. Lam TK, Uren RF, Scolyer RA et al. False-negative sentinel node biopsy because of obstruction of lymphatics by metastatic melanoma: the value of ultrasound in conjunction with preoperative lymphoscintigraphy. Melanoma Res 2009; 19: 94-99.

37. Martin RC, Murali R, Scolyer RA et al. So-called "malignant blue nevus": a clinicopathologic study of 23 patients. Cancer 2009.

38. McMasters KM, Wong SL, Tyler DS et al. Axillary and epitrochlear lymph node dissection for melanoma. In Balch CM, Houghton AN, Sober AJ et al. (eds): Cutaneous Melanoma, Edition 5th. St Louis: Quality Medical Publishing 2009; 447-456.

39. Moncrieff M, Martin R, O'Brien CJ et al. Adjuvant postoperative radiotherapy to the cervical lymph nodes in cutaneous melanoma: Is there any benefit for high-risk patients? Ann Surg Oncol 2008; 15: 3022-3027.

40. Moncrieff M, Scolyer R, Thompson J et al. Correct identification of a sentinel node postselective lymphadenectomy using antimony levels. Melanoma Res 2008; 18: 365-366.

41. Moncrieff M, Shannon K, Hong A et al. Dramatic reduction of chronic lymphoedema of the lower limb with sorafenib therapy. Melanoma Res 2008; 18: 161-162.

42. Moncrieff MD, Bowen F, Thompson JF et al. Keystone flap reconstruction of primary melanoma excision defects of the leg-the end of the skin graft? Ann Surg Oncol 2008; 15: 2867-2873.

43. Moncrieff MD, Kroon HM, Kam PC et al. Isolated limb infusion for advanced soft tissue sarcoma of the extremity. Ann Surg Oncol 2008; 15: 2749-2756.

44. Moncrieff MD, Martin R, O'Brien CJ et al. Adjuvant postoperative radiotherapy to the cervical lymph nodes in cutaneous melanoma: is there any benefit for high-risk patients? Ann Surg Oncol 2008; 15: 3022-3027.

45. Moncrieff MD, Spira K, Clark JR et al. Free flap reconstruction for melanoma of the head and neck: indications and outcomes. J Plast Reconstr Aesthet Surg 2009.

46. Morton DL, Cochran AJ, Thompson JF. The rationale for sentinel-node biopsy in primary melanoma. Nat Clin Pract Oncol 2008; 5: 510-511.

47. Morton DL, Cochran AJ, Thompson JF, Sondak VK. The sentinel lymph node and regional melanoma metastases. In Balch CM, Houghton AN, Sober AJ et al. (eds): Cutaneous Melanoma, Edition 5th. St Louis: Quality Medical Publishing 2009; 373-386.

48. Morton RL, Craig JC, Thompson JF. The role of surveillance chest X-rays in the follow-up of high-risk melanoma patients. Ann Surg Oncol 2009; 16: 571-577.

49. Morton RL, Howard K, Thompson JF. The cost-effectiveness of sentinel node biopsy in patients with intermediate thickness primary cutaneous melanoma. Ann Surg Oncol 2009; 16: 929-940.

50. Murali R, Hughes MT, Fitzgerald P et al. Interobserver variation in the histopathologic reporting of key prognostic parameters, particularly clark level, affects pathologic staging of primary cutaneous melanoma. Ann Surg 2009; 249: 641-647.

51. Murali R, Loughman NT, McKenzie PR et al. Cytologic Features of Metastatic and Recurrent Melanoma in Patients With Primary Cutaneous Desmoplastic Melanoma. Am J Clin Pathol 2008; 130: 715-723.

52. Murali R, Sharma RN, Thompson JF et al. Sentinel lymph node biopsy in histologically ambiguous melanocytic tumors with spitzoid features (so-called atypical spitzoid tumors). Ann Surg Oncol 2008; 15: 302-309.

53. Murali R, Thompson JF, Scolyer RA. Fine-needle biopsy as a diagnostic technique for metastatic melanoma. Expert Opin Med Diagn 2008; 2: 1-10.

54. Murali R, Thompson JF, Scolyer RA. Sentinel lymph node biopsy for melanoma: aspects of pathologic assessment. Future Oncol 2008; 4: 535-551.

55. Murali R, Thompson JF, Shaw HM, Scolyer RA. The prognostic significance of isolated immunohistochemically positive cells in sentinel lymph nodes of melanoma patients. Am J Surg Pathol 2008; 32: 1106-1107; author reply 1107-1108.

56. Orlow I, Tommasi DV, Bloom B et al. Evaluation of the Clonal Origin of Multiple Primary Melanomas Using Molecular Profiling. J Invest Dermatol 2009.

57. Reynolds HM, Smith NP, Uren RF et al. Three-dimensional visualization of skin lymphatic drainage patterns of the head and neck. Head Neck 2009.

58. Sanki A, Scolyer RA, Thompson JF. Surgery for melanoma metastases of the gastrointestinal tract: indications and results. Eur J Surg Oncol 2009; 35: 313-319.

59. Sassen S, Shaw HM, Colman MH et al. The complex relationships between sentinel node positivity, patient age, and primary tumor desmoplasia: analysis of 2303 melanoma patients treated at a single center. Ann Surg Oncol 2008; 15: 630-637.

60. Scolyer RA, Murali R, McCarthy SW, Thompson JF. Pathologic examination of sentinel lymph nodes from melanoma patients. Semin Diag Pathol 2008; 25: 100-111.

61. Scolyer RA, Murali R, Satzger I, Thompson JF. The detection and significance of melanoma micrometastases in sentinel nodes. Surg Oncol 2008; 17: 165-174.

62. Shaw HM, Scolyer RA, Thompson JF. Prognostic significance of histopathological parameters in sentinel nodes of melanoma patients. Histopathology 2008.

63. Skalicky SE, Holt PE, Giblin M et al. Australian Cancer Network clinical practice guidelines for the management of ocular and periocular melanoma: an evidence-based literature analysis. Clin Experiment Ophthalmol 2008; 36: 646-658.

64. Sober AJ, Shaw HM, Thompson JF. A history of melanoma: From Hunter to Milton. In Balch CM, Houghton AN, Sober AJ et al. (eds): Cutaneous Melanoma, Edition 5th. St Louis: Quality Medical Publishing 2009; 1-15.

65. Spillane AJ, Cheung BL, Stretch JR et al. Proposed quality standards for regional lymph node dissections in patients with melanoma. Ann Surg 2009; 249: 473-480.

66. Spillane AJ, Saw RP, Tucker M et al. Defining lower limb lymphedema after inguinal or ilio-inguinal dissection in patients with melanoma using classification and regression tree analysis. Ann Surg 2008; 248: 286-293.

67. Spillane AJ, Winstanley J, Thompson JF. Lymph node ratio in melanoma : a marker of variation in surgical quality? Cancer 2009.

68. Stephens FO, Aigner KR, Allen-Mersh T et al. Basics of Oncology. Berlin Springer-Verlag 2009.

69. Stretch JR, Scolyer RA. Surgical Strategies and Histopathologic Issues in the Management of Lentigo Maligna. Ann Surg Oncol 2009.

70. Thompson JF. Commentary on the Pro/Con Articles in Clinical advances in Haematology and Oncology. In Edition London: United Kingdom Melanoma Study Group 2008; Website article.

71. Thompson JF. The value of sentinel node biopsy in patients with primary cutaneous melanoma. Dermatol Surg 2008; 34: 550-554; discussion 554-555.

72. Thompson JF, Hersey P, Wachter E. Chemoablation of metastatic melanoma using intralesional Rose Bengal. Melanoma Res 2008; 18: 405-411.

73. Thompson JF, Kam PC. Current status of isolated limb infusion with mild hyperthermia for melanoma. Int J Hyperthermia 2008; 24: 219-225.

74. Thompson JF, Morton DL, Balch CM, Ross MI. Surgical excision of distant melanoma metastases. In Balch CM, Houghton AN, Sober AJ et al. (eds): Cutaneous Melanoma, Edition 5th. St Louis: Quality Medical Publishing 2009; 603-628.

75. Uren RF, Thompson JF, Coventry BJ, Chatterton BE. Lymphoscintigraphy in patients with melanoma. In Balch CM, Houghton AN, Sober AJ et al. (eds): Cutaneous Melanoma, Edition 5th. St Louis: Quality Medical Publishing 2009; 387-414.

76. Van Es SL, Colman M, Thompson JF et al. Angiotropism is an independent predictor of local recurrence and in-transit metastasis in primary cutaneous melanoma. Am J Surg Pathol 2008; 32: 1396-1403.

77. Warner RE, Quinn MJ, Hruby G et al. Management of merkel cell carcinoma: the roles of lymphoscintigraphy, sentinel lymph node biopsy and adjuvant radiotherapy. Ann Surg Oncol 2008; 15: 2509-2518.

78. Wiener M, Damian DL, Thompson JF. Systemic Phototoxicity following Intralesional Rose Bengal for Subcutaneous Melanoma Metastases. Dermatology 2008; 216: 361-362.

79. Zhuang L, Scolyer RA, Lee CS et al. Expression of glucose-regulated stress protein GRP78 is related to progression of melanoma. Histopathology 2009; 54: 462-470.