Research is key to finding better treatments for helping more patients survive melanoma. At the Masonic Cancer Center, physician scientists are focused on two areas of melanoma research: improving surgery and investigating a potentially new therapy.

Mohs Surgery

Dermatology specialist Peter Lee, M.D., Ph.D., performs Mohs micrographic surgery for melanoma. He also directs the Melanoma and Pigment Lesion Clinic at the University of Minnesota, which uses some of the most innovative technology available to detect skin cancer and melanoma at an early stage.

When melanoma is caught at an early stage, surgery is the most common and effective treatment. Lee and his colleagues perform a unique variation of Mohs micrographic surgery to remove cancer that has not penetrated deeply in cosmetically sensitive areas, such as on the nose, eyelids, and elsewhere on the face. During this procedure, damaged skin is removed in horizontal sections (routine surgery removes vertical sections). The goal of the surgery is to remove all of the cancer, but the least amount of normal, healthy skin. Damaged skin tissue is reviewed under a microscope during surgery to be sure all of the cancer has been excised.

Only a few medical centers in the country offer this Mohs micrographic surgery for melanoma. Lee recently published more of his research findings on Mohs Surgery in the Journal of Dermatologic Surgery. This newest study involved using a unique method for staining tissue samples to better visualize under a microscope the extent of the cancer. Two hundred patients with primary or recurrent forms of melanoma, called lentigo maligna and lentigo maligna melanoma, participated in the study. Each patient was followed on average for more than 38 months after surgery. Only one of the patients had a recurrence of melanoma during that time. On patients with a cancer lesion that measures 1 mm or more in thickness or has spread, Lee and his colleagues perform the more extensive surgery of removing the affected skin area, lymph nodes, and any distant tumors.

Pioneering Research

When the spread of melanoma means surgery is no longer a viable treatment option, then standard medical treatments include interferon therapy or IL-2. These treatments do not typically have high success rates and can be quite toxic.

The lack of viable treatment options has led Arek Dudek, M.D., Ph.D., and other Cancer Center scientists and physicians to search for a new therapy.

"We're designing a medicinal treatment that will enhance an individual's immune system to reduce or eliminate melanoma," says Dudek.

This experimental treatment, called Large Multivalent Immunogen (LMI) vaccine, was given to 31 patients in a recent phase 2 clinical trial run by Dudek. The vaccine was prepared by surgically removing a patient's tumor and breaking it down into a single cell. The cell membranes were then deposited on a small bead resembling the size of an immune cell and injected into the patient to activate his or her immune response.

The trial had promising results. "The vaccine had an impact on slowing or stopping the disease progression," says Dudek. "And one of the biggest components of the vaccine is that patients encountered little to no side effects."

Dudek is now preparing for another clinical trial to begin in a few months. Instead of using a cell from the patient's own tumor, this new trial will couple the LMI vaccine with a genetically engineered cancer cell.

This LMI vaccine research for melanoma is being funded, in part, by a gift from the Randy Shaver Cancer Research and Community Fund.

For more information

To learn more about skin cancer and melanoma, call the Masonic Cancer Center's information line at 612-624-2620 or toll-free in the five-state area at 1-888-CANCER MN (1-888-226-2376), or send an email to ccinfo@umn.edu. Be sure to ask for a copy of the free brochure on skin cancer. If you would like to partner with the Masonic Cancer Center to advance research on melanoma, call Sue Julson at 612-624-1913.

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This story was originally published in News from your Cancer Center, Spring 2006.