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WHAT IS MELANOMA

Melanoma occurs when pigmented cells, melanocytes, accumulate changes in their DNA (mutations) and they start to divide uncontrollably. In Australia, 15000 people develop melanoma per year, making it the fourth most commonly diagnosed cancer. Extensive public health campaigns have increased community awareness of the importance of sun-safety, slowing the increase in incidence that was observed for decades. Moreover, increased skin monitoring and early detection by training of GPs have also helped reduce the severity of ‘Australia’s cancer’. Today around 85% of patients with early stage disease are cured by surgery.

The most dangerous stage of melanoma is when melanoma cells spread and form metastases. Then melanoma is potentially a deadly disease. The last years have seen a revolution in the treatment of metastatic skin melanoma with the approval of both so-called targeted therapy (BRAF/MEK inhibitors) and immunotherapies (immune checkpoint inhibitors, ICI). Unfortunately, half of all patients’ melanoma are resistant, or acquire resistance, to these novel therapies, resulting in death of around 1500 Australians a year. This is especially true for melanoma of the eye, uveal melanoma (UM), where basically all patients with metastases succumb to their disease.

THE PROBLEM

Patients in WA have some of the highest survival rates of many cancers, demonstrating strengths in cancer care. With regards to melanoma there are still problems:

  • In spite improvements in sun habits and skin monitoring, some patients still develop melanoma that is discovered too late. Moreover, no molecular or genetic biomarker to identify those at risk for severe disease has been clinically developed.
  • WA patients receive the best approved therapies against metastatic melanoma in the world, and clinical trials are available at major public and private hospitals as well as Linear Clinical Research. But not all melanoma trials are run in Perth.
  • Melanoma research relies on so called biobanking of tissue but in a decentralized hospital system including many private hospitals, a comprehensive and longitudinal biobank with detailed clinical annotation is difficult to establish.
  • Cell therapy is a promising mode of therapy which works well in the laboratory but is difficult to translate to patients without proper infrastructure. National infrastructure requires long travel for WA patients and is not focused on melanoma. Infrastructure for cell therapy in WA is underdeveloped.

HOW WE CAN HELP

The solution to all serious diseases like melanoma is the concerted action between basic, translational and clinical research.

With a focused initiative we can:

  • Build a state-wide effort to biobank tissue and blood from all patients with metastatic melanoma
  • Implement biomarker and molecular testing to the clinic.
  • Perform drug and genetic screens to identify novel treatments for therapyresistant melanoma.
  • Offer all patients with melanoma in WA the most advanced therapies,including cell therapy.

Western Australia Melanoma Initiative (WAMI)

The idea of a Western Australia Melanoma Initiative (WAMI) was initiated in 2021 with the aim to bring consumers, medical professionals and researchers working on melanoma together to enhance research that in the short-, medium- and long-term will benefit patients.

WAMI provides an opportunity to link organisations, providing an open platform with research as the focus. Additional organisations and stakeholders not yet listed are welcome to attend pending contact with the steering committee. Finally, WAMI will establish links to organisations in other states, e.g Melanoma Institute of Australia in Sydney or Peter Mac in Melbourne, where several of WAMI members have trained or worked at.

The current steering committee consists of Professors Jonas Nilsson and Michael Millward, and Associate Professor Elin Gray and Doctor Jason Waithman. Additional members will be announced.

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