Diagnosis and Treatment of Melanoma
Stanford University Medical Center offers longstanding clinical expertise in the management of Pigmented Lesions and Melanoma. Patients at increased risk of melanoma based on mole pattern and those with thin melanomas are evaluated and followed in the Stanford Pigmented Lesion and Cutaneous Melanoma Clinic. The Stanford Multidisciplinary Melanoma Clinic is a multi-specialty (dermatology, srugery, oncology, radiation therapy, dermatopathology) tumor board which provides evaluation and management for patients diagnosed with thicker cutaneous melanoma, lymph node metastasis and disseminated disease. A number of clinical trials are available at Stanford for patients with advanced melanoma, stemming from our participation in the Eastern Cooperative Oncology Group (ECOG). High-dose interleukin-2 (IL-2) therapy is now available at Stanford for appropriate patients with stage IV disease.
As a leader in the global scientific and medical community, Stanford University Medical Center continues to pioneer new aproaches to understanding and treating melanoma. With a better grasp of how and why normal melanocytes (pigment cells) become melanoma, more effective therapies are now possible. By drawing upon discoveries made in the basic sciences (biochemistry, immunology, engineering and physics), we are "translating" these advances into changes in the management of melanoma. This collaboration between basic scientists and clinician investigators bridges the gap from "bench to bedside".
Clinical Trials
The Stanford Melanoma Program offers clinical trials for treatment of advanced melanoma. Stanford is an active participant in the Eastern Cooperative Oncology Group (ECOG) multicenter clinical trials for melanoma, and a number of studies are open for patients with high risk cutaneous disease, regional nodal metastasis and disseminated disease.
Collaboration with our premier basic science departments will continue to provide new techniques and insights in the diagnosis and treatment of melanoma.
Multidisciplinary Melanoma Clinic (MMC) Trials for Stage II (cutaneous), Stage III (nodal), and Stage IV disease (visceral metastasis)
Currently Available:
- Phase III Randomized Adjuvant Study of High Dose Interferon Alfa-2b Therapy in Patients with Stages IIA, IIB, and IIIA Melanoma (ECOG 1697)
(Purpose: To determine the effectiveness of one month of intravenous, high-dose interferon alfa in treating patients with stage IIA, IIB, IIIA melanoma that has been completely excised).
- Placebo-Controlled Phase III Trial of GM-CSF vs. Peptide Vaccination vs. GM-CSF + Peptide vs. Placebo After Complete Resection of "Locally Advanced" and/or Stage IV Melanoma (ECOG 4697) Note: patient accrual achieved; trial to close 10/31/06 per ECOG.
(Purpose: To determine the effectiveness of immune-based therapies GM-CSF and/or peptide vaccination in the treatment of patients with “locally advanced” or stage IV melanoma which has been completely removed surgically).
- E1602: A Randomized Phase II Trial of Multi-epitope Vaccination with Melanoma Peptides for Cytotoxic T-Cells for Patients with Metastatic Melanoma
(Purpose: To determine the cytotoxic T cell (CTL) response to each of 12 melanoma peptides in vaccinated patients with or without helper peptides. To estimate the rates of clinical response and survival, in patients vaccinated with a multi-peptide vaccine vaccine consisting of epitopes for CTL alone, epitopes for T-helper cells alone, or both).
- E2603: A Double-blind, Randomized, Placebo-Controlled Phase III Trial of Carboplatin, Paclitaxel and Sorafenib (BAY 43-9006) versus Carboplatin, Paclitaxel and Placebo in Patients with Unresectable Locally Advanced or Stage IV Melanoma
(Purpose: To test the chemotherapeutic agents (carboplatin and paclitaxel) alone or in combination with sorafenib (a targeted B-RAF inhibitor), to assess response in patients with unresectable stage III or IV melanoma).
Diagnosis and Treatment
Stanford surgeons were among the first surgeons in northern California to perform sentinel node biopsy/dissection and have been performing this staging prcedure since 1996. The sentinel node biopsy examines the regional lymph nodes for possible microscopic spread of melanoma. This advanced procedure sequentially combines peroperative lymphoscintigraphy and intraoperative mapping to provide a highly reliable means of identifying the sentinel lymph in malignant melanoma. this procedure is generally used to state cutaneous (skin) melanomas great than or equal to 1 mm depth.
Positron emission tomography (PET) is used to detect melanoma within the body as part of the staging work up. Stanford utilizes PET scanning to reveal collections of melanoma cells in the body that may otherwise be clinically or radiologically undetectable. PET scanners are able to detect melanoma based upon the increased metabolic activity of cancer cells, and do not use standard radiation.
Stanford now offers state-of-art technology for whole-body scanning for melanoma with the combined PET/CT scanner. The PET/CT scanner creates a fusion of the diagnostic capabilities of CT and PET scanning to deliver the most accurate and sensitive detection of melanoma possible.
CyberKnife (stereotactic radiosurgery) for brain metastases is a novel technique also available at Stanford.
Trial Administration