Diagnosis and Treatment of Melanoma
Stanford Medicine 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 cutaneous and more advanced melanomas are evaluated and followed in the Stanford Pigmented Lesion and Melanoma Clinic, as well as in concurrent Melanoma Surgery and Medical Oncology Clinics, when appropriate. Patients with metastatic melanoma (lymph node metastasis and disseminated disease) are generally managed by Stanford melanoma oncologists; however, the simultanously-occuring dermatology, surgery, and oncology clinics allow for multispecialty input into the care of complex patient on an ongoing basis . 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 also available at Stanford for appropriate patients with stage IV disease.
As a leader in the global scientific and medical community, Stanford Medicine continues to pioneer new approaches 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.
Stanford Melanoma Program Trials for Stage III (nodal), and Stage IV disease (visceral metastasis)
Currently Available:
(Purpose: To estimate the objective tumor response rate in patients with unresectable locally advanced or metastatic acral, mucosal, or solar melanoma treated with dasatinib monotherapy. Metastatic tumor blocks are required for the evaluation of KIT mutations or amplifications, which are necessary for study eligibility (per E2697 study amendment). Brain metastasis patients with stable disease. Ocular melanoma is excluded.)
- Multicenter Treatment Protocol for Expanded Access Use of Ipilimumab (BMS-734016) Monotherapy in Subjects with Unresectable Stage III or Stage IV Melanoma
(Purpose: To provide treatment with ipilimumab to subjects who have serious or life-threatening unrsectable stage III or stage IV melanoma, who have no alternative treatment options and who meet inclusion and exclusion criteria. Brain metastasis patients with stable disease and all melanoma subytes (including ocular and mucosal) are allowed. Patients must have failed first line therapy. Unresectable stage III patients are included.)
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 procedure 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 staGe 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.
CyberKnife (stereotactic radiosurgery) for brain metastases is a novel technique also available at Stanford.
Trial Administration