MELANOMA
PROGRAM SUMMARY
About 60,000 new cases of malignant melanoma arise each year in the U.S. and 8000 people succumb to metastatic disease. Current melanoma therapies are ineffective, other than in small undefined subsets of patients. This suggests that there may be biologically distinct melanoma subtypes, and indicates the potential for targeted therapies.
The APCR-Melanoma Biomarker Group Collaboration aims to identify the characteristics of subtypes that are most malignant using techniques like those employed by the APCR-Core. The melanoma group brings considerable experience in translating research into clinical trials and contains molecular and cellular research expertise designed to provide rapid identification, development, and validation of melanoma markers, for eventual use as prognostic markers, and hopefully as targets for therapies.
The APCR Melanoma Adoptive Cell Transfer Group Collaboration is based on a recent Surgery Branch, National Cancer Institute protocol where patients with metastatic melanoma were transiently depleted of resident immune cells with a standard chemotherapy just prior to receiving their cultured, tumor-reactive tumor infiltrating lymphocytes (TILs) and IL-2. In this study, 49% of 43 treated patients had major tumor regressions. In this collaboration the Surgery Branch, NCI will function as a lead center involved in disseminating their findings and allow a consortium of other centers to develop expertise and then contribute in novel and collaborative ways. The goal of this collaboration is to determine if this treatment can be exported to these other institutions and if the dramatic initial results seen can be confirmed by others.
Director:
DONALD MORTON
Dr. Morton is not only an accomplished surgical oncologist, but also a renowned clinical scientist whose fundamental discoveries during the last 30 years have profoundly changed the treatment of human cancer. Dr. Morton's pioneering work with intratumoral Bacillus Calmette Guérin (BCG) for melanoma in the early 1970s represented the first successful clinical application of immunotherapy against a metastatic human cancer. His team's research with BCG in melanoma metastatic to the bladder set the stage for BCG as the first (and still the only) FDA-approved immunotherapy for human bladder cancer.
In the mid-1970s, Dr. Morton introduced cutaneous lymphoscintigraphy to identify the regional lymphatic basin receiving drainage from a primary cutaneous melanoma. In 1990, he first reported his innovative lymphatic mapping technique, a surgical procedure that identifies the sentinel lymph node(s) in the regional lymphatic basin. Histopathologic examination of the sentinel node was found to indicate the tumor status of the entire lymphatic basin; thus, patients with tumor-negative sentinel nodes could be spared a radical lymphadenectomy. Sentinel node mapping has become a highly successful, minimally invasive surgical staging procedure that has now been extended to many other solid neoplasms such as breast, colon, and thyroid cancers.
Dr. Morton and his research team were the first to develop clinically effective vaccines to treat patients with advanced melanoma. His polyvalent allogeneic cell vaccine (Canvaxin ) has been shown to improve average survival rates threefold and has reached Phase III pivotal trials, the final step before FDA approval.
Dr. Morton's scientific contributions toward the immunology of cancer and surgical oncology have yielded more than 600 publications in peer-reviewed journals and have garnered him a long series of prestigious awards and honors, notable among which are his recognition by the Cancer Research Institute of New York as one of the pioneers in tumor immunology, his listing in Current Contents as one of the most quoted contemporary scientists, and his receipt of M.D. Anderson's Jeffrey A. Gottlieb Memorial Award for cancer therapeutic research. He is a recent past president of both the Society of Surgical Oncology and the World Federation of Surgical Oncology Societies. In addition, he has served on numerous review committees for the National Cancer Institute and the American Cancer Society.
Dr. Morton was head of the tumor immunology section in the surgery branch at the National Cancer Institute in Bethesda, Maryland, and then chief of the division of surgical oncology at UCLA before establishing the John Wayne Cancer Institute at Saint John's Health Center in Santa Monica, California. As Medical Director and Surgeon-in-Chief of JWCI, he has guided the Institute to its present position as an internationally respected melanoma, breast, surgical oncology, and immunotherapy center. Dr. Morton and his staff have trained 69 postdoctoral fellows, most of whom now hold academic positions.