Among the 23 investigators who make up the Interdisciplinary Melanoma Cooperative Group are (left to right) Nina Bhardwaj, MD, PhD; David Polsky, MD, PhD; Iman Osman, MD, the group's director; and Eva Hernando, PhD. (Photo by John Abbott)

Group Therapy

Melanoma Investigators Practice Collaborative Research at Its Best

You see them every summer—the lobster-red sunbathers who forgot the sunscreen. A blistering burn may be a painful reminder of the oversight now, but the cumulative damage could eventually lead to something much worse: melanoma, the most deadly form of skin cancer.

“In melanoma, we measure in millimeters,” says David Polsky, MD, PhD, associate professor of dermatology and pathology. “If you have a melanoma that’s thicker than 1 millimeter and 6 millimeters across, you’re talking about something that can kill.”

Fortunately, NYU Langone Medical Center’s Interdisciplinary Melanoma Cooperative Group (IMCG) is gaining ground on what Dr. Polsky calls “the tumor that gives cancer a bad name.” In 2002, he banded with Iman Osman, MD, associate professor of dermatology and urology, and four other colleagues to form the IMCG so that they could leverage their collective knowledge and resources. With Dr. Osman as director, the IMCG has since grown to 23 investigators. This “center without walls” has not only become a valuable source of patient samples and extensive clinical information, but the focal point of the Melanoma Program for the new Center of Excellence on Cancers of the Skin, led by Seth Orlow, MD, PhD, the Samuel Weinberg Professor of Pediatric Dermatology, chairman of the Ronald O. Perelman Department of Dermatology, and professor of cell biology and pediatrics.

With melanoma, of course, the challenge is more than just scientific. “We’re all facing the same monster,” says Dr. Osman. This year alone, melanoma will strike an estimated 68,720 Americans and kill 8,650, according to the National Cancer Institute. When detected and properly treated in its early stages, melanoma has a cure rate of greater than 90 percent. But once it has metastasized, this aggressive cancer can claim its victim in just four months.

The IMCG has marshaled some impressive forces, including a roster of medical researchers who view melanoma from nearly every angle. When Eva Hernando, PhD, assistant professor of pathology, attended her first group meeting in 2006, the collaborative energy made a lasting impression and convinced her to add melanoma to her research efforts. “This was a dream come true,” she says. “This was really what I was looking for.”

In a recent study, Dr. Hernando and colleagues found that a small RNA molecule known as a microRNA can enhance the invasiveness and spread of melanoma cells grown in a Petri dish. Using tissue samples collected by clinicians within the group, she was able to validate her findings with clinically relevant cells. Already, the cooperative group is helping to formulate the next step: testing the molecule’s potential as a therapeutic and diagnostic target.

Another team, led by Dr. Polsky, showed that a genetic variation in the promoter of a gene called MDM2 is associated with an elevated melanoma risk in women younger than 50. The finding, he says, opens up a new line of molecular research to understand why, a question that group members like Dr. Hernando are well positioned to help answer.

One major hurdle has been melanoma’s tendency to migrate to the brain. “The problem with brain metastasis is that most of the chemotherapy available doesn’t cross the blood-brain barrier,” explains Dr. Osman. Through a separate collaboration, however, Dr. Hernando has brought one of the few models of brain metastasis to NYU Langone, where pathologists and other group members are using it in coordinated clinical studies to understand early indicators that might predict brain metastasis and survival. “Everything,” notes Dr. Osman, “works together to give us something cohesive and strong.”

Ultimately, the team is seeking a lasting intervention. Nina Bhardwaj, MD, PhD, director of NYU Langone’s Tumor Vaccine Program and an IMCG member, reports that she and her colleagues have completed three clinical trials aimed at creating a melanoma vaccine, and they are in the midst of a fourth. Two more trials are planned for later this year. Eventually, the IMCG’s coordinated research strategy may help ensure that the wince-worthy sunburns of summer lead to far fewer tragedies in later years.