Using An App to Confront Your Metastatic Melanoma

GEORGE D. LUNDBERG

If you or anyone else you know has had a malignant melanoma, you and that other person, and your respective physicians, should click here to access the Targeted Therapy Finder–Melanoma (ttf-melanoma). It is free and does not require registration.

Collabrx of Palo Alto has developed this first of its kind application (app) under the leadership of noted internet entrepreneur and melanoma survivor Marty Tenenbaum.

The app is based upon the science of the original Melanoma Molecular Disease Model (MMDM) in Cancer Commons built by David Fisher and Keith Flaherty of Harvard Medical School and Smruti Vidwans and colleagues on our staff.

Over decades, medicine has developed a comprehensive approach to diagnosing, grading, and staging malignant melanoma and many physicians follow that knowledge to deliver treatment at the “standard of care”. Thus, of the 70 000 melanomas diagnosed in the USA each year, approximately 90% are cured, mostly by surgery. The problem comes with those 7000 per year that progress “beyond standard of care”. Most of these patients have metastases to organs far from the site of the primary melanoma and its related lymph nodes. This clinical circumstance has long been considered hopeless for most patients, since no therapy has been consistently successful.

For many patients with dread malignancies, there is now a therapeutic opportunity “beyond standard of care” that might be called “state of the art” or it could be called “developmental or experimental”. Clinical trials are the hallmark, but only a small percentage of cancer patients actually participate in clinical trials.

We now know that the diagnosis and classification of many malignant tumors by traditional gross and microscopic techniques in anatomical pathology are often insufficient for selection of “best therapy” and may not even enable correct placement of a patient into an arm of a clinical trial. Because of errors in diagnosis brought about by our not understanding the genomic makeup of many cancers, we have been mixing “apples, oranges, and walnuts” far too long.

The science of molecular genomics is leading to our ability to sub-classify many cancers, and those new subtypes have provided opportunities to develop and use potential targeted therapies. No field of cancer has progressed faster than melanoma in elucidating this new approach. Based upon genomic molecular testing, many melanomas are found to have mutated genes that affect metabolic pathways. There are promising therapies that may target specific melanomas once mutations are identified.

Most patients and many physicians are not yet aware of these options. Voila’! Http://therapy.collabrx.com .

Prepare yourself to be patient; molecular oncology is not simple; click the URL; paddle around the initial straightforward algorithms; use your cursor to seek pop-ups ; click the many potential clinical situations; use the MMDM to learn of the genes, the pathways, the appropriate tests and the labs that perform them; locate the best available trials for each subtype; learn about promising treatments that your physician may use in a “clinical trial with an N of one”. It could be YOUR HEALTH!

There is new hope for many patients with metastatic melanoma for whom there had been little. But first they have to know to have their tumor tested.

Help us spread the word.

George D. Lundberg MD, is former Editor in Chief of Medscape, eMedicine, and the Journal of the American Medical Association. He’s now President and Chair of the Board of The Lundberg Institute.