Dr. Kelly McMasters , Ben A. Reid, Sr, MD Professor and Chair, Department of Surgery, and his research team have been awarded a $200,000 grant from the Melanoma Research Foundation to study gene expression patterns in the lymph nodes of patients whose melanoma has not spread beyond the primary site.

Overall, 15 to 20 percent of these patients with cancer-free lymph nodes eventually go on to develop metastases and ultimately die from their disease. McMasters and his team are trying to identify these high-risk node-negative patients who might benefit from additional therapy.

While other research has focused on molecular detection of melanoma cells in sentinel lymph nodes in order to identify the node-negative patients likely to experience recurrence, we have not found that such methods are reliable, McMasters said. In high-risk patients, it is likely true that melanoma cells regularly travel through the lymphatic system to sentinel nodes, whether we can detect the presence of such cells in the nodes or not.

McMasters and his team hypothesize that rather than trying to detect melanoma cells in the sentinel nodes, it may be more effective to examine gene expression patterns in the lymph nodes to determine the response of the sentinel nodes to exposure to melanoma cells.

This may allow us to identify those patients who may benefit from additional therapy, he said.

The funded study aims to develop a prognostically significant gene expression signature, which, in combination with other clinical factors, could be used to better predict prognosis, stratify risk, and guide drug therapy decisions in node-negative patients. This study will use some already available data from the Sunbelt Melanoma Trial, the world's largest study of melanoma, involving 79 centers with more than 3600 patients from around the United States and Canada, which also was led by McMasters.

Melanoma, the most lethal form of skin cancer, is the fifth most common cancer in American men and the seventh most common in American women, killing more than 8,000 Americans annually.