By Emilia Migliano and Patrizio Giacomini

During year 2020, the group has built on a pre-existing collaborative network and has strenghthened the interactions among the Melanoma Disease Management Team, the institutional Melanoma 4P project, and work in the context of Alliance Against Cancer (ACC).

Organization

The Melanoma DMT convenes on Tuesdays to discuss the most critical clinical cases, but is also a forum for the dissemination of the ongoing clinical and clinical-translational projects and ideas. Melanoma 4P stands for Precision, Predictive, Personalized and Participated.

During 2020, we have been able to enrol in this study 97 more patients, 68 from the cohort at early stages, and 29 from the late-stage cohort. The total numbers of enrolled patients is now 149 (since May 2019) which demonstrates our commitment to make precision oncology available to an expanding coohrt of high-risk patients. The project is run under the supervision of Professors Gennaro Ciliberto and Aldo Morrone, Scientific Directors of the Regina Elena National Cancer Institute and S. Gallicano Dermatological Institutes, respectively. Collaboration of our twin Institutes is a plus enabling Melanoma 4P to span from prevention and Dermatology to Medical and Molecular Oncology in a single uninterrupted flowchart.

Achievements

During 2020, a joint initiative of the Regina Elena and S, Gallicano Institutes has met with success. The application of a young investigator from ISG (fully supported by a team of young promising investigators from IRE) has been funded by the Ministry of Health to investigate the role of radiomics and radiogenomics in the context of checkpoint treatment. Hopefully, this new project will help to establish novel routines for our patients. We expect that combining tissue genomics, liquid biopsies, and radiomics (medical imaging texture) features, it will be possible to describe melanoma in more detail. Concepts such as genomic profiling, ctDNA relapse, and medical imaging texture are likely to become important independent variables guiding melanoma management in the next future. We do expect that response to checkpoint blockade may be predicted and monitored, sparing unnecessary toxic regimens to ‘resistant’ patients, and optimizing dosages and schedules for susceptible patients. This new project is fully synergistic with Melanoma 4P and several ongoing clinical activities. IRE and ISG are aso active in a project on melanoma organoid s that is carried out under the egida of Alliance Against Cancer (ACC). In this study, we will establish short term 3D cultures of melanoma explants and will determine in a multi-institutional context, how these can help to address the long vexing question of the tumor immune environment in patients undergoing checkpoint blockade therapy. In addition, the group is active in a variety of other projects that are not desfcribed here in the interest of space, but aim at the characterization and better knowledge of major transduction pathways, drugs, and miRNA profiling. Finally, the two Pathology groups at ISG and IRE are fully collaborating to bring innovative molecular diagnostics (e.g. NGS panels of ever increasing complexity) into the diagnostic routine, providing an important ‘backbone’ to all other activities.