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Research at Mass General
The major loci of clinical research are the Pigmented Lesion Center (PLC), which provides care for patients with cutaneous melanoma and individuals with an elevated risk of developing melanoma, and the Cancer Center, which offers a wide array of experimental therapeutics for patients with advanced melanoma.
The PLC is the oldest continuously operating multidisciplinary melanoma group in the country and one of the first in the world. Established in 1966 by Dr. Thomas B. Fitzpatrick (Dermatology), Dr. John Raker (Surgery), Dr. Wallace Clark, and Dr. Martin C. Mihm (Pathology), the PLC was created to advance understanding of cutaneous melanoma, a relatively rare cancer at that time. Over the ensuing four decades, the incidence of cutaneous melanoma has risen dramatically, and the PLC has become the major center for melanoma patient care in the New England area and a leader in all aspects of melanoma investigation. Given its rich history, the PLC is recognized internationally, sharing a seat on the World Health Organization Melanoma Programme.
As a care center, the PLC evaluates more than 200 new melanoma patients per year and attends to more than 3,000 visits. Additional patients are also treated and managed in the medical and surgical oncology units as well as within surgery. As a teaching site, the PLC trains dermatology residents from Harvard Medical School and other rotating residents and students, postgraduate dermatopathology fellows, and fully trained physicians from around the world interested in melanocytic tumors. As a research unit, investigators from the PLC were among the first to describe the different cutaneous melanoma subtypes, the association between sun exposure and cutaneous melanoma, the various factors that predict outcome from histological markers such as tumor-infiltrating lymphocytes to molecular markers such as melastatin, and the use of sentinel lymph node biopsies in the staging of melanoma patients.
The PLC is currently staffed by dermatologists (Drs. David Fisher, Arthur Sober and Hensin Tsao), a rotating surgical oncologist (Drs. Kenneth Tanabe, A. Ben Cosimi, and Michele Gadd), a medical oncologist ( Donald Lawrence). Second pathology opinions are rendered in rotation by a dermatopathologist (Drs. Lyn M. Duncan, Mai Hoang, Rosalynn Nazarian and Adriano Piris). Although members have research interests, they all contribute to the flow of patient care and the establishment of melanoma care guidelines within Massachusetts General Hospital.
Research and treatment for patients with advanced stages of melanoma are carried out in the Divisions of Surgical Oncology and Hematology/Oncology and the Department of Radiation Oncology in the Cancer Center. Specialized treatment modalities available to patients include advanced plastic and reconstructive surgery, proton therapy for ocular melanoma, stereotactic radiosurgery, isolated hyperthermic limb perfusion, and high dose interleukin-2 treatment. Research is focused on the development of novel therapeutics, including small molecule signal transduction inhibitors and immunotherapeutic approaches.
1 McDermott DF, Mier JW, Lawrence DP, van den Brink MR, Clancy MA, Rubin KM, Atkins MB A phase II pilot trial of concurrent biochemotherapy with cisplatin, vinblastine, dacarbazine, interleukin 2, and interferon alpha-2B in patients with metastatic melanoma. Clin Cancer Res. 09/29/2000; 6(6); 2201-8.
2 Tsao H, Zhang X, Kwitkiwski K, Finkelstein DM, Sober AJ, Haluska FG Low prevalence of germline CDKN2A and CDK4 mutations in patients with early-onset melanoma. Arch Dermatol. 10/03/2000; 136(9); 1118-22.
3 Yu LL, Flotte TJ, Tanabe KK, Gadd MA, Cosimi AB, Sober AJ, Mihm MC, Duncan LM Detection of microscopic melanoma metastases in sentinel lymph nodes. Cancer. 09/03/1999; 86(4); 617-27.
4 Duncan LM, Deeds J, Cronin FE, Donovan M, Sober AJ, Kauffman M, McCarthy JJ Melastatin expression and prognosis in cutaneous malignant melanoma. J Clin Oncol. 03/06/2001; 19(2); 568-76.
5 Tsao H, Millman P, Linette GP, Hodi FS, Sober AJ, Goldberg MA, Haluska FG Hypopigmentation associated with an adenovirus-mediated gp100/MART-1-transduced dendritic cell vaccine for metastatic melanoma. Arch Dermatol. 06/11/2002; 138(6); 799-802.
6 Geller AC, Emmons K, Brooks DR, Zhang Z, Powers C, Koh HK, Sober AJ, Miller DR, Li F, Haluska F, Gilchrest BA Skin cancer prevention and detection practices among siblings of patients with melanoma. J Am Acad Dermatol. 09/26/2003; 49(4); 631-8.
7 Evans HL, Krag DN, Teates CD, Patterson JW, Meijer S, Harlow SP, Tanabe KK, Loggie BW, Whitworth PW, Kusminsky RE, Carp NZ, Gadd MA, Slingluff CL Lymphoscintigraphy and sentinel node biopsy accurately stage melanoma in patients presenting after wide local excision. Ann Surg Oncol. 05/07/2003; 10(4); 416-25.
8 Tsao H, Atkins MB, Sober AJ Management of cutaneous melanoma. N Engl J Med. 09/02/2004; 351(10); 998-1012.
9 Tsai KY, Tsao H The genetics of skin cancer. Am J Med Genet C Semin Med Genet. 10/27/2004; 131C(1); 82-92.
10 Singh M, Lin J, Hocker TL, Tsao H Genetics of melanoma tumorigenesis. Br J Dermatol. 12/14/2007; 158(1); 15-21.
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