Using An App to Confront Your Metastatic Melanoma

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If you or anyone else you know has had a malignant melanoma, you and that other person, and your respective physicians, should click http://therapy.collabrx.com 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 Editor in Chief of Cancer Commons and Editor at Large for MedPage Today.

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4 replies »

  1. As one doorway opens for Australia , an additional 1 slams in their faces.
    Tim Cahill is again for the last group game in opposition to Serbia but Harry Kewell should sit it out following the accidental handball
    he fears has killed his World Cup With just a single position
    from their 1st two video games Australia have the most function to do in
    Group D, but equally Cahill and Kewell realise
    that if Serbia can be conquered the chance of England
    raises its head. Danny Welbeck scored 2 times as England cruised to a 4- earn
    over Moldova at Wembley in their FIFA World Cup qualifier on Friday.

  2. Comme France Inter lui demandait s’il partageait l’avis de Guillaume Peltier, l’un des vice-présidents de l’UMP et cofondateur du courant sarkozyste La Droite Forte, ancien du FN, pour qui le PS et le FN « se valent », le président du groupe parlementaire a répondu : « Ce sont deux formations politiques tout à fait différentes, avec parfois des points de programme qui se ressemblent. Je pense aux retraites où on ne voit pas la différence entre le PS et le Front national. Ce sont deux formations politiques différentes mais pour nous ce sont deux adversaires ».

  3. Dazzling hardware in search of a “killer app.” The use of RT-PCR and DNA microarrays in personalized oncology is analogous to the introduction of the personal computer. Dazzling hardware in search of a killer application. This was wonderful technology and the geekiest of people bought them and played with them, but they really didn’t start to do anything for a mass market until the introduction of the first killer application, which was a spreadsheet program called Visicalc.
    So what research scientists in universities and cancer centers have been doing for the past ten years is to try and figure out a way to use this dazzling technology to look for patterns of gene expression which correlate with and predict for the activity of anticancer drugs. Hundreds of millions of dollars have been spent on this effort. Objectively speaking, it’s like the emperor’s new clothes.
    Academics are besides themselves over the promise of genome sequencing. It seems so cool that it simply must be good for something. How about in the area of identifying drugs which will work in individual patients? All DNA or RNA-type tests are based on “population” research. They base their predictions on the fact that a higher percentage of people with similar genetic profiles or specific mutations may tend to respond better to certain drugs. This is not really “personalized” medicine, but a refinement of statistical data.
    The particular sequence of DNA that an organism possess (genotype) does not determine what bodily or behaviorial form (phenotype) the organism will finally display. Among other things, environmental influences can cause the suppression of some gene functions and the activation of others. Out knowledge of genomic complexity tells us that genes and parts of genes interact with other genes, as do their protein products, and the whole system is constantly being affected by internal and external environmental factors.
    The gene may not be central to the phenotype at all, or at least it shares the spotlight with other influences. Environmental tissue and cytoplasmic factors clearly dominate the phenotypic expression processes, which may in turn, be affected by a variety of unpredictable protein-interaction events. This view is not shared by all molecular biologists, who disagree about the precise roles of genes and other factors, but it signals many scientists discomfort with a strictly deterministic view of the role of genes in an organism’s functioning.