Research Projects 2012
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Recurrence of thin melanoma in Western Australia
Population Health Research
Health Informatics and Genomics
Anytime
Professor Peter O’Leary
Dr Danielle Dye (Pathogenesis & Management of Disease)
The incidence of cutaneous melanoma has risen faster than any other
malignancy in Caucasian populations in the last 30 years, and Australia has the
highest rates worldwide. Although most patients now present with thin
melanoma curable by surgical resection, melanoma metastasizes early in disease
progression, such that 3% of patients with lesions <0.75 mm thick and 15% with
lesions 0.75 – 1.00 mm develop metastatic disease and die within 10 years.
Survival in patients with thicker lesions or regional and distant metastases at the
time of diagnosis is significantly worse.
To date, most research has focussed on identifying features associated with
recurrent disease. Identifying recurrence risk in patients with thin melanoma
would enable patients to receive less intensive follow up, and allow resources to
be directed towards patients at high risk of recurrence.
The WA Melanoma Health Study (WAMHS) is a population-based case-collection
and bio-specimen resource established in 2006. Participants were recruited
through the WA Cancer Registry (WACR), which is notified of all incident cancer
cases in WA. The WAMHS collected clinical pathology data, case data (family
history, health, lifestyle), serum and DNA from approximately 1400 patients
diagnosed with melanoma between January 2006 and September 2009. The
strength of WAMHS, compared to other melanoma databases, is the collection of
biological specimens (serum, DNA and RNA) in addition to the case and pathology
data.
This project will focus on disease recurrence in patients with melanoma < 1 mm
thick where there is no histological or clinical evidence of metastatic spread at
the time of diagnosis and will be conducted in two stages:
1) Patients in the WAMHS who re-present with metastatic disease within 5 years
of diagnosis will be identified by data linkage with the WACR. The pathology and
case data and controls (i.e. patients with thin primary melanoma who do not represent in 5 years) will be analysed to identify whether any patient
characteristics (as collected at recruitment) are associated with relapse. Cases
and controls identified from the WAMHS will be re-contacted and asked to
complete a second questionnaire regarding their health status and health
challenges faced since initial diagnosis. This phase of the study will also validate
the cohort, by investigating whether known risk factors for recurrence (age, sex,
site of primary lesion) are identified in this population
2) The second phase of the study will investigate genetic and/or biochemical
markers that may be associated with recurrence of disease in cases verses
controls. Although markers that predict disease progression in late-stage
melanoma have been examined (e.g. circulating tumour cells), there are few (if
any) predictors of risk in patients with primary melanoma. However, recent
research has identified several genetic variants in genes associated with the host
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immune response and serum micro-RNAs that may be associated melanoma risk.
The exact nature of the genetic markers to be identified will be determined
iteratively, once phase 1) of the project has been completed.
This project represents a new research endeavour combining biochemical and/or
genetic analyses with patient clinical outcome. We aim to identify patient
characteristics associated with risk of recurrence of thin melanoma, with a long
term outcome of developing a risk-stratification model for these patients. Dr
Danielle Dye completed her PhD in melanoma cell and molecular biology
(laboratory based) and has ongoing projects in this area, and has also been
involved in several epidemiological projects using linked datasets and
questionnaire data. Prof Peter O’Leary has considerable experience in both
clinical biochemistry and in analysis of linked data in genetic screening programs.
We would also like to involve an Honours or Masters student in this study.
Melanoma, data linkage, biomarkers, genetic testing
Honours
X
Masters
X
PhD
BSc for honours candidates, BSc (Hons) for PhD candidates
Suitable for biochemistry, molecular genetics, public health graduates
Essential: Ability to work in a multi-disciplinary team, willing to learn new skills.
Word processing, literature database searching, writing skills,
Desirable: Knowledge of biomedical analytical techniques, genetics, database
analysis
Applicant should apply for APA, UPA or other scholarship
Professor Peter O’Leary, Centre for Population Health Research, Building
400.241
peter.oleary@curtin.edu.au