Specialized Clinical Programs in Melanoma
Specialized Clinical Programs in Melanoma include:
- Intraoperative lymphatic mapping and sentinel lymphadenectomy: This minimally invasive surgical procedure allows accurate identification of lymph node metastases without the morbidity of a complete lymph node dissection.
- PET (Positive Emission Tomography) scanning is available in combination with CT imaging, providing state-of-the-art diagnosis to detect disseminated disease earlier than standard approaches.
- Cutaneous Photography: Vanderbilt dermatologists conduct one of the longest standing dysplastic nevi clinics in the Southeast with the use of photography to make a detailed map of the skin of patients with melanoma or atypical moles. This allows the dermatologists to closely follow the appearance of these moles and diagnose changes that may signal the presence of melanoma sooner than possible with routine skin examinations.
- Comprehensive Pathology Review: All slides from outside consultations are reviewed by an experienced team of pathologists prior to the formulation of a treatment plan.
- Melanoma and Pigmented Lesion Tissue Repository: Blood and tumor tissue is collected from melanoma patients to create a state-of-the-art tissue repository and clinical database that protects all patient personal identity. This will allow us to perform important laboratory studies, which may bring new treatments to melanoma patients.
T-VEC (talimogene laherparepvec) is a GM-CSF modified HSV virus proven to improve durable response rates lasting >6 months in a randomized Phase III trial from 2% with GMCSF to 16% with TVEC, and overall response rate to 26% in patients with advanced melanoma, especially stages IIIB, IIIC, IVA. T-VEC is locally injected into melanoma tumors and leads to the tumor regression and disappearance with complete response for selected patients as high as 11% with minimal side effects. We now offer this therapy at Vanderbilt as one of selected centers with the highest expertise in the world. We are also participating in the combination trial of T-VEC+pembrolizumab in melanoma patients as well as in a study of T-VEC injections into liver metastases which includes not only melanoma, but also liver cancer, breast cancer, and renal cancer.