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If you have any qustions or inquirys, please do not hesitate to contact our scientific nurses Marie Sjögren, Carina Eriksson or Catharina Natt och Dag. The contactinformation is in the blue box to the right on the screen. They can be reached either by phone or e-mail.

 

The BioMEL-study

BioMEL is a scentific study about new diagnostics, prognosis and responsivness to treatment. Malignant melanoma has a varied progression of disease, where the vast majority is cured by an operation. But if the disease has spread, you will need specific care in the Oncology Department. The medical profession and science must work together in order to become better in finding the special characteristics which shows the progression of malignant melanoma and how new medical treatments can suit different subtypes of malignant melanoma. 

The scientists working with the BioMEL-study comes from different areas of medicine such as Oncology, Surgery, Dermatology, Biomedicine and Pathology. They are all part of the Lund Melanoma Study Group (LMSG). This shows the different medical specialities that are involved in the treatment of malignant melanoma and the translational approch of the research. Together we want to explore and study if we can enhance our diagnostics of melanoma in regard to biomarkers in the melanoma, and in turn give us better tools for giving a more precise prognosis of the disease. With an improved diagnostics of melanoma we will also study the responsiveness of  treatment with the new medicines for spread disease.   

 

Lund Melanoma Study Group (LMSG)

LMSG started already in the early 1980ies as a collaboration between the epidemiologist/ clinical oncologist Håkan Olsson and the surgeon Christian Ingvar, investigating if melanoma patients travelled more often to the sunny countries in south Europe compared to a control group of patients operated for benign disease and a group of lymphoma patients. Melanoma patients were found to be attracted to the UV-light and a connection to sunburns was established in our case-control studies. 

In 1989 LMSG started a prospective investigation, called the MISS-cohort (Melanoma in South Sweden), where every 8:th healthy woman (25-65 years old) in the southern Swedish health care region were invited to participate. The focus was on known risk factors for melanoma and breast cancer. Later the surgeon Johan Westerdahl joined, and in several epidemiological studies LMSG clearly established the fact that the acute sunburn was associated with melanoma and that the use of sun tanning devices (solarium) increased the risk of melanoma 8 times in young women. His thesis was presented in 1995.

Since more than 25 years LMSG has administered questionnaires to all patients with a melanoma diagnosis in the southern Swedish Health Care Region. The questionnaires include questions concerning risk factors (sun, tanning, family history, education, occupations and social factors among others), in order to follow known risk factors and hopefully discover new ones.  In the late 1990-ies and  in 2000-2002 Anna Måsbäck, our pathologist, worked together with Johan W and investigated the histopathological aspects of melanoma over time in the large cohorts that LMSG had collected. She presented her thesis in 2002.

In 1996 LMSG described the CDKN2A germline mutation in the Swedish melanoma families for the first time and this finding lead to a fruitful international collaboration within the Melanoma Genetics Consortium (GenoMEL). This collaboration started in the early 2000 and is still ongoing. GenoMEL received a large EU contract (9 mil. Euro) and some of the money was spent on LMSG.

Kari Nielsen, now one of our senior dermatologists, began studying familial melanoma and found that the phenotype for the CDKN2A mutation positive patients was not the phenotype of the dysplastic naevus syndrome, but still the patients had a small but limited increase of atypical moles. Her thesis was presented in 2009.  Professor Göran Jönsson, molecular biologist, investigated as a PhD student ocular familiar melanoma. His thesis was presented in 2005. Lately, together with his PhD student and LMSG member Katja Harbst, he presented a new molecular subdivision of melanoma that turned out to be independent of the classical prognostic factors like Breslow thickness, ulceration etc. Katja presented her thesis in 2012.

Of the 40 000 women invited 1989 -90 for the MISS-cohort study, three out of four responded, and the cohort has so far been re-interviewed every 10 years (2001 and again in 2010). The follow up period of this cohort is thus more than 20 years. Related to the latest questionnaire occasion, LMSG also distributed a collection set for saliva, in order to collect individual DNA from those who wanted to participate. At the present time LMSG have collected about 18 000 individual saliva samples. Samples will then be analyzed for known genes (exons) with association to melanoma and also potential candidate genes (predisposing). Molecular findings can then by biostatistics be related to lifestyle and constitutional factors that we have individual information about through the repeated questionnaires. During the 20 years we have prospectively followed the MISS cohort- about 300 cases of melanoma have been diagnosed within the cohort.

 

The unique BioMEL biobank for primary and metastatic melanoma started in 2013. In collaborations with dermatologists, surgeons and dermatopathologists, fresh frozen samples of clinically suspected primary and metastatic melanomas will be collected to the biobank. As the histopathological diagnosis for excised lesions in such a sample is not established pre-operatively, there will also be non-melanoma lesions collected in the biobank. Blood samples from all patients will also be collected to the biobank for comparative studies, as well as dermoscopic photos of primary lesions.

A new international collaboration (Japan) including evaluation of hyper spectral data of melanocytic lesions has been conducted since 2014. The first results will be presented during 2019.

 

LMSG is a research team, which gives priority to translational research.

The full spectra of melanoma and also non-melanoma skin cancer are now covered with our multidisciplinary group with researching clinicians including surgeons, oncologists, epidemiologists, dermatologists and pathologists together with molecular biologists, statisticians, secretaries and research nurses. PhD students and researching medical students are successively included in the LMSG.

LMSG's most important questions: 

WHO, WHY and HOW individuals get melanoma? What patients respond to the new targeted treatments?

1. Why is this disease growing so fast?

2. Why does not everyone get melanoma despite the same risk factors?

3. What individual genes are important and is there a certain order of action?

4. Interaction between environment (UV-radiation) and certain genes?

5. Which advice concerning tanning and UV protection should be given? (Total avoidance do not work).

6. Which genes predispose for distant spread and dead? Can non-invasive techniques foresee this clinical prognosis?

7. Which genes predispose for long term survival? Can non-invasive techniques foresee this clinical prognosis?

8. The specific mechanisms influence the new drugs for distant disease?

9. Why do only a minority respond to the new treatment despite the same targets?

10. Can better biological and genetic information give safer individual prognosis and influence the way we treat and follow up patients?  Individual risk categories?

Research facilities: For multidisciplinary reasons LMSG works at many different locations but the molecular biology part (Head: Göran B Jönsson) is located at Medicon Village where 180 m2 are used for melanoma research. The epidemiological part is located at Skåne University Hospital in Lund.  Outpatients’ facilities are at the moment located in Lund, Helsingborg and Malmö but will soon start in Kristianstad and hopefully in all other hospitals in the Southern Region.

LMSG and projects within the research group are supported by: BioGenoMel (the continuation of GenoMel), The Swedish Cancer foundation, ALF-Lund university/Region Skåne, T. Zoegas foundation, S.R. Gorthon foundation, M Paulsson trust, G, the Region of Skåne, and several other funds.