Melanoma

Director 
Mark B. Faries, M.D. 

The Donald L. Morton, MD, Melanoma Research Program was named after one of the founders of the John Wayne Cancer Institute. Dr. Morton dedicated his professional life to improving the lives of patients with melanoma. In this effort he was more successful than perhaps anyone in history, and his contributions will continue to benefit patients for generations. Through this program, JWCI works to advance the values of Dr. Morton so that the work he started is preserved and extended into the future. The program focuses on the issues that were most important to him throughout his career, including the education of young surgeon-scientists, the use and improvement of surgery as a treatment for cancer, and immunotherapy.  

To learn more about supporting the life-saving cancer research at the Donald L. Morton, MD, Melanoma Research Program, please call JWCI's Development Office at (310) 315-6111.  

Goals and Areas of Research

As one of the largest melanoma centers in the United States, the Donald L. Morton, MD, Melanoma Research Program conducts landmark research to identify new or recurring melanoma at its earliest stages, predict and monitor the response to systemic treatments, and develop active and passive immunotherapies for surgical and nonsurgical patients.

Sentinel Node Biopsy

Although surgical removal is curative in most patients with an early (localized) melanoma on the skin, about 15-20 percent of these patients will subsequently be diagnosed with melanoma in the regional lymph nodes. Until the early 1990s, melanoma patients with clinically normal lymph nodes either underwent extensive nodal surgery (which usually proved unnecessary) or an anxiety-provoking “watch-and-wait” observation period. Because neither was satisfactory, JWCI’s co-founder Dr. Morton pioneered sentinel node biopsy (SNB), a minimally invasive surgical technique that can identify the regional lymph node that is most likely to contain any tumor cells that have spread from the skin melanoma. When this sentinel node (SN) is free of tumor cells, no further nodal surgery is performed. SNB is saving thousands of patients from unnecessary surgery, and JWCI clinical researchers have successfully adapted this technique for other solid cancers. Today, SNB has replaced extensive nodal surgery for melanoma and breast cancer, reducing this country’s healthcare costs by about $3.5 billion each year  

JWCI’s first Multicenter Selective Lymphadenectomy Trial (MSLT-I; ClinicalTrials.gov number NCT00275496) reported that surgical management based on SNB can significantly improve the overall survival of patients whose early melanoma has spread to the regional lymph nodes. The third interim analysis was published in the New England Journal of Medicine and has already been cited almost 400 times in the medical literature (ISI Web of Science). Recently Dr. Faries and JWCI’s international MLST group published a report confirming that immediate nodal treatment based on SNB provides critical prognostic information and a likely therapeutic effect for patients whose melanoma has spread to the regional nodes. In addition, early nodal treatment is less likely to result in lymphedema. 

MSLT-II, which is JWCI's second multicenter international phase III trial of SNB, was started in 2005 to explore whether all patients with a tumor-positive SN must undergo complete nodal dissection. MSLT-II (ClinicalTrials.gov number NCT00389571) is a sophisticated multidisciplinary trial that will determine whether immediate completion lymphadenectomy provides a therapeutic advantage over postoperative ultrasonographic monitoring of the nodal basin. Thousands of patients have been entered from dozens of institutions worldwide. Crucial answers to melanoma management questions are expected from this study. 

Multicenter Clinical Trials Group for Melanoma Studies

JWCI’s multicenter trial network comprises approximately 40 prestigious cancer centers in the United States and around the world. This cooperative trial network is a unique melanoma resource that links the expertise, technical resources, and clinical populations of internationally respected melanoma referral centers. It is responsible for standardized treatment and data collection from more than 7,000 patients with early or advanced melanoma, who are enrolled in JWCI-sponsored phase III clinical trials. Results of studies conducted by this cooperative group have been published in top-ranked journals such as New England Journal of Medicine, Journal of Clinical Oncology, Annals of Surgery and Annals of Surgical Oncology. In addition, findings have been presented at annual meetings of the American Society for Clinical Oncology, the Society of Surgical Oncology, the American Surgical Association, and other respected groups.

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Melanoma Program at Saint John's Health Center ›