Assessing the value of precision medicine health technologies to detect and manage melanoma

Mahumud, Rashidul Alam; Janda, Monika; Soyer, H. Peter; Fernández‐Peñas, Pablo; Mar, Victoria; Morton, Rachael L.

doi:10.5694/mja2.51696

Cited by 4 publications

(4 citation statements)

References 21 publications

(37 reference statements)

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“…further facilitate shared care and communicating lesions of concern which would particularly be useful for ruralbased GPs. 24 It was postulated that rurality may have positively affected the confidence of respondents for reasons including more older sun-exposed patient demographics and reduced access to specialist services. This study was however unable to discern statistically significant differences and therefore further emphasizes the need for additional training and resources to support these practitioners working with higher-risk communities.…”

Section: Discussionmentioning

confidence: 99%

“…This should also include current viewpoints on devices with integrated artificial intelligence algorithms 23 . Incorporating elements of digital dermoscopy and photography could further facilitate shared care and communicating lesions of concern which would particularly be useful for rural‐based GPs 24 . It was postulated that rurality may have positively affected the confidence of respondents for reasons including more older sun‐exposed patient demographics and reduced access to specialist services.…”

Section: Discussionmentioning

confidence: 99%

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Stage IA melanoma follow‐up: Exploring the level of confidence of South Australian general practitioners in undertaking surveillance skin checks including considerations for shared care

2023

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Background The literature highlights the role of Australian general practitioners (GP) in the management of skin cancers. With melanoma incidences on the rise, there have been discussions into whether lower‐risk stage IA patients could safely be followed up by their GPs for annual surveillance full skin examinations (FSE). This study explores the level of confidence of South Australian (SA) GPs in undertaking FSEs including factors that could support discussions around shared care between GPs and dermatology units for lower‐risk patients. Methods An online survey was designed and distributed to SA GPs via email, newsletters and social media between 5 December 2021 and 30 January 2022. Descriptive statistics were used to describe survey responses. Pearson's Chi‐squared analysis was used to investigate associations between key variables of interest and explanatory variables. Logistic regression analysis was used to model odds ratios for associations between the dependent variable and independent variables. Results A total of 135 responses were obtained. Forty‐four per cent of GPs were comfortable undertaking annual FSEs, 41% were uncomfortable and 15% were unsure. Scope of work, >20 years experience and additional training had statistically significant relationships (p < 0.05). Dermoscopy and detecting melanoma recurrences were reported to be skills with lower levels of confidence. With regards to shared care, 77% indicated that they would feel supported undertaking FSEs if rapid access referral pathways were allocated for patients who developed suspicious lesions. Preferred upskilling modalities included, face‐to‐face sessions in a dermatology unit (39%), dermatologist run webinars (25%) and certificate courses (20%). Conclusions At present, there is a subset of SA GPs who are comfortable undertaking FSEs and therefore could be engaged in shared care with specialists. Further considerations have to be made in the areas of upskilling and supporting the workforce to enhance engagement in shared care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Stage IA melanoma follow‐up: Exploring the level of confidence of South Australian general practitioners in undertaking surveillance skin checks including considerations for shared care

2023

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“…Although advanced diagnostic imaging technology is currently being implemented, there is a relative lack of evidence supporting its clinical efficacy and cost‐effectiveness 36 . For example, machine learning algorithms are integrated into imaging systems that can detect change in individual lesions and provide risk assessments for malignancy.…”

Section: Advances In Diagnostic Technologymentioning

confidence: 99%

Management of cutaneous melanoma in Australia: a narrative review

Bhave

Wong

McInerney-Leo

et al. 2023

Medical Journal of Australia

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ustralia has one of the highest incidences of cutaneous melanoma in the world. 1 Indeed, melanoma is so common that it is estimated to be the third most diagnosed cancer in Australia in 2022 and is the most common cancer in people aged 20-39 years. 1 The management of melanoma continues to evolve, with significant advances being made over historical approaches, resulting in improved patient outcomes. This review provides a concise overview of the screening, diagnosis and management of melanoma in Australia. MethodsWe conducted a literature search on the MEDLINE and PubMed electronic databases for articles published from 2000 to 2022 to include updated data on the management of melanoma. Articles in English and studies involving humans only were included. The search included combinations of the keywords "melanoma", "cutaneous melanoma", "metastatic melanoma", "risk assessment", "risk models", "risk prediction", "risk stratification", "polygenic risk", "genome wide association studies", "diagnosis", "imaging", "biopsy", "surgery", "resection", "excision", "immunotherapy", "checkpoint inhibitors", "targeted therapy", "adjuvant therapy" and "neoadjuvant therapy". Specialist society publications and guidelines were also reviewed, including those from Cancer Council Australia, the American Society of Clinical Oncology and the European Society for Medical Oncology. There were no exclusions on article type, and abstracts, review articles, letters and editorials were considered.

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“…Melanoma is a deadly skin cancer that represents a global important public health concern [ 1 , 2 ]. In 2020, it was estimated that 325,000 new cases of melanoma were detected globally, and 57,000 people died from melanoma each year [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

The Emerging Burden of Genetic Instability and Mutation in Melanoma: Role of Molecular Mechanisms

Mahumud

Shahjalal

2022

Cancers

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Melanoma is a severe skin cancer affecting thousands of people and a growing public health concern worldwide. The potential hallmarks of melanoma are genetic instability and mutation (GIAM), which are driving mechanisms for phenotypic variation and adaptation in melanoma. In metastatic melanoma, DNA repair-associated genes are frequently expressed at higher levels than in primary cancers, suggesting melanoma cells rely on genetic stability to spread distantly. The tumour microenvironment is affected by genomic instability and melanoma mutation (GIMM), which plays significant roles in developing GIMM and their contributions to the overall disease burden. The GIAM is the crucial vulnerability of cancer cells, determining their sensitivity to harmful treatments, including radiation and many chemotherapeutics. The high incidence of melanoma is typically associated with genetic modifications, and several clinical and genetic interventions have been critical in easing the burden.

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Assessing the value of precision medicine health technologies to detect and manage melanoma

Cited by 4 publications

References 21 publications

Stage IA melanoma follow‐up: Exploring the level of confidence of South Australian general practitioners in undertaking surveillance skin checks including considerations for shared care

Stage IA melanoma follow‐up: Exploring the level of confidence of South Australian general practitioners in undertaking surveillance skin checks including considerations for shared care

Management of cutaneous melanoma in Australia: a narrative review

The Emerging Burden of Genetic Instability and Mutation in Melanoma: Role of Molecular Mechanisms

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