Researcher Q&A: Dr. Niroshana Anandasabapathy

In our latest research feature, we spoke with Niroshana Anandasabapathy of Brigham and Women’s Hospital, who is the recipient of an MRA Young Investigator Award. Funded in collaboration with Brigham and Women’s Hospital, Dr. Anandasabapathy’s research is titled “Expanding immune-surveillance and immunotherapy of melanoma.” Here she explains more about her research.

Anandasabapathy, NHow did you get interested in melanoma and your field of research?

I have always been really interested in why the immune system fails to detect cancer, and I completed my PhD in cancer biology while an MD-PhD student. I am a dermatologist, so melanoma is a critical concern, and as one of our more immunogenic cancers, melanoma is a fascinating and challenging area to work in.

Explain your research and how it can make a difference to melanoma patients.

Our research is geared at developing new drugs for melanoma immunotherapy. To do this, we study how the immune system responds to cancer and how we can improve that response in new ways.

What is one thing about your research that surprised you when you first started?

I am still amazed by how effective immunotherapy is. Although conceptually we thought it would work, seeing it in place is so gratifying. In my own work I am actually amazed by how little we understand about how protective vaccines work (for example, the vaccine to smallpox). A better knowledge of known vaccines could help develop therapies to improve immunity to cancer.

How has MRA funding helped your work?

We made some very intriguing findings for how the immune system maintains tolerance to itself in the skin. We feel it is likely skin cancer in general, and melanoma in particular, that can hijack these mechanisms, and this opportunity allows us to test whether that is true. With these data in hand we can develop new drugs to combat melanoma that block these pathways.

Have there been any recent advances in your research that are particularly encouraging?

We identified a particular target for drug development I believe is extremely promising. Because a drug to this target would work very differently from current immunotherapy, it could be combined with current therapies to improve responses in the 60-70% of patients for whom current immunotherapy does not work.

What do you do when you’re not seeing patients or conducting research?

I love to cook, paint, play the piano and am often with my family. We love being outside (with sun protection on of course) and traveling when possible. But I admit I also love work. I wake up every day excited by these questions and grateful to be trying to make a difference.

Learn more about Dr. Anandasabapathy’s work and our other funded Young Investigators.

The Latest on Skin Cancer Screenings

To routinely screen for skin cancer or not to screen? That hot-button question still doesn’t have a solid answer.

In 2009, the U.S. Preventive Services Task Force found insufficient evidence to recommend annual skin cancer screenings for all adults. Currently, the Task Force is reviewing the most recent research findings and may (or may not) change this recommendation. MRA has funded research looking at the benefits and harms of population-based skin checks, and the results of this research will mature over the next year.

In the meantime, certain high-risk people should discuss with their healthcare provider about annual skin exams with a dermatologist or other trained professional.

Am I High Risk for Skin Cancer?

You’re considered high risk if you meet one or more of these criteria:

  • You have a family history of skin cancer.
  • You have a personal history (prior diagnosis) of skin cancer.
  • You have a lot of moles or freckles.
  • You have a fair complexion and/or have red or blonde hair.
  • History of sunburns and/or use of tanning beds.

Skin Cancer Screening: What to Expect

Most skin checks begin with a doctor (usually a dermatologist) visually giving your skin a once-over to look for suspicious-looking moles, freckles, lesions or skin changes. Your doctor may use a dermatoscope during this process. This magnifying device uses a special light source to illuminate features below the skin’s surface.

Screening with Total Body Photography

Total body photography (TBP) systems can aid melanoma screening for certain high-risk individuals, particularly those with many moles.

There are several advantages to this technology:

  • TBP can help physicians keep track of many suspicious lesions on an individual. Should your doctor detect a possible skin change at a later appointment, he or she can compare it to baseline images.
  • Doctors avoid performing unnecessary biopsies if the comparison indicates that the suspicious area really hasn’t changed.

If you’re at high risk for melanoma, check with your dermatologist to see if TBP is available. You also should check with you health insurance provider since the service may not be covered.

MRA funded a research award to develop a three-dimensional TBP system. Using more than 40 cameras, the system photographs the entire surface of the skin and creates a digital model in less time than current TBP systems. It is currently only available at one skin cancer clinic in the U.S.

Learn more about early detection and prevention: Educate yourself about melanoma.

You can read the full recap in our Scientific Retreat Report.


MRA Announces RFP for Translational Research

MRA is pleased to announce a Request for Proposals (RFP) soliciting high-impact translational research from scientists and clinicians around the world. This RFP is for 2015-2016, with awards being announced in the spring of 2016.

The RFP calls for ideas that have the potential to lead to near-term clinical application in melanoma prevention, detection, diagnosis, staging, and treatment. Due to the generosity of our founders and supporters, we anticipate awarding at least $10 million in grants for this awards cycle.

Proposals will be accepted for:

  • Team Science Awards
  • Young Investigator Awards
  • Academic-Industry Partnership Awards (for Established Investigators)
  • Special Opportunity Awards

Several Special Opportunity Awards are available through the RFP, including:

  • Saban Family Foundation-MRA Team Science Awards (for Israel-led teams)
  • L’Oreal Paris-MRA Team Science Award for Women in Scientific Research
  • Uveal Melanoma Team Science Award
  • Acral Melanoma Team Science Award
  • Society for Immunotherapy of Cancer-MRA Young Investigator Award

MRA announced its first RFP in August, 2015 and the second RFP in September, 2015. The RFP that is currently available includes the complete range of applications for 2015-2016, including the Special Opportunity Awards.

Important Dates:

October 12, 2015: Team Science Award Letters of Intent are due

November 16, 2015: Young Investigator Award and Academic-Industry Partnership Award proposals are due

As in years past, we look forward to receiving high quality proposals that will help advance the field of melanoma research. Good luck!

Researcher Q&A: Dr. Neil Ganem

In an effort to share more about the work being done in the field of melanoma research, we are beginning a new feature on our blog to showcase some of our funded investigators. Today we’re talking with Neil Ganem, Ph.D., Assistant Professor of Pharmacology and Medicine at Boston University School of Medicine and recipient of the Jackie King-MRA Young Investigator Award.

Neil Ganem. Photo courtesy of Boston University School of Medicine.

Neil Ganem. Photo courtesy of Boston University School of Medicine.

How did you get interested in melanoma and your field of research?

My lab studies the causes and consequences of a phenomenon known as chromosome instability, which is a hallmark of solid tumors, including melanoma. Normal human cells maintain all of their genetic information on 23 pairs of chromosomes. By contrast, a common feature of human cancer cells is that they possess an abnormal number of chromosomes, a state known as aneuploidy. Though already abnormal, many aneuploid cancer cells continue to shuffle their chromosome content, often gaining and losing chromosomes with each cell division. This trait of cancer cells is termed chromosome instability (CIN).

CIN is known to facilitate tumor initiation, progression, the development of chemo-resistance, and relapse. Consequently, patients with CIN tumors have a poor clinical prognosis. One major focus of my research program is to uncover the cellular defects that generate chromosome instability in human cancer cells. Several years ago a colleagues of mine, Craig Ceol, generated a transgenic zebrafish model to expresses oncogenic BRAF specifically in melanocytes. Interestingly, Craig and I found that oncogenic BRAF, which is one of the most common causes of melanoma, acted as a potent driver of chromosome instability. My lab is now attempting to define the mechanisms through which oncogenic BRAF promotes abnormal chromosome segregation and CIN. To do this, we are using highly sophisticated microscopic techniques to visualize individual chromosomes as they separate during cell division.

How can your research make a difference to melanoma patients? 

A major focus of my group is to identify whether chromosome instability generated by oncogenic BRAF represents a point-of-weakness that can be therapeutically exploited. My lab has recently developed an innovative screening approach to comprehensively identify the proteins and molecular pathways required for chromosomally unstable cancer cells to survive and proliferate.

Ultimately, our long-term scientific goal is to develop new strategies to specifically inhibit the growth of abnormal, chromosomally unstable melanoma cells while sparing the normal cells from which they originated. We hope that by targeting chromosome stability, rather than a specific oncogene, we may ultimately develop new and innovative treatments for melanoma patients.

How has MRA funding helped your work?

The Jackie King Young Investigator Award from the MRA is supporting the salary of Sanghee Lim, an M.D./Ph.D. student in my laboratory. Sanghee is a fantastic student who has already finished his first two years of medical school. He will now spend the next four years earning his Ph.D. in my lab before completing his final two years of medical training. Sanghee is interested in pursuing a career in oncology/dermatology. This is one of the long-reaching effects of the support from the MRA: Awards provide the financial support to engage young M.D./Ph.D. candidates in projects directly relevant to melanoma, which may ultimately influence those students to make melanoma research their career ambition.

What do you do when you’re not seeing patients or conducting research?

As the father of three young boys, I spend most of my free time doing dad stuff! I spend a lot of time at playgrounds, playing sports and games, and building Legos. When I have time to myself, I really enjoy yard work and doing projects around the house. I used to enjoy playing hockey, but it’s been so long since I last played that I guess I should consider myself retired at this point.

Learn more about Dr. Ganem and all the MRA Young Investigators.

Immunotherapy for Melanoma: Where We Are

As was reported last week, Former President Jimmy Carter has melanoma that has spread to other organs, and part of his treatment will include an immunotherapy drug. Immunotherapy is a term used to describe treatments that harness the body’s immune system to fight cancer cells. Several of these are approved by the FDA for treating melanoma, including the one Mr. Carter is getting, and newer ones are in the pipeline.

How Does Immunotherapy Work?

Using your immune system to fend off cancer sounds natural and appealing, right?  After all, the immune system helps to combat other diseases like infections, so why not cancer, too? Doctors have been trying for decades to take advantage of the ability of immune cells to distinguish between healthy normal tissue and diseased cancer tissue. Unfortunately, only recently has this worked well in cancer.

It turns out that in patients with melanoma, component cells of the immune system have been fooled into ignoring the melanoma. How does this happen? Certain molecules act as “checkpoints” to prevent attacks on healthy cells and turn off a potentially over-eager immune response to minimize autoimmune disease (when the body attacks and destroys healthy body tissues by mistake). Melanoma cells take advantage of this regulatory step and turn on checkpoint signals that let them avoid being detected by the immune system. It’s like Harry Potter and his cloak of invisibility or Klingon Warships with the same…pick your metaphor. The melanoma cells subvert checkpoint signaling to essentially become invisible and avoid being killed by the immune system.

A truly profound change in recent years is the advent of certain immunotherapy drugs that target and block these checkpoints, which increases your body’s immune response. Without the checkpoint signal, the immune cells can do their job of recognizing the tumor as foreign. In this way, immunotherapy drugs activate the immune system to invade tumors and attack melanoma cells.

Patients receive checkpoint inhibitor immunotherapy drugs intravenously (into a blood vein). They are systemic, which means that the treatments travel through the bloodstream to reach all parts of the body. Cancer physicians use systemic immunotherapy to treat metastatic cancer, which is cancer that has spread from its original location to other areas of the body.

What Immunotherapy Drugs are Used for Melanoma?

Since 2011, the U.S. Food and Drug Administration (FDA) has approved three immunotherapy drugs:

  • Yervoy® (Ipilimumab),an anti-CTLA-4 antibody, approved in 2011
  • Keytruda® (Pembrolizumab), an anti-PD-1 antibody, approved in 2014
  • Opdivo® (Nivolumab), an anti-PD-1 antibody, approved in 2014

The anti-PD-1 immunotherapy drugs in particular are showing promise for other types of cancer, too. In fact, earlier this year, the FDA approved nivolumab to treat a certain type of lung cancer.

What’s Next for Immunotherapy Drugs?

The approvals of these immunotherapy treatments have come at an amazing pace and along with targeted therapies the melanoma treatment landscape is dramatically improved compared to just 5 years ago. Unfortunately, the current treatments don’t yet offer a universal cure. The gains are significant and unprecedented – make no mistake.  But some tumors are resistant to treatment and new approaches must be developed to overcome the limitations.

Now, researchers are trying to understand how to tailor the treatments to maximize results for more patients. And history teaches us that using active drugs in unique combinations often works well in cancer. So, some of what we’re trying to understand now include questions like:

  • What are the optimal combinations that balance good activity and good tolerability
  • What is the best order to give these therapies to patients
  • How long should patients be treated for the best results
  • Which patients will most likely benefit from certain drugs or combinations

The European Commission recently approved nivolumab and pembrolizumab for treatment of patients with advanced metastatic melanoma, including in the first-line treatment of the disease. In the US, the FDA is considering this same indication for each drug, as well as the combination of nivolumab and ipilimumab. FDA decisions are expected by the end of 2015.

With anti-PD-1 drugs first approved just last year, these expanded uses clearly demonstrate the remarkable pace of advances for melanoma patients around the world and the hope for even better outcomes for patients in the months and years to come.

What We Can Learn from President Carter’s Melanoma Diagnosis and Treatment

By Louise M. Perkins, Ph.D.

Chief Science Officer

President Jimmy Carter revealed to the world his diagnosis with melanoma with both the grace and bravery that we may all aspire to in the face of such news. His melanoma presentation was a bit unusual and naturally confusing. He was initially diagnosed with a tumor in his liver and then on closer exploration it was found to have spread to the brain. Once the tumor in his liver was removed and analyzed, his doctors could tell that it was a melanoma. Understanding what type of cancer he has is important, as it is helping to direct his treatment. It is fairly typical for melanoma to progress to the brain, as has been reported in President Carter’s case.

Image courtesy of

            Image courtesy of

So, how can a cancer that usually starts in the skin suddenly pop up in someone’s brain and liver?  Well, first of all, this is really rare. Some estimates say only 2% to 6% of melanomas are identified without ever finding the original (primary) tumor. Where do these odd melanomas come from?

Let’s back up a second. Melanomas are pigment-producing cells called melanocytes that have become cancerous.

Melanocytes are not only present on what we think of as skin, but also found in mucosal surfaces like the inside of the nose or mouth, under nails, as well as in eyes and ears – and even some organs.

So, in the case of President Carter, there are a couple possibilities:

  1. He may have had a skin melanoma that had a couple bad cells that split off and hid while his immune system effectively dealt with the primary tumor and he was none the worse. For whatever reason the stray cells then got out of control, leading to his current disease.
  2. Alternatively, something similar may have happened with the melanoma being relatively benign at a rare site in his body, but a few “bad guy” cells broke away and seeded in the brain and liver and then grew more aggressively.

We may never know.

The good news is that Mr. Carter is able to take advantage of the benefits of research that has led to sweeping advances in melanoma. Beginning in 2011, care for patients with advanced melanoma changed profoundly and the FDA has approved eight new treatments since then. Of relevance to President Carter’s specific treatment plan, MRA has funded research on melanoma brain metastases as well as on the combination of anti-PD-1 treatment and radiation therapy, similar to what has been offered him by his doctors.

MRA’s critical and timely infusion of funding has contributed to the sweeping changes in melanoma care with a significant part of our portfolio invested in research on just the types of treatments that will hopefully help President Carter and tens of thousands of other cancer patients in the future. My thoughts and prayers are with him and the many others engaged in their fight against melanoma.

You can learn more about our investments and hope you will consider making a donation to continue to support melanoma research.

A Conversation with Board Member Jami Gertz

We’re featuring an interview with MRA Board Member and actress Jami Gertz on our blog. This was repurposed, with permission, from the blog of our partners at Neiman Marcus

JAMI GERTZNM: How did you get involved with Melanoma Research Alliance?
JG: My sister-in-law, Debra Black, founded Melanoma Research Alliance (MRA) with her husband Leon, after her personal battle with melanoma. During the early days after her diagnosis, we were all shocked to learn just how few treatments were available – and how little progress had been made over the years. Debra and Leon’s passion for advancing treatment options for melanoma patients led to the creation of MRA. I’m so proud of Debra and thrilled to be a board member.

NM: What are the greatest challenges that MRA faces with the rise of melanoma and the survival for those with advanced disease remaining static?
JG: There have been tremendous advances in treatment for melanoma in the last five years, including many new FDA-approved drugs. There has also been a lot of media attention about immunotherapy and personalized medicine for cancer treatment, which is really fantastic. But there is still a lot that we do not understand about why certain treatments work for some people and not for others. We have to keep working to ensure that we’re doing the best we can for patients with this terrible disease.

NM: How is MRA addressing these challenges?
JG: What’s unique about MRA is that thanks to Debra and Leon’s ongoing support, 100% of donations go directly to research. MRA has provided more than $60 million for melanoma research worldwide. The organization fosters collaboration among multiple stakeholders, bringing together researchers, the pharmaceutical industry, foundations, donors and patients to help accelerate progress toward finding treatments and hopefully a cure.

NM: Describe some of the ways in which we can protect ourselves from the sun’s damaging rays?
JG: One of the easiest things we can do is to wear sunscreen every day. It should be part of your daily routine, all year round. It’s also good to cover up with hats, UPF clothing and sunglasses. Fortunately, there are many new brands that are blending fashion and sun safety quite well.

NM: How has social media affected public awareness of melanoma?
JG: Social media can be an agent for good, and it plays an important part in melanoma awareness because melanoma is the second most common cancer among young men and women. My hope is that we can continue to share information about the dangers of melanoma so that everyone knows how important prevention and early detection are for survival.

NM: What is the biggest misconception about melanoma?
JG: I think people have a tendency to downplay the seriousness of melanoma and think it can be easily treated. While other types of skin cancers have lower death rates, melanoma is very serious and has the highest death rate of all skin cancers. And while genetics may increase your chances of getting melanoma, we know that exposure to UV rays is a major risk factor for this disease.

NM: How can we improve early detection?
JG: One way we can improve early detection is to really know your skin. Perform monthly skin checks to look for changes to your moles or freckles. If you’re familiar with your skin, you’re more likely to spot a change early.

NM: What is the most rewarding aspect of your work with MRA?
JG: MRA is truly making a difference for people with melanoma. In the last five years, there have been eight drugs approved for melanoma treatment, which is more than in the previous 30 years combined. It’s providing hope for patients with melanoma, and it’s also showing promise for patients with other types of cancers.

NM: What motivates you to continue to fight for this cause?
JG: My sister-in-law courageously battled melanoma and has poured so much of her time and resources into this very personal cause. She is my biggest motivation.

NM: I hope to one day…
JG: Live to see a time when we have found a cure for everyone suffering from melanoma.