Clinical, Laboratory, and Epidemiologic Characterization of Individuals and Families at High Risk of Melanoma



Status:Recruiting
Conditions:Skin Cancer, Dermatology
Therapuetic Areas:Dermatology / Plastic Surgery, Oncology
Healthy:No
Age Range:1 - 100
Updated:4/6/2019
Start Date:July 1, 2002
Contact:Alisa M Goldstein, Ph.D.
Email:goldstea@mail.nih.gov
Phone:(240) 276-7233

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This study will investigate how genetic and environmental factors contribute to the
development of melanoma, a type of skin cancer, and related conditions.

Individuals of any age with a personal or family history of melanoma may be eligible for this
study. Participants will:

- Fill out one or two questionnaires about their personal and family medical history.

- Provide written consent for researchers to review their medical records and pathology
materials related to their care and those of deceased relatives with melanomas, tumors,
cancer, or other related illnesses for whom they are the next-of-kin or legally
authorized representative.

- Donate a blood or cheek cell sample to be used for genetic studies. (The blood sample is
collected through a needle in an arm vein. The cheek cell sample is obtained either by
gently brushing the inside of the mouth with a soft brush or by swishing a tablespoon of
mouthwash and then spitting it into a container.)

- Undergo a skin biopsy (removal of a small piece of skin tissue) for genetic study. For
this procedure, the area of skin to be removed is numbed with a local anesthetic and a
1/4-inch piece of skin is excised with a cookie cutter-like instrument. The wound is
then covered with a band-aid.

Participants may be asked to travel to the NIH Clinical Center for evaluation, including a
medical history, physical examination, and some of the following procedures:

- Full body skin examination to evaluate the type and number of moles and document any
evidence of sun damage to the skin. The examination involves all the skin from the scalp
to the bottoms of the feet. After the examination, a medical photographer will
photograph the skin, with close-ups of skin lesions marked by the examiner. If there are
parts of the skin the participant does not want examined or photographed, he or she can
tell the examiner.

- Blood draw of about 120 milliliters (4 ounces) or less

- Skin biopsy

- Cheek cell sample

- X-rays, ultrasound and magnetic resonance imaging (MRI) studies to detect tumors or
changes in tumors or other types of changes in specific tissues. MRI is a diagnostic
test that uses strong magnetic fields and radiowaves to examine body tissues. The
subject lies on a table that is moved into a large tunnel-like machine (the scanner) for
about 45 minutes to 1 hour.

When the tests are finished, a doctor will discuss the results with the participant and the
need, if any, for clinical follow-up.

Background:

- Persons may be prone to develop melanoma for a variety of reasons including: family
history; environmental exposures; other malignant or premalignant conditions which may
or may not be heritable; immune deficiency; or, preneoplastic conditions such as
dysplastic nevi.

- Investigations of individuals and families at high risk of melanoma have led to
etiologic clues that are important in the general population.

- Identification of melanoma susceptibility genes, the estimation of their effects, and
gene-covariate and gene-gene interactions could improve prevention, screening and
treatment of this cancer.

Objectives:

- To evaluate and define the clinical spectrum and natural history of disease in syndromes
predisposing to melanoma.

- To evaluate potential precursor states of disease in families at risk.

- To quantify risks of melanoma, pancreatic cancer, and other cancers in family members.

- To map, clone, and determine function of tumor susceptibility genes in melanoma-prone
families, including modifier genes such as pigmentation or dysplastic nevi genes.

- To identify genetic determinants and gene-environmental interactions conferring melanoma
(and other cancer) risk in individuals and families.

- To evaluate gene-gene and gene-environment interactions in melanoma (and other cancer)
formation.

- To educate and counsel study participants about their melanoma risk and methods for
primary and secondary prevention of melanoma.

- To develop educational materials for medical professionals and high-risk family members.

Eligibility:

Persons of any age will be considered if,

- There is a family or personal medical history of melanoma of an unusual type, pattern,
or number; or,

- There are known or suspected factor(s) predisposing to melanoma, either genetic or
congenital factors, or unusual demographic features.

- For familial melanoma, three or more living affected cases with invasive melanoma among
family members are required.

Design:

- This is a prospective study. Families are studied long-term using a cohort approach.

- Two melanoma susceptibility genes have been identified, but it is likely others are yet
to be found. We are also exploring potential modifier genes in participating families.

- The affection status of each participant, information on their skin examination, sun
exposure history, medical photographs (both overview and close-up) and blood draw for
localizing genetic loci, identifying genes and evaluating phenotype/genotype
correlations, constitute the workup for newly recruited families.

- Study volunteers are reevaluated every few years to document changes in their skin exam
over time. This is essential for establishing the natural history of dysplastic nevi and
melanoma.

- INCLUSION CRITERIA:

- On referral, persons of any age will be considered for inclusion in the study because
of either:

- A family or personal medical history of melanoma of an unusual type, pattern, or
number; or

- Known or suspected factor(s) predisposing to melanoma, either genetic or congenital
factors (bathing trunk nevi, dysplastic nevi), or unusual demographic features (e.g.
very young age of onset, multiple melanomas, previous history of heritable
retinoblastoma, Hodgkin's disease, lymphoma, or organ transplant).

EXCLUSION CRITERIA:

- Referred individuals and families for whom reported diagnoses cannot be verified;

- Inability to provide informed consent.
We found this trial at
1
site
9000 Rockville Pike
Bethesda, Maryland 20892
Phone: (888) NCI-1937
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mi
from
Bethesda, MD
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