Breakthroughs in Skin Cancer Research: New Detection and Treatment Methods

14th May 2024

By Samantha Weetman, Science Writer.

It’s May, which means it is Skin Cancer Awareness Month – time to remind ourselves of the importance of prevention and early detection. In science news, we have some hot topics and interesting innovations on the horizon, and in this blog we’ll shine some light on recent skin cancer research developments and explore two new and exciting clinical trials hoping to improve detection and diagnosis, and develop personalised treatments.

Sun Burn – Not Just Skin Deep

Skin cancer is one of the most common forms of cancer worldwide, with three main occurring types, basal cell carcinoma, squamous cell carcinoma, and melanoma. The cells involved in these cancers are all part of the epidermis (upper skin layer). Skin cancers are often caused by UV radiation damage to exposed skin. However, melanoma, although less common than other types, is the most aggressive form. It is the skin cancer most likely to metastasise if left untreated; its growth can also originate from existing moles and areas typically covered from the sun. Early diagnosis, as well as understanding and identifying skin cancer type are therefore crucial for the effective management and treatment of skin cancer.

Making Waves in Cancer Diagnosis

It is a simple fact that early cancer diagnoses save lives. The sooner a cancer is detected, the more likely it is that treatment will be successful. In skin cancer, diagnosis traditionally relies on visual examination and biopsies. While effective, these methods have limitations, particularly in detecting subtle or early-stage changes in skin cells. It requires a professional with a well-trained eye to determine the presence of cancerous cells. This diagnosis process can be time consuming and is limited to the availability of such consultants.

However, there is some good news on the horizon. Pioneering researchers at the University of Warwick have developed a new method using low-frequency Terahertz (THz) waves with the potential to detect skin cancer [3]. These waves, falling between infrared and microwaves, were recently used in a trial by the group to develop a handheld scanner that was successfully able to quantify skin hydration and stratum corneum (the outer most epidermal layer) thickness. Because abnormalities in the stratum corneum and changes in flow of blood and water occur in skin cancer, the innovative device has a high applicability in skin cancer detection.

The exciting breakthrough by Professor MacPherson and her group at Warwick could bring significant benefits to patients and doctors. The handheld device could be used to accurately detect differences in cell water retention in real-time. Not only does this provide doctors with a speedier and non-invasive means of diagnosing skin cancer, but also helps to more precisely determine the border between cancerous and regular cells. This can help to reduce removal of healthy tissue, minimise scarring, and ensure that the area requiring post-surgery skin grafting is kept as small as possible. This also provides a tool to check that abnormal cells aren’t left behind that may otherwise increase the chance of the cancer growth returning.

Additionally, there are ongoing research efforts to train AI to identify cancerous cells from biopsy thin-section images, in the way that a consultant would [1,2]. This is one of the other approaches being explored to save time and tackle the lack of consultant resources, hopefully assisting with faster diagnoses in the future.

Personalised Treatment on Trial

Following surgery to remove skin cancer, patients often undergo treatments such as chemotherapy or immunotherapy to target any remaining cancer cells. Immunotherapy drugs like pembrolizumab (Keytruda) have shown promising results in improving survival rates for melanoma patients and reducing reoccurrence [4,5]. Pembrolizumab works by targeting and blocking the PD-1 T cell surface protein—enabling them to identify and kill cancer cells [5].   

At the forefront of a groundbreaking Phase 3 clinical trial in the UK, University College London Hospital (UCLH) is exploring a new frontier in cancer treatment – the world’s first mRNA-based personalised neoantigen therapy, designed by Moderna and Merck specifically for melanoma.

Harnessing the technology that powered COVID-19 vaccines, this cutting-edge treatment, known as mRNA-4157 (V940), is crafted to match the unique genetic blueprint of each patient’s tumour. Tumour samples are taken from the patient and the DNA and RNA are sequenced. Neoantigens (mutated antigens present only in the cancerous cells) specific to the patient, are identified and manufactured. Administration of the increased neoantigen load back to the patient stimulates the immune response to increase the production of antibodies against the cancer cells.     

In the previous phase of the trial, it was concluded that patients with high-risk (Stage IIB–IV) melanoma benefited most from receiving the new mRNA vaccine alongside Keytruda, with a significant reduction in the risk of recurrence or death compared with not receiving the combination [6]. 

This promising result led to the initiation of the Phase 3 trial with patients in Australia enrolling from July 2023. The Phase 3 trial aims to further evaluate the therapy’s efficacy. By combining mRNA-4157 (V940) with Keytruda, this approach offers new hope for improved outcomes in melanoma treatment. The therapy’s individualised nature ensures that each patient’s treatment is precisely targeted to their unique tumour characteristics, revolutionising post-surgery melanoma care.

Turning the Tides

These breakthroughs in skin cancer research offer new optimism for patients facing this challenging disease. The development of more precise and effective detection methods, such as the Terahertz wave technology can help with earlier detection and diagnosis leading to more effective treatment options and lives saved.

Individualised neoantigen therapy, like the personalised mRNA vaccines, holds the potential to revolutionise cancer treatment, offering patients a tailored and targeted therapy. These advances can help reduce reoccurrence and improve survival rates and quality of life. This state-of-the-art approach could usher in a new wave of individualised treatments –  a momentous step in the fight against cancer.

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References

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2. Yang, J.; Chen, L.; Liu, E.; Wang, B.; Driman, D. K.; Zhang, Q.; Ling, C. Deep Learning System for True- and Pseudo-Invasion in Colorectal Polyps. Sci. Rep. 2024, 14 (1), 426. https://doi.org/10.1038/s41598-023-50681-5.

3. Hernandez-Serrano, A. I.; Ding, X.; Young, J.; Costa, G.; Dogra, A.; Hardwicke, J.; Pickwell-MacPherson, E. Terahertz Probe for Real Time in Vivo Skin Hydration Evaluation. Adv. Photonics Nexus 2024, 3 (1), 016012. https://doi.org/10.1117/1.APN.3.1.016012.

4. Grob, J.-J.; Gonzalez, R.; Basset-Seguin, N.; Vornicova, O.; Schachter, J.; Joshi, A.; Meyer, N.; Grange, F.; Piulats, J. M.; Bauman, J. R.; Zhang, P.; Gumuscu, B.; Swaby, R. F.; Hughes, B. G. M. Pembrolizumab Monotherapy for Recurrent or Metastatic Cutaneous Squamous Cell Carcinoma: A Single-Arm Phase II Trial (KEYNOTE-629). J. Clin. Oncol. 2020, 38 (25), 2916–2925. https://doi.org/10.1200/JCO.19.03054.

5. Rizzetto, G.; De Simoni, E.; Molinelli, E.; Offidani, A.; Simonetti, O. Efficacy of Pembrolizumab in Advanced Melanoma: A Narrative Review. Int. J. Mol. Sci. 2023, 24 (15), 12383. https://doi.org/10.3390/ijms241512383.

6. Weber, J. S.; Carlino, M. S.; Khattak, A.; Meniawy, T.; Ansstas, G.; Taylor, M. H.; Kim, K. B.; McKean, M.; Long, G. V.; Sullivan, R. J.; Faries, M.; Tran, T. T.; Cowey, C. L.; Pecora, A.; Shaheen, M.; Segar, J.; Medina, T.; Atkinson, V.; Gibney, G. T.; Luke, J. J.; Thomas, S.; Buchbinder, E. I.; Healy, J. A.; Huang, M.; Morrissey, M.; Feldman, I.; Sehgal, V.; Robert-Tissot, C.; Hou, P.; Zhu, L.; Brown, M.; Aanur, P.; Meehan, R. S.; Zaks, T. Individualised Neoantigen Therapy mRNA-4157 (V940) plus Pembrolizumab versus Pembrolizumab Monotherapy in Resected Melanoma (KEYNOTE-942): A Randomised, Phase 2b Study. The Lancet 2024, 403 (10427), 632–644. https://doi.org/10.1016/S0140-6736(23)02268-7.