Alternate Title
Basic Trial Information
Objectives
Entry Criteria
Expected Enrollment
Outline
Published Results
Related Publications
Trial Contact Information
Related Information
Registry Information

Alternate Title

Study of Individuals and Families at High Risk for Melanoma

Basic Trial Information

Special Category: NIH Clinical Center trial, NCI Web site featured trial

Objectives

1. Evaluate and define the clinical spectrum and natural history of disease in syndromes predisposing individuals and families to melanoma.
2. Evaluate potential precursor states of disease in families at risk for melanoma.
3. Quantify risks of melanoma, pancreatic cancer, and other cancers in family members.
4. Map, clone, and determine function of tumor susceptibility genes in melanoma-prone families, including modifier genes such as pigmentation or dysplastic nevi genes.
5. Identify genetic determinants and gene-environmental interactions conferring melanoma (and other cancer) risk in individuals and families.
6. Evaluate gene-gene and gene-environmental interactions in melanoma (and other cancer) formation in individuals and families.
7. Educate and counsel study participants about their melanoma risk and methods for primary and secondary prevention of melanoma.

Entry Criteria

Disease Characteristics:

• Either of the following:
  • Individuals with a personal or family history of melanoma of an unusual type, pattern, or number
  • Individuals with known or suspected factor(s) predisposing to melanoma (e.g., dysplastic nevi)
    • Genetic (e.g., albinism) or congenital factors (e.g., large congenital nevi)
    • Unusual demographic features (very young age of onset, multiple melanomas, prior history of heritable retinoblastoma, Hodgkin's disease, lymphoma, or organ transplantation)

• At least 3 living affected cases with invasive melanoma must be available for study of familial melanoma

• Diagnoses must be verifiable

Prior/Concurrent Therapy:

Biologic therapy

• Not specified

Chemotherapy

• Not specified

Endocrine therapy

• Not specified

Radiotherapy

• Not specified

Surgery

• Not specified

Patient Characteristics:

Age

• Any age

Performance status

• Not specified

Life expectancy

• Not specified

Hematopoietic

• Not specified

Hepatic

• Not specified

Renal

• Not specified

Expected Enrollment

A total of 100 additional families will be accrued for this study within the next few years.

Outline

One family member completes a family history questionnaire for verification of diagnosis and construction of a family pedigree. Information collected from all individuals may include skin examination and sun exposure history, overview and close-up photographs, medical history, and limited physical examination (entire skin exam for all family members and lymph node palpation for individuals with current or prior melanoma). Some individuals may also undergo an MRI and/or a skin biopsy.

Blood is collected for localizing genetic loci, identifying genes, and evaluating phenotype/genotype correlations. Each family is tested for mutations in CDKN2A and CDK4 and other potential melanoma susceptibility genes.

Each family member receives educational materials about sun protective behavior, skin self-examination, recognition of melanoma warning signs, recognition of dysplastic nevi, and changes worrisome for melanoma. Each person also receives individual risk counseling about melanoma based on personal cutaneous phenotype and position in the pedigree.

Individuals are followed every few years to document changes in their skin exam as sun exposure is decreased and to collect information from those who have undergone mole biopsies . Specific nevi are followed and photographed.

When the genetic testing results would impact clinical care recommendations, genetic testing and notification of results are offered only to participants who, after appropriate education and counseling, want to know their individual genetic status. Because of the exploratory nature of this study, results are not routinely returned to participants at this time.

A certificate of confidentiality protecting the identity of research participants in this project has been issued by the National Cancer Institute.

Goldstein AM, Chan M, Harland M, et al.: Features associated with germline CDKN2A mutations: a GenoMEL study of melanoma-prone families from three continents. J Med Genet 44 (2): 99-106, 2007.[PUBMED Abstract]

Goldstein AM, Chan M, Harland M, et al.: High-risk melanoma susceptibility genes and pancreatic cancer, neural system tumors, and uveal melanoma across GenoMEL. Cancer Res 66 (20): 9818-28, 2006.[PUBMED Abstract]

Laud K, Marian C, Avril MF, et al.: Comprehensive analysis of CDKN2A (p16INK4A/p14ARF) and CDKN2B genes in 53 melanoma index cases considered to be at heightened risk of melanoma. J Med Genet 43 (1): 39-47, 2006.[PUBMED Abstract]

Goldstein AM, Landi MT, Tsang S, et al.: Association of MC1R variants and risk of melanoma in melanoma-prone families with CDKN2A mutations. Cancer Epidemiol Biomarkers Prev 14 (9): 2208-12, 2005.[PUBMED Abstract]

Harland M, Taylor CF, Chambers PA, et al.: A mutation hotspot at the p14ARF splice site. Oncogene 24 (28): 4604-8, 2005.[PUBMED Abstract]

Goldstein AM, Struewing JP, Fraser MC, et al.: Prospective risk of cancer in CDKN2A germline mutation carriers. J Med Genet 41 (6): 421-4, 2004.[PUBMED Abstract]

Gillanders E, Juo SH, Holland EA, et al.: Localization of a novel melanoma susceptibility locus to 1p22. Am J Hum Genet 73 (2): 301-13, 2003.[PUBMED Abstract]

Rutter JL, Goldstein AM, Dávila MR, et al.: CDKN2A point mutations D153spl(c.457G>T) and IVS2+1G>T result in aberrant splice products affecting both p16INK4a and p14ARF. Oncogene 22 (28): 4444-8, 2003.[PUBMED Abstract]

Bishop DT, Demenais F, Goldstein AM, et al.: Geographical variation in the penetrance of CDKN2A mutations for melanoma. J Natl Cancer Inst 94 (12): 894-903, 2002.[PUBMED Abstract]

Feng Y, Shi J, Goldstein AM, et al.: Analysis of mutations and identification of several polymorphisms in the putative promoter region of the P34CDC2-related CDC2L1 gene located at 1P36 in melanoma cell lines and melanoma families. Int J Cancer 99 (6): 834-8, 2002.[PUBMED Abstract]

Goldstein AM, Chidambaram A, Halpern A, et al.: Rarity of CDK4 germline mutations in familial melanoma. Melanoma Res 12 (1): 51-5, 2002.[PUBMED Abstract]

Buckel TB, Goldstein AM, Fraser MC, et al.: Recent tanning bed use: a risk factor for melanoma. Arch Dermatol 142 (4): 485-8, 2006.[PUBMED Abstract]

Goldstein AM, Tucker MA: A piece of the melanoma puzzle. J Natl Cancer Inst 97 (20): 1486-7, 2005.[PUBMED Abstract]

Goldstein AM: Familial melanoma, pancreatic cancer and germline CDKN2A mutations. Hum Mutat 23 (6): 630, 2004.[PUBMED Abstract]

Millen AE, Tucker MA, Hartge P, et al.: Diet and melanoma in a case-control study. Cancer Epidemiol Biomarkers Prev 13 (6): 1042-51, 2004.[PUBMED Abstract]

Rutter JL, Bromley CM, Goldstein AM, et al.: Heterogeneity of risk for melanoma and pancreatic and digestive malignancies: a melanoma case-control study. Cancer 101 (12): 2809-16, 2004.[PUBMED Abstract]

Kefford R, Bishop JN, Tucker M, et al.: Genetic testing for melanoma. Lancet Oncol 3 (11): 653-4, 2002.[PUBMED Abstract]

Tucker MA, Fraser MC, Goldstein AM, et al.: A natural history of melanomas and dysplastic nevi: an atlas of lesions in melanoma-prone families. Cancer 94 (12): 3192-209, 2002.[PUBMED Abstract]

Trial Contact Information

Trial Lead Organizations

NCI - Center for Cancer Research

Margaret Tucker, MD, Protocol chair		Ph: 301-496-4375

U.S.A.
Maryland
	Bethesda
	NCI - Division of Cancer Epidemiology and Genetics
		Genetic Epidemiology Branch Referral Nurse	Ph:  800-518-8474
	Warren Grant Magnuson Clinical Center - NCI Clinical Trials Referral Office
		Clinical Trials Office - Warren Grant Magnusen Clinical Center - NCI Clinical Trials Referral Office	Ph:  888-NCI-1937

Related Information

Featured trial article

Registry Information
Official Title		Clinical, Laboratory And Epidemiologic Characterization Of Individuals And Families At High Risk Of Melanoma
Trial Start Date		2002-06-03
Trial Completion Date		2012-12-31 (estimated)
Registered in ClinicalTrials.gov		NCT00045240
Date Submitted to PDQ		2002-07-01
Information Last Verified		2007-02-08

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