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Melanoma tissue should be collected, frozen, and saved for potential future diagnosis and therapy, if the melanoma is advanced, recurrent, or metastatic.  Frozen tissues provide the best specimen to enable the search for either the mutations that drive the cancer or for the proteins that activate the immune system.

Usually, the melanoma tissue is placed into formalin which fixes and preserves it for examination under the microscope, but, unfortunately, also chemically modifies it.  These chemical modifications decrease the ability to identify genetic mutations such as BRAF that affects 50% of melanoma patients and is a guide for further therapies.  Also, these chemical changes alter the tumor and immune cells enough that it makes it more difficult to guide further immune therapies.

The current standard of care when a melanoma recurs is to give checkpoint inhibitors and BRAF inhibitors.  And these are wonderful additions to the toolkit of therapies for advancing melanoma. However, these therapies still fail in over 50% of patients with advanced melanomas.  It is necessary to think of and plan for the next steps.

SpeciCare offers the patient with advancing melanoma two critical next steps. First, we collect and maintain your melanoma tissue in a frozen but living state.  Second, we have developed relationships with many companies in the melanoma arena and match melanoma patients to these companies if standard-of-care therapies fail.    

The bottom line is that the best tissue to find the mutations and the abnormal proteins is cryopreserved tissue, rather than tissue that has been fixed and modified in formalin.  SpeciCare works with companies that provide additional therapies in the fields of bispecific antibodies, cancer neoantigen vaccines, and tumor-infiltrating lymphocytes.  We will keep the tumor tissue frozen and, at the right time, help the patient find the right answers for that specific melanoma patient, if that patient fails either the BRAF inhibitors or the checkpoint inhibitors. 

Call Specicare at 770 531 0093 if you have an advanced melanoma.  Specicare will work with your surgeon and pathologist to collect and save as much of your tissue as possible before you start your first treatment for advanced or recurrent melanoma. 

See articles below for more background information.

Ken Dixon, MD  FACS

Comparison of whole-exome sequencing of matched fresh and formalin fixed paraffin embedded melanoma tumours: implications for clinical decision making – PubMed (nih.gov)

Identification of neoantigens for individualised cancer immunotherapy (nih.gov)

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