Melanie Cole, MS (Host): Welcome to AHN Med Talks, an informative resource for physicians across various specialties as we delve into the latest medical insights and best practices, ensuring you stay at the forefront of your field. I'm Melanie Cole. And today, we're highlighting advanced treatments in melanoma. Joining me is Dr. Deanna Huffman. She's a medical-oncologist with the AHN Cancer Institute.

Dr. Huffman, thank you so much for joining us today. Just start by telling us a little bit about melanoma, the prevalence and incidence. What are you seeing in the trends these days?

Dr. Deanna Huffman: Yeah. Thank you so much for having me to talk about melanoma today. So, melanoma is becoming more prevalent as the years go on. You know, you wouldn't think of it being so common here in Western Pennsylvania, but I can tell you we're pretty busy in the melanoma sector over at West Penn Hospital. As screening techniques are becoming more evolved, we're actually detecting melanoma sooner, which is great for treatment outcomes of patients, but it also means we are seeing more cases of melanoma.

Melanie Cole, MS: That is interesting. Now, tell us a little bit about the melanoma and Skin Cancer Center of Excellence at WPH. Tell us about the multidisciplinary team that you have there and what makes you so unique. What are you offering there?

Dr. Deanna Huffman: We have a wonderful comprehensive center over at West Penn, which is just amazing. So, we encourage you to refer any skin cancer patients over there. We have myself as a medical-oncologist. We also consult with Dr. Pallavi, who's out of Wexford as a medical-oncologist. We have a team of onco-dermatologists led by Dr. Mount. We have surgical oncologists led by Dr. Edington. We have specialized dermatopathologist, radiation-oncologist. And we all get together. We have a collaborative clinic over at West Penn where we help screen patients and come up with best treatment options as well as ongoing clinical trials at West Penn Hospital.

Melanie Cole, MS: So, what's new, Dr. Huffman? What's exciting in screening and diagnosis? You said it's a pretty busy clinic. So, you know, as we always know, early detection is paramount to those better outcomes, as you said before. So, what are we doing as far as screening and diagnosis for at-risk and not at-risk people?

Dr. Deanna Huffman: So, I think the most exciting thing we have going on as far as screening, especially at West Penn, is we have a machine called the Vectra 3D Body imaging. We're the only center in western Pennsylvania that has one. And what it is, is basically a 3D camera that takes a snapshot of a patient's whole body and uses AI algorithms to track changes in moles, which may be a little bit more intuitive than maybe the naked eye from a dermatologist following them.

You know, not only is it maybe more advanced than the naked eye, but it's also more efficient. It allows us to screen patients more quickly. And so, patients can come in and get their Vectra scan however often it is recommended by their dermatologist, whether that be once every six months, once a year, without having to wait to meet with a provider, because as we all know, wait times to get into dermatology can be quite long. So, that's something we're most excited about over at West Penn.

Melanie Cole, MS: That's pretty cool. So, now that we've got screening and diagnosis advancements, speak about treatment options for advanced melanoma. You can speak about non-advanced melanoma, you know, at first diagnosis, early stage, but then segue into advanced and what's going on today as far as surgical medical treatment options for cancer that spread to the lymph nodes and other organs.

Dr. Deanna Huffman: So, melanoma is a field where we are rapidly gaining new insights all the time. The advent of immunotherapy and the treatment for melanoma has totally revolutionized treatment in the last 10 years. And now, we have immunotherapies that are approved for early stage melanoma as well, whether in the adjuvant or neoadjuvant setting, either before or after surgery, as well as in advanced metastatic patients. So, always recommend a referral as early as possible so we can assess patients for treatments that might improve their chance of recurrence, reduce their risk of recurrence, and improve their outcomes.

And then, additionally, for metastatic patients, for more advanced patients, beyond immunotherapies, we have lots of trials going on at West Penn and, of course, all over the nation, but what we're most excited about is something called TIL therapy, tumor-infiltrating lymphocytes. So, it's actually gotten an FDA approval since 2024 for patients with relapsed metastatic melanoma. So, patients who have already failed one line of therapy. And that's something that we can offer at West Penn to our patients, just from a commercial standpoint, from an FDA approval.

But we also have ongoing clinical trials with TIL therapy, working in how to improve these types of therapies, how to reduce toxicities from these type of therapies. So, we're really excited about that. We also have research going on in oncolytic viral proteins, kind of vaccine development against cancer as well.

Melanie Cole, MS: That is exciting. It's a pretty exciting time in your field. And what about some of the treatments for refractory or recurrent disease? What's going on in that realm?

Dr. Deanna Huffman: So again, that's another area where TIL therapy would be very useful, very exciting. We also offer clinical trials, immunotherapy-based clinical trials, TIL-based clinical trials and then, of course, BRAF-directed therapy. So, we use genetic sequence like in most cancers nowadays, to look for specific gene targets, namely one being BRAF, which can be positive in up to two-thirds of melanoma patients. And we can use targeted therapies as well for advanced cases.

Melanie Cole, MS: Yeah, TIL therapy is pretty exciting. And do you have any clinical trials, Dr. Huffman, going on at AHN that you want to mention to other providers?

Dr. Deanna Huffman: Sure. So, we actually have two clinical trials going on right now for TIL therapy. The first one is called Obsidian. And so, that's for patients in kind of the typical setting, patients who have relapsed metastatic melanoma refractory disease who have failed one line of therapy. But the cool thing about this clinical trial, it's looking at ways to reduce toxicity from TIL therapy and easier ways to get the TILs out of the patients in a safer, more effective way. So, that's a trial that most patients would be eligible for with refractory disease. So, we definitely encourage referral for your advanced patients.

Another trial we have going on is called Iovance Melanoma, and that's actually a first-line metastatic trial, which is really exciting. So, patients with newly diagnosed, advanced or metastatic disease, they've never had any treatment before. And that's looking at the combination of immunotherapy alongside TIL therapy. So again, if you have any questions at all, we encourage you to reach out to the AHN Skin Cancer website. Send us a message, send us a referral on Epic, and we'd be happy to evaluate your patients for clinical trials.

Melanie Cole, MS: Well, it seems like you have a lot more tools in your toolbox. And when someone hears a diagnosis of melanoma, Dr. Huffman, it can be life-altering. You know that it hasn't gotten great rep in the media. And so, speak a little bit about working with the patients and their families and the psychosocial aspect of this while they're trying some of these available therapies.

Dr. Deanna Huffman: Yeah, I think one of the things that is most interesting about melanoma is that it is so heterogeneous. You know, it doesn't discriminate. We can see patients of all ages. We see young, healthy patients. And we often see elderly patients as well. And the good thing about that is it opens us up to a lot more treatment options when the patients are a little more healthy to start. It also allows us for a higher chance of cure. These patients often go on to live very long lives. So, it's really important to consider early therapies and the toxicities that may come with therapies. So, it's really given us a chance to take a holistic approach to cancer care at the Skin Cancer Center at West Penn.

Melanie Cole, MS: Dr. Huffman, as we get ready to wrap up, you've mentioned early referral a few times. I'd like you to describe a little bit about what that really means to referring physicians, dermatologists, community physicians, and what makes the AHN Cancer Institute at West Penn really that center of excellence.

Dr. Deanna Huffman: Yeah. I think, for us, early referral means the first-time you notice an abnormal lesion or even prior to that, when you have a patient who has a strong family history of things like melanoma and other skin cancers, or maybe at high-risk because of their history of sun exposure or other immunosuppressive medications, we're always happy to see those patients.

And the reason is because we have so many tools at West Penn. We have excellent surgical oncologists who are up-to-date in the most appropriate ways to surgically resect melanomas because there are a couple different methods out there. And then, also, we have multiple medical oncologists who can evaluate patient's need for therapy, even before surgery.

So, that's what we mean by getting the patient in the soonest possible. It's always going to be helpful for us in getting them the best options for treatment, the best options for surgery, and then help us get them plugged into appropriate screening, all of which we can offer at West Penn.

Melanie Cole, MS: Thank you so much, Dr. Huffman, for joining us today. You've given us a lot to think about and so much great information. Thank you so much again. And to learn more or to refer your patient to Dr. Huffman, please call 844-MD-REFER or visit findcare.ahn.org. Thank you so much for listening to this edition of AHN Med Talks with the Allegheny Health Network. I'm Melanie Cole. Thanks so much for joining us today.