Report Back 12 th Canadian Melanoma Conference February 22 24, 2018

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1 1 Report Back 12 th Canadian Melanoma Conference February 22 24, 2018

2 2 Below is a report back of major themes gleaned from the 12 th Annual Canadian Melanoma Conference along with some photos, anecdotes, and learnings from the event. The Canadian Melanoma Conference (CMC) is Canada s international flagship meeting on the research and treatment of melanoma. This event took place February 22nd-24th, 2018 at the Fairmont Banff Springs Hotel in Banff, Alberta, Canada. This conference brings together medical oncologists, surgeons, dermatologists, radiotherapists, pathologists, molecular biologists, immunologists, and other allied health professionals interested in the treatment of melanoma worldwide. Representatives from Save Your Skin Foundation attended all of the presentations, workshops, and plenary sessions included in the program, and highlighted key points and interesting notes on our social media accounts. We also hosted a booth with educational materials and informational items from fellow interested groups, namely Alberta Society of Melanoma, Canadian Dermatology Association, Canadian Skin Patient Alliance, and David Cornfield Melanoma Fund. Also at this table was a group of patients on hand to greet physicians and industry representatives who wished to meet them and discuss the patient experience and it s relevance to the treatment of melanoma in Canada.

3 3 The Welcome Address was delivered by Dr. Scott Ernst on the evening of the 22 nd, to open the conference and begin a productive conference attended by varied medical professionals from around the world. In addition to many Canadian doctors, there were melanoma experts from Australia, Switzerland, and the United States, among others, openly discussing their research, best practices, and varied findings in the field. Dr. Ian Watson presented his work in driver mutations in melanoma, creating a framework for targeted and immune therapy. Following that, Dr. Phil Halloran presented on Predictive Immunological Markers. Should any reader of this report wish to have more detail on any of the presentations titles mentioned, they can contact Save Your Skin Foundation for provision of more detail. Throughout the following two days, the popular topics in melanoma were discussed in sessions. The latest news in the field included the following: New AJCC Classification (Staging Guidelines) Immuno-intervention in patients with Merkel Cell Carcinoma The debate between Completion Lymph Node Dissection vs. Observation, post-mslt-ii Trial Updates in the field of Dermoscopy Advancements in testing and treatment of melanoma in the adjuvant setting Many de-identified patient case studies were cited as examples and served as reference points for the experience gained and presented by each physician. It was fascinating to watch the collaboration in action, and, as a patient group we were grateful to be given the opportunity to attend, and to witness the work being done by this collection of caring individuals who are evidently passionate about their work.

4 4 New AJCC Classification: What s In and What s Out? Presented by Dr. Charles Balch On January 1, 2018 the new staging guidelines went into effect for melanoma staging. The American Joint Committee on Cancer (AJCC) Eighth Edition Cancer Staging Manual can be found online. In this presentation at CMC, Dr. Balch outlined the summary of changes to staging guidelines and how they affect patients survival rate and treatment options. These new guidelines were also referred to several times in subsequent presentations with the challenges presented by an updated system. Physicians indicated that it will take some adjustment to realize the new guidelines on an every day basis. Abstract: To update the melanoma staging system of the American Joint Committee on Cancer (AJCC) a large database was assembled comprising >46,000 patients from 10 centers worldwide with stages I, II, and III melanoma diagnosed since Based on analyses of this new database, the existing seventh edition AJCC stage IV database, and contemporary clinical trial data, the AJCC Melanoma Expert Panel introduced several important changes to the Tumor, Nodes, Metastasis (TNM) classification and stage grouping criteria. Key changes in the eighth edition AJCC Cancer Staging Manual include: 1) tumor thickness measurements to be recorded to the nearest 0.1 mm, not 0.01 mm; 2) definitions of T1a and T1b are revised (T1a, <0.8 mm without ulceration; T1b, mm with or without ulceration or <0.8 mm with ulceration), with mitotic rate no longer a T category criterion; 3) pathological (but not clinical)

5 5 stage IA is revised to include T1b N0 M0 (formerly pathologic stage IB); 4) the N category descriptors microscopic and macroscopic for regional node metastasis are redefined as clinically occult and clinically apparent ; 5) prognostic stage III groupings are based on N category criteria and T category criteria (ie, primary tumor thickness and ulceration) and increased from 3 to 4 subgroups (stages IIIA- IIID); 6) definitions of N subcategories are revised, with the presence of microsatellites, satellites, or intransit metastases now categorized as N1c, N2c, or N3c based on the number of tumorinvolved regional lymph nodes, if any; 7) descriptors are added to each M1 subcategory designation for lactate dehydrogenase (LDH) level (LDH elevation no longer upstages to M1c); and 8) a new M1d designation is added for central nervous system metastases. This evidence-based revision of the AJCC melanoma staging system will guide patient treatment, provide better prognostic estimates, and refine stratification of patients entering clinical trials. CA Cancer J Clin 2017;67: V C 2017 American Cancer Society. Patients seeking more information about the changes in this system should ask their oncologist for more information.

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7 7 Updates and best practices in Dermatology and Diagnosis: Difficult to Diagnose Melanomas Interactive Session on Dermoscopy Presented by Dr. Ashfaq Marghoob & With Dr. Ashfaq Marghoob and Dr. Joel Claveau

8 8 Dermatology and Surgical Oncology - Imaging in Melanoma: Staging and Surveillance With Dr. Merrick Ross, Dr. Denise Chan, Dr. Alina Makoyevna, Dr. Thomas Salopek Highlighting the advantages of Neoadjuvant Therapy in melanoma - Dr. Merrick Ross

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10 10 In addition to gaining insight into the research of and advancements being made in the treatment of melanoma, Save Your Skin Foundation presented findings from our 2017 survey regarding the affect of a melanoma diagnosis on patients mental health. The display of our first poster was a warming experience alongside the booth presence we had and the conversations we participated in. We had the opportunity to answer questions about our present work and the objectives we will strive to meet in the coming year. Very excited to debut our scientific poster titled: THE AFFECTS OF MELANOMA ON THE MENTAL WELLNESS OF PATIENTS, AND THE LANDSCAPE OF MENTAL HEALTH SUPPORT IN THE CANADIAN MELANOMA COMMUNITY We intend to continue work in this area, and we plan to publish this poster at an event in the coming year. For more information about anything contained in this report, please contact Save Your Skin Foundation at The information in this report is not intended to replace the medical advice of a doctor or healthcare provider. If you have any questions about what you have read here please do not hesitate to ask your doctor, and/or you can contact us and we will help to connect you to further information.