War on Melanoma: Taking it to the Streets with MoleMapper & Screening

Transcription

1 War on Melanoma: Taking it to the Streets with MoleMapper & Screening Sancy Leachman, MD, PhD Winship Cancer Institute 2018 Atlanta, GA; Saturday, March 3, 2018 Rollins Auditorium

2 Conflicts of Interest: - MoleMapper App: None, free and open source. - Skin Cancer Free: Medical Director, non-profit Arm of DermDetect, mobile teledermoscopy company - Myriad Genetics & Castle Biosciences: Received honorarium as MSAB member, Early Access Programs, not relevant to this presentation

3 Guiding Principles of Melanoma Screening Early detection of melanoma (when a cure is still possible) is dramatically better than effective therapy because it: Reduces disfigurement Reduces side effects from aggressive therapies Prevents long-term side effects of aggressive therapies Saves lives that don t respond to aggressive therapies Reduces cost

4 The Vision (AKA Unattainable Goal): Every Potentially Lethal Melanoma Detected & Removed Before It Can Kill

5 Different Populations LOWER RISK Moderate Risk Population 1 in Affected 2-4 fold risk Suspicious Lesions High-Risk Population 1 in Affected 5-10 fold risk HIGHER RISK Melanoma Patient General Population 1 in 100 Affected Suspicious Lesion Ultra-High Risk Hereditary Population 1 in 2-3 Affected 30 fold risk

6 LOWER RISK Different Populations, Different Tools Social Media Educational Campaigns Mobile Phone Apps Skin-Related Services Opportunistic Screens Basic Screenings Primary Care Dermatology Moderate Risk Population 1 in Affected 2-4 fold risk Teledermatology Teledermoscopy Dermatology Diagnostic Imaging Dermoscopy In-Vivo Confocal OCT Suspicious Photoaccoustic Lesions High-Risk Population GEP 1 in Tape-stripping Affected 5-10 Molecular fold Pathology risk Molecular Diagnostics HIGHER RISK Melanoma Patient General Population 1 in 100 Affected Suspicious Lesion Deep Learning / Artificial Intelligence Image Recognition & Non-invasive Bx Genetic Testing Ultra-High Risk Pigmented Lesion Clinic Hereditary Population Multidisciplinary Care Whole 1 in 2-3 Body Affected Imaging 30 fold risk Lesion Registration

7 LOWER RISK Different Populations, Different Tools Social Media Educational Campaigns Mobile Phone Apps Skin-Related Services Opportunistic Screens Basic Screenings Primary Care Dermatology Moderate Risk Population 1 in Affected 2-4 fold risk Teledermatology Teledermoscopy Dermatology Dermoscopy Diagnostic Imaging In-Vivo Confocal OCT Suspicious Photoaccoustic Lesions High-Risk Population GEP 1 in Affected Tape-stripping 5-10 Molecular fold Pathology risk Molecular Diagnostics HIGHER RISK Melanoma Patient General Population 1 in 100 Affected Suspicious Lesion Deep Learning / Artificial Intelligence Image Recognition & Non-invasive Bx Genetic Testing Ultra-High Risk Pigmented Lesion Clinic Hereditary Population Multidisciplinary Care Whole 1 in 2-3 Body Affected Imaging 30 fold risk Lesion Registration

8 The War on Melanoma in Oregon: A Statewide Experiment on Early Detection Massive Public Education Campaign Providers Skin Care Services Lay Public Grass Roots AND Top-Down Discovery of Suspicious Lesions Screening & Biopsy If Needed Early Stage Removal If Needed Expansion To Other States INTERVENTION Experimental Design Baseline Measures: Obstacles Tumor Depth/Stage Cost Comparison to controls Refine & Repeat Unsuccessful Repeated Measures Successful

9 A Massive Campaign Requires A Massive Army Melanoma Community Registry Patients Family Friends 9 Education: Symposia Curriculum Teach-the-teachers Outreach Activism: Legislation Community Events Fundraising Research: Questionnaires Imaging Phone Apps New Tests Biannual Symposia Event Reach >100,000 on social media Passed a school sunscreen bill 7679 research participants (3236 Melanoma patients)

10 Activating The Full-Spectrum Operations Pyramid Population Outreach Method Screening Technique Melanoma Dermatology & Multidisciplinary Melanoma Clinics CODE, specialty clinics, advanced skin imaging High-Risk Population Oregon Dermatologic Society Telederm, in-person clinics, referrals, dermoscopy, biopsies Suspicious Lesions State Medical Boards & Societies, PCPs E-visits, e-consults, in-person clinics Modified INFORMED Curriculum 10 General Population Melanoma Community Registry Oregon Health Authority MoleMapper, Mobile Screening

11 11 Melanoma Community Registry Data

12 Crowdsourcing Research: Melanoma Community Registry 12

13 War On Melanoma Community Registry

14 MoleMapper: A Research Tool PHI Strip Identifiers OHSU War on Melanoma Cohort De-Identified Data Linkers Sage Bionetwork Consent to Share Data Image Analysis & Challenges Human Research Citizen Science Mole Map Keep Data On Phone No back-up Optimization 14

15 3 Goals for Mole Mapper App For The People - Provide a free, quantitative mole-tracking tool 15 For Providers & Patients: Facilitate productive patient visits Clinician Participant Researcher For Researchers: Conduct a large-scale, Crowdsourced research study Download in the App Store, Instructional Materials Available

16 Ways to Get Involved 1. Check out WOM Progress at 2. Encourage interested people/patients to join the Melanoma Community Registry. 3. Promote the use of Mole Mapper V app 4. Contact me with ideas, questions & suggestions: 16 16

17 Acknowledgements WOM Oregon Thought Leaders Thought Leaders Lisa Domenico Eric Smith Pamela Cassidy Oliver Wisco Tracy Petrie Ravi Samatham Anuja Shah Faith Tirrell Terri Rivera OHSU & Knight Cancer Institute Sage & Apple Dan Webster Andrew Trister Stephen Friend Divya Nag Rhoda Alani Diane Baker Marianne Berwick Suephy Chen Clara Curiel Lee Eberting Rick Edelson Karen Edison Alan Geller Jeff Gershenwald Valerie Guild Allan Halpern Mo Kashani-Sabet Jim Kean John Kirkwood Cont d David Norris Suzanne Olbicht Darrell Rigel Debjani Sahani Susan Swetter Paul Tumeh Martin Weinstock John Zone Melanoma Prevention Working Group (MPWG) Pigmented Lesion Subcommittee International Melanoma Working Group & AIM SMR/MRA/MRF DermDetect & Skin Cancer Free Larry Findleton Roger Sparks Rob Schumacher Ed Yokum Sharon Liese CUREate Your Canvas Terri Rivera 17

18 Thank you!