Department of Plastic- and Breast Surgery, Louise Bønnelykke

Metastasis from a primary melanoma is the leading cause of melanoma-related death. While surgery is the treatment of choice in localized disease, immunotherapies have been proven beneficial to survival in patients with metastatic melanoma. However, relapse within the first years after surgery and acquired resistance to immunotherapy is a clinical problem. While surgery is favourable in some patients, one hypothesis is that inflammation may hasten metastatic development for others, providing optimal conditions for preexisting metastases. Our previous zebrafish results have shown that by blocking prostaglandins, a trophic signal expressed by the inflammatory cells, tumour progression was reduced. Interestingly, a clinical study from our collaborators, analyzing women with breast cancer, perioperative anti-inflammatory drug (Keterolac), decreased early relapses by 60%. We aim to test whether Keterolac can prevent remnant tumour cells during melanoma surgery.

These proposed studies will address the role of the immune-contexture in melanoma progression. We will screen for factors that will elevate T cell recruitment to tumours in the zebrafish model (Harvard University) and conduct a clinical study with perioperative anti- inflammatory drugs (Danish Melanoma Group), aiming to improve the current treatment and to bring forth new treatment modalities for patients with melanoma.