When melanoma oncologist and clinical investigator Sapna Patel, MD, arrived at the University of Colorado Cancer Center last summer, she hit the ground running.
Patel was recruited from the MD Anderson Cancer Center in Houston to be leader of the Cutaneous Oncology Program at the CU Division of Medical Oncology. In less than a year at the CU Anschutz Medical Campus, she has relaunched a melanoma clinical trials initiative, with seven trials slated to open by the end of summer; attracted new grant funding for research; and established a clinical partnership to investigate eye melanoma.
The melanoma clinical trials team is “very excited,” Patel says, adding that the coming flurry of activity offers “major opportunities” for patients with all types of melanoma.
The trials opening soon include studies of neoadjuvant therapy (given before surgery); a biomarker study of tebentafusp immunotherapy for uveal melanoma, a rare cancer that affects parts of the eye; a study under the National Cancer Institute’s National Clinical Trials Network for mucosal melanoma, involving the inner lining of some organs and body cavities; and several studies for cutaneous (skin) melanoma including cell therapy, oncolytic agents, and novel immunotherapies.
“Once we have these clinical trials going, it’s an ‘if you build it, they will come’ situation,” Patel says. “We’ll draw even more patients than we already have from across the Southwest and probably even beyond, because we will most likely have a clinical trial that’s appropriate for any number of patients with melanoma and skin cancer.”
Patel looks forward to welcoming new colleagues to the CU Cancer Center’s melanoma program in the near future. “The program is on track for growth. As these trials come on board and we treat more patients, we’ll be able to justify new staffing,” she says. “By this time next year, we should have a new melanoma surgeon.”
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Sapna Patel, MD (front row, center) and her clinic team at the Melanoma Research Foundation gala in Denver in September 2024. Photo courtesy Sapna Patel.
Focus on rare melanomas
The American Cancer Society projects about 105,000 new melanoma diagnoses across the United States this year, and about 8,400 deaths. In Colorado, the society predicts 2,060 new cases this year, and about 160 deaths. When detected and treated early, melanoma is often curable, but advanced melanoma that has spread can be challenging to treat.
Patel’s mission at the CU Cancer Center includes growing the rare-melanoma program, dealing mostly with non-sun-related melanomas. Patel focuses much of her own research on uveal melanoma, which affects the choroid layer, the ciliary body, or the iris of the eye. It’s a relatively rare but dangerous disease that, if left untreated, can spread to the liver and other organs. Other rare melanomas include mucosal and acral (involving hands, feet, and nails).
Patel, who has a secondary appointment in the CU Department of Ophthalmology, has started a clinic at the Sue Anschutz-Rodgers Eye Center on the CU Anschutz Medical Campus with another CU Cancer Center member, Scott Oliver, MD, associate professor of ophthalmology and director of the Eye Cancer Program.
“We have a joint practice where we see patients together,” she says. “It’s great for patients to see the ophthalmologist and the cancer doctor together. He dilates them, and then it takes about an hour for that dilation to kick in, and they’re not doing anything at that time, so I slide in and do my visit with them rather than them having to navigate multiple clinics and different buildings.”
Through the joint clinic, Patel and Oliver have begun banking and sequencing donated patient uveal tumors. “We hope in a few years we’ll have several hundred tumors where we know the sequence, we know the outcomes of these patients, and we can start to connect those dots. Are certain mutations connected with a more aggressive form of this melanoma? And what are the mutations telling us about causative risk factors or opportunities to monitor for cancer recurrence?”
Studying a cold tumor
Meanwhile, Patel is now about six months into a four-year, $2 million U.S. Department of Defense grant she brought with her CU – a collaboration with the University of Pittsburgh’s Hillman Cancer Center to study metastatic uveal melanoma. It’s considered a “cold tumor,” meaning it doesn’t trigger a strong immune response and often lacks T cell infiltration, making it less responsive to immunotherapy. The joint project seeks to uncover drivers of response that could lead to novel immunotherapeutic treatments.
Patel also has landed her first grant that she has applied for as a CU investigator: A three-year, $375,000 award from the Melanoma Research Alliance, the world’s largest nonprofit funder of melanoma research. The grant will fund Patel’s study of blood samples from skin melanoma patients to look for predictors of response and toxicity.
The new study is tied to Patel’s role as chair of the Melanoma Committee of the SWOG Cancer Research Network (formerly the Southwest Oncology Group), a global cancer research community.
“SWOG just had a trial of patients who were on treatment from one to five years, and from those patients we have about 25,000 vials of blood by permission of the patients, and this grant helps to fund that analysis,” she says. “We have the outcomes, how these patients did on treatment, and now we have the funding to analyze their blood, which is fantastic.”
And Patel notes that the CU Cancer Center will be co-sponsoring the Melanoma Research Foundation’s Denver Miles for Melanoma 5K fundraiser at Sloan’s Lake Park on Saturday, June 14. The cancer center’s “We All Scream for Sunscreen” team will take part.
Coming from a standalone cancer center on its own campus at MD Anderson, Patel says the fact that the CU Cancer Center is part of a multidisciplinary academic medicine campus “has a unique set of advantages. When I have an informatics problem, or an infectious disease issue, we have people and expertise here. There’s probably no problem I might encounter that we wouldn’t have resources here to help address.”
Photo at top: Sapna Patel, MD (third from right) and her clinic team pose in the clinic in front of a skin cancer poster. Photo courtesy Sapna Patel.
