Recently published papers from GWUMC researchers could offer a prospect for anticancer drugs as well as the early diagnosis and treatment of invasive melanoma.

The September 2002 issue of Journal of Investigative Dermatology, the leading research journal in its field, features two papers from researchers Drs. Raymond Barnhill and Claire Lugassy, GWUMC colleagues, and a commentary about the research. The papers provide data to demonstrate that tumor cells spread along the external surface of vessels to migrate and metastasize, rather than crossing the vascular basement membrane. This migration mechanism has been termed Extravascular Migratory Metastasis by Drs. Lugassy and Barnhill in former works. Drs. Barnhill and Lugassy, principal investigators, say that it is the extravascular type of migration that could explain the latency between the development of a primary tumor and
the appearance of the first metastasis, usually in the regional lymph nodes.

Dr. Barnhill's paper suggests that there is a unique association between tumor and vascular cells, which is termed “angiotropism,” and that this phenomenon (angiotropism) could be a prognostic factor predicting risk for metastasis.

Dr. Lugassy's paper indicates that the melanoma cells exhibit angiotropism and migrate along the external surface of vascular tubules grown in culture.

The duo came to GW nearly two years ago—Dr. Barnhill as chair of the Dermatology Program and Dr. Lugassy as a research associate professor. Since coming to GW, Dr. Barnhill, a melanoma expert and member in the World Health Organization Melanoma Program, has secured accreditation from the Accreditation Council for Graduate Medical Education, opened a melanoma clinic and expanded the research activities of the Department of Dermatology.

According to Dr.Barnhill, the incidence of melanoma is doubling every 10 years with an estimated 1 in 75 persons developing the disease in the U.S. Drs. Barnhill and Lugassy hope that their research findings and ongoing work will enable earlier diagnosis and treatment. “The implications of the research are that it potentially shows that cancer may spread by another mechanism (in addition to spreading through lymphatics and blood) not previously considered,” say Drs. Barnhill and Lugassy. “The manner of spread could explain the stepwise or regional pattern of melanoma (and other solid tumor) metastasis. This type of spread suggests a reversion to an embryonic phenotype and mechanism of cellular migration through tissue, perhaps recapitulating embryonic development.” Both credited the support of Dr. Steven Patierno of GW and Dr. Hynda Kleinman at
NIH as well as their GWUMC colleagues as instrumental to their work.

Their next step is to try to discover “more specific markers for angiotropism to facilitate identifying it in tumors and to identify angiotropism as early as possible in developing melanomas and correlate this with patient outcomes,” according to the two. “We also want to try to better define the interactions between the external blood vessel and melanoma cells so that we better understand why this interaction occurs and perhaps how to disrupt or block it.”

- Reprinted with permission from Progress , October 2002