Determining whether a melanoma remains confined to the surface of the skin or has progressed to an invasive form can be one of the most challenging decisions clinicians face.
Thanks to funding support from the Australian Melanoma Research Foundation awarded in 2022 in honour of Warren Meanwell, researcher Dr Bruna Melhoranse Gouveia from Melanoma Institute Australia and The University of Sydney has spent the past several years tackling this challenge through her groundbreaking Lentigo Maligna Spectrum Project.
The project focused on lentigo maligna, the most common form of melanoma in situ in Australia. While lentigo maligna itself remains confined to the upper layers of the skin, some lesions progress to an invasive form known as lentigo maligna melanoma, which can require more extensive treatment and carries a greater risk to patients.
The question facing clinicians is a critical one: How can we accurately distinguish an early melanoma from one that has already become invasive?
“It is an honour to be awarded the Inaugural Warren Meanwell Melanoma Research Grant 2022. We hope our work will make a real difference that will ultimately improve outcomes for melanoma patients. Thank you.”
Distinguishing between early-stage and invasive disease is not always straightforward. Current diagnostic methods can struggle to identify the most concerning areas within larger lesions, making treatment decisions more complex.
Improving diagnostic accuracy has the potential to help clinicians determine when surgery is necessary, when less invasive treatments may be appropriate, and how best to manage each individual patient.
To address this challenge, Dr Gouveia’s research explored the use of Reflectance Confocal Microscopy (RCM), an advanced imaging technology that allows clinicians to examine skin cells in real time without the need for surgery.
Using this technology, the research team investigated how specific imaging features could be used to identify microscopic signs of melanoma invasion.
The findings demonstrated that RCM can help clinicians detect invasive components within lentigo maligna lesions more accurately and identify the most suspicious areas for biopsy.
This non-invasive approach has the potential to improve diagnostic confidence while helping ensure patients receive the most appropriate treatment.
A New Tool for Melanoma Diagnosis
One of the most significant outcomes of this project was the development of the Lentigo Maligna Spectrum Score: a new diagnostic scoring system designed to improve clinicians’ ability to distinguish between benign sun-damaged skin, early melanoma, and invasive melanoma.
The research showed that the tool significantly improved diagnostic accuracy, representing an important step toward more personalised and precise melanoma care.
By helping clinicians better understand where a lesion sits along the melanoma spectrum, the scoring system may support earlier diagnosis and more informed treatment decisions in the future.
While further research and validation are still required, the findings from this project have the potential to deliver earlier and more accurate diagnosis, improved detection of invasive melanoma and better targeted biopsies.
For patients, this could mean receiving the right treatment sooner while avoiding unnecessary interventions.
Building the Future of Melanoma Research
The project also highlights the importance of supporting emerging researchers who are dedicated to improving outcomes for people affected by melanoma.
Since receiving the inaugural Warren Meanwell Melanoma Research Grant in 2022, Dr Gouveia has continued to build on this work, contributing to ongoing advances in melanoma diagnosis and management.
Reflecting on the support she received, Dr Gouveia said:
“It is an honour to be awarded the Inaugural Warren Meanwell Melanoma Research Grant 2022. We hope our work will make a real difference that will ultimately improve outcomes for melanoma patients. Thank you.”
As melanoma rates continue to rise, research projects like the Lentigo Maligna Spectrum Project are helping bring us closer to a future where melanoma can be detected earlier, diagnosed more accurately, and treated more effectively.
Every breakthrough begins with research, and every research project begins with support from a community committed to changing the future of melanoma.
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