Melanoma in Children, Adolescents and Young Adults (MELCAYA)

Better Understanding of Risk Factors and Progression of Melanoma in Children, Adolescents and Young Adults to Implement Health Care Strategies (MELCAYA; European Commission)

Melanoma in childhood and adolescence is under-studied, lacking adequate preventive, diagnostic, and therapeutic strategies. The incidence of melanoma is reported to be about 1.3-1.6 per million in children under 15 years of age and 15 per million in 15-19 y.o., with increasing incidence in adolescents by 4.1% annually since 1997. Additionally, melanoma is among the most frequent solid tumors diagnosed in young adults, having in Europe an incidence of 6.6 per 100.000 and a mortality of 4 per million. Little is known about the interaction between genetic and environmental factors associated with melanoma risk in this context or in the progression from benign nevus to melanoma. As benign melanocytic lesions develop in nearly every child and are present in over 1% at birth, the diagnostic accuracy of melanoma is very low in this age group. A large number of benign lesions are unnecessarily excised (593.8 benign nevi per melanoma under 20 y.o.). Furthermore, lower sensitivity than in adults results in late diagnosis with poorer outcomes, when children, adolescents and young adults (CAYA) patients, particularly the children, could show a 90% 10-year survival rate from stage I/II disease. Thus, melanomas in CAYAs represent a medical challenge. Increasingly, machine learning algorithms are starting to play an important role in melanoma diagnosis. However, these algorithms are based on adult data with a selection bias that could be detrimental and potentially dangerous with respect to both melanoma underdiagnosis and overdiagnosis in CAYA.

Within a consortium of international experts in melanoma from diverse areas, international reference hospitals for pediatric and adolescent patients, AI data scientists, basic researchers, innovative technologic SMEs and patient associations, the Brinker group at the DKFZ is the PI for the development of strategies for digital prevention and early detection for melanoma in CAYAs.

The main aim of the overall project is to obtain insights into the mechanisms of melanoma development and progression in CAYA to develop novel strategies for prevention and innovative technologies for diagnosis and prognosis.