Background Explained: Utah has the highest incidence of melanoma per 100,000 individuals in the United States. While fewer people from minority communities such as Native Americans, Hispanics/Latinos, and African Americans develop melanoma, they tend to have lower survival rates. Challenges in accessing dermatology care, economic hurdles, and limited health knowledge are suspected to play a part in these disparities. We aim to understand from patients, providers and community leaders how these factors interplay to affect optimal melanoma care with the goal to develop targeted, actionable interventions in the future. Importance: By pinpointing the specific obstacles faced by minoritized groups in Utah with regards to melanoma diagnosis and optimal treatment, we will work collaboratively with our community partners to create targeted interventions that resonate with them to improve melanoma outcomes. populations. Method: Our research involves gathering insights through focus group discussions with melanoma patients, healthcare workers, and minoritized community leaders. Before these discussions, participants will be surveyed to assess their perceptions, beliefs, and knowledge regarding melanoma and its care disparities. These conversations will delve into the real-life challenges they face, informed by their personal experiences and cultural contexts. We aim to capture the subtleties of these challenges through careful listening and analysis. Expected Insights: We expect to identify specific barriers and cultural nuances that hinder optimal melanoma care for these communities. The knowledge gained will inform policy changes and suggest modifications in clinical practice, all designed to reduce the disparities in melanoma outcomes.

Despite being the second most common group in the U.S. to be diagnosed with melanoma after non-Hispanic whites, Hispanics have significantly more-advanced-stage diagnoses and significantly higher mortality rates from melanoma than do non-Hispanic whites. The reasons behind this are multifactorial and include the important aspect of decreased melanoma awareness in this population, as well as decreased access to care. Our proposed project will take place at a clinic for the underserved and include a volunteering board-certified dermatologist and patient education about prevention and recognition of melanoma, as well as the ability to schedule an appointment with the volunteering dermatologist, thus uniquely affording participants both self-empowering education and real access to specialist care. This is a practical, boots-on-the-ground project that could serve as an effective example of improving access to care and decreasing disparities in melanoma awareness and prevention. Research is critical to assess efficacy and to appraise systems utilized to draw conclusions and make recommendations for future possible models.

Melanoma is the fifth most common cancer in the United States, with over 97,000 new cases diagnosed in 2023. Localized melanoma has favorable outcomes with a 5-year relative survival rate of 90%. However, metastatic melanoma remains difficult to treat, with a 5-year relative survival rate of 32%. These statistics emphasize the importance of trying to prevent the spread of melanoma (metastasis) and to improve treatment. Previous work has shown that a receptor located on the surface of melanoma tumor cells, called erythropoietin receptor (EPO-R), is associated with metastasis and drug resistance. Research from the field of blood cancer has shown that the interaction of EPO-R and a protein inside the cell called RasGPR3 causes blood stem cells to move into the bone marrow. Notably, recent work has shown that prior to metastasis, a small group of melanoma cells leave the tumor site on the skin and travel to the bone marrow. While in the bone marrow, these melanoma cells start to develop characteristics of the blood stem cells that are naturally found there. Given these findings, we propose that melanoma cells move into the bone marrow where their levels of EPO-R and RasGRP3 increase, which allows melanoma cells to migrate to different parts of the body (metastasize) and develop drug resistance. Previous work in our lab has allowed for the creation of a new compound, called URV3, that blocks EPO-R. In our studies, URV3 has been effective in preventing the movement of leukemia cells and blood stem cells. We aim to use URV3 to block EPO-R in melanoma cells and decrease cell movement by lowering EPO-R and RasGRP3 levels. We also predict that URV3 will increase the ability of melanoma cells to respond to treatment.