Clinical Trial Finder

Inclusion Criteria:

Patients will be eligible for inclusion in this trial if all the following criteria apply: 1. Patient has provided written informed consent using the IMPACT Patient Information and Consent form (PICF) 2. Diagnosis of melanoma (Stage II, III or IV) in the de novo or recurrent setting. 3. Has a life expectancy of greater than or equal to 1 year. 4. Planned to receive ICI treatment, either in the neoadjuvant, adjuvant or metastatic setting, including as:

• - Monotherapy.

• - Combination therapy.

For cohort 1: premenopausal women with melanoma. 5. Age greater than or equal to 18 and less than or equal to 45 years at the time of signing consent. 6. Patient is premenopausal (defined as baseline FSH within the premenopausal range per local laboratory at registration). Women on hormonal contraception who have an abnormal FSH level, will be included if their AMH level is greater than or equal to 1.0 pmol/L at registration. 7. AMH level greater than or equal to 1.0 pmol/L at registration. For Cohort 2: men with melanoma. 8. Age greater than or equal to 18 and less than or equal to 60 years at the time of signing consent. 9. Fasting morning total testosterone, LH and FSH within the normal range (per local laboratory) at the time registration.

Exclusion Criteria:

Patients will not be eligible for inclusion in this trial if any of the following criteria apply: 1. Previous removal of both ovaries (females) or previous removal of both testes or previous vasectomy (males) 2. Planned for or previously had pelvic radiotherapy. 3. Any medications within the prior 6 months known to disrupt the hypothalamic pituitary gonadal axis, e.g., GnRH agonists or antagonists, selective estrogen receptor modulators (SERMs), aromatase inhibitors, testosterone, anabolic steroids, etc. 4. Previous or concurrent alkylating or platinum-based chemotherapy within the last 2 years. 5. Previous use of ICI. 6. History of hypogonadism. 7. Presence of any psychological, social, geographical, or other condition for which, in the opinion of the site Investigator, participation would not be in the best interest of the patient (e.g., compromise the well-being) or that could prevent, limit, or confound the protocol-specified assessments

While immune checkpoint inhibitors (ICIs) are widely used in young melanoma patients and may cause immune-related side effects, their impact on human gonadal function is unknown. Eligible patients will be identified by their oncologist and provide informed consent. Menstrual/contraceptive history, sexual function questionnaires, and blood samples for gonadal biomarkers will be collected at baseline, 3, 6, and 12 months. Semen and testicular volume (in a subset) will be assessed in men at baseline and 6 months. Patients who cease ICI before the 12 month timepoint will have also have an end of treatment assessment within 4 weeks of stopping treatment. Patients will be asked to consent to the future use of their biological samples collected during the trial. Samples will be securely stored at Peter MacCallum Cancer Centre, coded, and linked to clinical data. Patients can request sample destruction at any time, but past analyses cannot be undone. The Sponsor or delegate will manage trial data, while sites are responsible for data entry and resolving queries. Data will be entered into REDCap, a secure system hosted by Peter MacCallum Cancer Centre. Site staff will be trained, and only authorized personnel listed on the delegation log may complete eCRFs.

Arms

: Cohort 1: premenopausal women with melanoma

Cohort 1: premenopausal women with melanoma, aged ≤45 years, to describe the change in: 1. ovarian reserve (using serum AMH), 2. ovarian function (using serum LH, FSH, oestradiol and related sex steroids), 3. menstrual pattern, 4. sexual function (using the European Organisation for Research and the Treatment of Cancer questionnaire for the assessment of sexual health in cancer patients (EORTC QLQ SH22), and 5. circulating cytokine levels before, during and after ICI treatment.

: Cohort 2: men with melanoma

Cohort 2: men with melanoma, aged ≤60 years, to describe the change in: 6) testicular function (using serum testosterone, FSH, LH, Sex Hormone Binding Globulin (SHBG), inhibin B and related sex steroids), 7) semen parameters (sperm concentration, count, motility, morphology), 8) sexual function (using the EORTC QLQ SH22 questionnaire, International Index of Erectile Function 5 questionnaire (IIEF-5) and the Psychosexual Daily Questionnaire Question 4 (PDQ-Q4)), 9) testicular volume (using orchidometry) in a subset of patients, and 10) circulating cytokine levels before, during and after ICI treatment.

Interventions