Monitoring the progression of advanced cutaneous melanoma through a simple blood draw or urine sample, in order to obtain information that can help personalise therapies and make them less invasive for patients. This is the goal of EXOMEL, the new research project coordinated by the University of Trieste, which will study the use of liquid biopsy to monitor a form of cancer in which the ability to observe disease progression accurately can have a significant impact on therapeutic decisions.

The project, entitled “Exosomal microRNA from liquid biopsy for the monitoring and personalisation of treatments for advanced cutaneous melanoma”, aims to develop and validate innovative diagnostic technologies, shared among the clinical centres involved, to make treatments increasingly targeted, effective and tailored to the characteristics of each patient. The most innovative aspect concerns the use of urine samples as a form of liquid biopsy: EXOMEL will study exosomes, small vesicles involved in communication between cells, and the microRNAs they carry, with the aim of identifying a combination of biological signals that may help distinguish patients who respond to immunotherapy from those who do not.

EXOMEL is funded by the Interreg VI-A Italy–Austria 2021–2027 cross-border cooperation programme, with support from the European Regional Development Fund (ERDF), for a total amount of 572,055.59 euros. The project, which will end on 31 March 2028, confirms the value of international cooperation in cancer research, bringing together healthcare institutions, universities and technological expertise from Italy and Austria.

The University of Trieste acts as lead partner and coordinates the project activities through its Department of Medicine, Surgery and Health Sciences, involving a research team composed of Serena Bonin, Iris Zalaudek, Ilaria Gandin and Gabriele Grassi.

The partnership also includes the South Tyrol Health Authority, with the hospitals of Bruneck and Bolzano, an Italian small and medium-sized enterprise, and the University Clinic of Dermatology and Allergology of Paracelsus Medical University in Salzburg.

“At the heart of EXOMEL,” explains Serena Bonin, lecturer in Technical Sciences of Laboratory Medicine at the University of Trieste and principal investigator of the project, “is the development and validation of liquid biopsy, a diagnostic approach that makes it possible to obtain relevant information about the disease from biological samples that are easy to collect, such as blood or urine. Today, plasma liquid biopsy is used mainly in research to detect circulating tumour DNA, that is DNA carrying tumour-specific mutations. However, this approach requires the mutations to be monitored to be already known. With EXOMEL, we instead want to study the microRNAs contained in exosomes, vesicles through which cells communicate with one another, to verify whether a combination of them can help discriminate between patients with advanced cutaneous melanoma who respond to immunotherapy and those who do not.

At present,” Bonin adds, “there are no predictive biomarkers used in hospital practice to systematically guide these therapeutic choices. For this reason, the aim of the project is to contribute to the development of tools that are more accessible, repeatable and potentially useful for the personalisation of treatments.”

During the project, liquid biopsy technology will be extended to the study of urine samples and applied in the clinical centres involved through the development of common and standardised protocols. This step will make it possible to test the robustness of the approach in different clinical settings, harmonise diagnostic practices among the partner healthcare facilities and foster the creation of a stable collaborative network between Italy and Austria.

The expected results may also have an impact beyond the strictly academic and clinical fields. EXOMEL may contribute to the development of new diagnostic tools based on liquid biopsy, opening up possible prospects for technology transfer and industrial valorisation of research, including through the interest of companies active in the biomedical and diagnostic sectors.