1
|
Shimizu MR, van de Langerijt ON, Torres D, de Groot T, Groot OQ. Incidence, Risk Factors, and Survival of Bone Metastases and Skeletal-Related Events in Melanoma Patients: A Systematic Review and Quality Assessment of 29 Studies. J Bone Oncol 2024; 46:100603. [PMID: 38765703 PMCID: PMC11098944 DOI: 10.1016/j.jbo.2024.100603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/17/2024] [Accepted: 04/18/2024] [Indexed: 05/22/2024] Open
Abstract
Background Skeletal metastases make up 17% of all metastases from advanced-stage melanoma. Bone metastases are associated with increased morbidity and mortality and decreased quality of life due to their association with skeletal-related events (SREs), including pathological fracture, spinal cord compression, hypercalcemia, radiotherapy, and surgery. The study aimed to determine the incidence of bone metastases and SREs in melanoma, identify possible risk factors for the development of bone metastases and SREs, and investigate survival rates in this patient population. Methods A computer-based literature search was conducted using Pubmed, Embase, and Cochrane Central Register of Controlled Trials up to July 2023. The Newcastle-Ottawa Quality Assessment Scale (NOS) was utilized for quality assessment. Study characteristics, patient information, risk factors for developing bone metastases and SREs, and characteristics for survival were recorded. Results We included 29 studies. The average bone metastasis-free interval ranged from four to 72 months. Incidence of bone metastases varied from 2 % to 49 % across 14 studies. 69 % (20/29) of studies described the location of bone metastases, with 24 % (7/29) focusing solely on spinal metastases. In one study, 129 SREs were recorded in 71 % (59/83) of the patient cohort, with various manifestations. The use of bone-directed agents was independently associated with lower risk of SREs. Survival after detection of bone metastasis ranged from three to 13 months. Factors associated with survival included clinical, tumor-related, and treatment features. Conclusion This review highlights the notable prevalence and risk factors of developing bone metastases and subsequent SREs in patients with melanoma. The surge in bone metastases poses a challenge in complication management, given the high prevalence of SREs. While this study offers a comprehensive overview of the incidence, risk factors, and outcomes associated with bone metastases and SREs in melanoma patients that may guide patient and physician decision-making, a notable gap lies in the limited availability of high-quality data and the heterogeneous design of the existing literature. Future research should address predictive factors for bone metastases and SREs in melanoma to facilitate patient and physician decision-making and ultimately improve outcomes in this patient population.
Collapse
Affiliation(s)
| | | | - Daniel Torres
- Loyola University Stritch School of Medicine, Maywood, IL, USA
| | - Tom de Groot
- Department of Orthopedic Surgery, University Medical Center Groningen, Groningen, the Netherlands
| | - Olivier Q. Groot
- Department of Orthopedic Surgery, University Medical Center Utrecht, Utrecht, the Netherlands
| |
Collapse
|
2
|
Sugimoto M. Targeting cellular senescence: A promising approach in respiratory diseases. Geriatr Gerontol Int 2024; 24 Suppl 1:60-66. [PMID: 37604771 DOI: 10.1111/ggi.14653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 07/26/2023] [Accepted: 08/02/2023] [Indexed: 08/23/2023]
Abstract
Cellular senescence serves as a significant tumor suppression mechanism in mammals. Cellular senescence is induced in response to various stressors and acts as a safeguard against the uncontrolled proliferation of damaged cells that could lead to malignant transformation. Senescent cells also exhibit a distinctive feature known as the senescence-associated secretory phenotype (SASP), wherein they secrete a range of bioactive molecules, including pro-inflammatory cytokines, growth factors, and proteases. These SASP components have both local and systemic effects, influencing the surrounding microenvironment and distant tissues, and have been implicated in the processes of tissue aging and the development of chronic diseases. Recent studies utilizing senolysis models have shed light on the potential therapeutic implications of targeting senescent cells. The targeting of senescent cell may alleviate the detrimental effects associated with cellular senescence and its SASP components. Senolytics have shown promise in preclinical studies for treating age-related pathologies and chronic diseases, including cancer, cardiovascular disorders, and neurodegenerative conditions. Respiratory diseases have emerged as a significant global health concern, responsible for a considerable number of deaths worldwide. Extensive research conducted in both human subjects and animal models has demonstrated the involvement of cellular senescence in the pathogenesis of respiratory diseases. Chronic pulmonary conditions such as chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis have been linked to the accumulation of senescent cells. This review aims to present the findings from research on respiratory diseases that have utilized systems targeting senescent cells and to identify potential therapeutic strategies for the clinical management of these conditions. Geriatr Gerontol Int 2024; 24: 60-66.
Collapse
Affiliation(s)
- Masataka Sugimoto
- Laboratory of Molecular and Cellular Aging, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan
| |
Collapse
|
3
|
Karponis D, Stratigos IA, Joshy J, Craig PJ, Mistry K, van Bodegraven B, Venables ZC, Levell NJ. Lentigo maligna: a review. Clin Exp Dermatol 2024; 49:218-225. [PMID: 37966718 DOI: 10.1093/ced/llad394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/19/2023] [Accepted: 11/07/2023] [Indexed: 11/16/2023]
Abstract
Lentigo maligna (LM) is a melanoma in situ with distinct clinical features and histology. It commonly affects men after the sixth decade of life. Incidence rates of LM have increased based on early 21st century data from different countries; however, data are suboptimal. Data from England show a plateauing crude incidence between 2013 and 2019. By comparison, invasive melanoma and other types of melanoma in situ commonly appears in younger age groups (median age 58 and 67 years old, respectively) and incidence is rising. The most important risk factors for LM include fair skin and cumulative ultraviolet solar radiation exposure. Although LM is limited to the epidermis and connected skin adnexa, it may progress to invasive LM melanoma. The reported rate of malignant progression varies, reflecting a challenge for LM epidemiology research as often lesions are removed on diagnosis. LM poses a challenge in diagnosis and management. Although it can be diagnosed clinically or dermoscopically, histopathological assessment of biopsied skin tissue remains the gold standard. Reflectance confocal microscopy allows for better appreciation of the complexity of LM at a cellular level, often progressing beyond clinical margins. Management of LM may involve Mohs micrographic surgery or excision, although recurrence may occur even with 5 mm clinical margins. Imiquimod cream may be effective, but incomplete treatment and recurrence has been reported. Conservative management with observation or radiotherapy may be used in selected patients' cases. Five-year net survival rates are excellent. This paper reviews the natural history, epidemiology, aetiology, pathogenesis, diagnosis and management of LM.
Collapse
Affiliation(s)
- Dimitrios Karponis
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
| | | | - Jilse Joshy
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Paul J Craig
- Cellular Pathology, Gloucestershire Hospitals NHS Foundation Trust, Cheltenham, UK
| | - Khaylen Mistry
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Birgitta van Bodegraven
- British Association of Dermatologists, London, UK
- National Disease Registration Service, Data and Analytics, NHS England, UK
| | - Zoe C Venables
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
- National Disease Registration Service, Data and Analytics, NHS England, UK
| | - Nick J Levell
- Department of Dermatology, Norfolk and Norwich University Hospital, Norwich, UK
- Norwich Medical School, University of East Anglia, Norwich, UK
| |
Collapse
|
4
|
Xiao Q, Zhang W, Jing J, Zhong T, Li D, Zhou J, Liu P, Duan Z, Gao H, Shen L. Patterns of de novo metastasis and survival outcomes by age in breast cancer patients: a SEER population-based study. Front Endocrinol (Lausanne) 2023; 14:1184895. [PMID: 38027167 PMCID: PMC10657995 DOI: 10.3389/fendo.2023.1184895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background The role of age in metastatic disease, including breast cancer, remains obscure. This study was conducted to determine the role of age in patients with de novo metastatic breast cancer. Methods Breast cancer patients diagnosed with distant metastases between 2010 and 2019 were retrieved from the Surveillance, Epidemiology, and End Results database. Comparisons were performed between young (aged ≤ 40 years), middle-aged (41-60 years), older (61-80 years), and the oldest old (> 80 years) patients. Adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) were estimated using multivariate Cox proportional hazard models. Survival analysis was performed by the Kaplan-Meier method. Results This study included 24155 (4.4% of all patients) de novo metastatic breast cancer patients. The number of young, middle-aged, older, and the oldest old patients were 195 (8.3%), 9397 (38.9%), 10224 (42.3%), and 2539 (10.5%), respectively. The 5-year OS rate was highest in the young (42.1%), followed by middle-aged (34.8%), older (28.3%), and the oldest old patients (11.8%). Multivariable Cox regression analysis showed that middle-aged (aHR, 1.18; 95% CI, 1.10-1.27), older (aHR, 1.42; 95% CI, 1.32-1.52), and the oldest old patients (aHR, 2.15; 95% CI, 1.98-2.33) had worse OS than young patients. Consistently, middle-aged (aHR, 1.16; 95% CI, 1.08-1.25), older (aHR, 1.32; 95% CI, 1.23-1.43), and the oldest old patients (aHR, 1.86; 95% CI, 1.71-2.03) had worse BCSS than young patients. Conclusion This study provided clear evidence that de novo metastatic breast cancer had an age-specific pattern. Age was an independent risk factor for mortality in patients with de novo metastatic breast cancer.
Collapse
Affiliation(s)
- Qian Xiao
- Department of Breast and Thyroid Surgery, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
- Department of Breast and Thyroid Surgery, Chongqing Health Center for Women and Children, Chongqing, China
| | - Weixiao Zhang
- Department of Nutrition, Chongqing Jiangbei Hospital of traditional Chinese medicine, Chongqing, China
| | - Jingfeng Jing
- Department of Breast and Thyroid Surgery, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
- Department of Breast and Thyroid Surgery, Chongqing Health Center for Women and Children, Chongqing, China
| | - Tingting Zhong
- Department of Cardiology, Chongqing General Hospital, Chongqing, China
| | - Daxue Li
- Department of Breast and Thyroid Surgery, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
- Department of Breast and Thyroid Surgery, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jing Zhou
- Department of Breast and Thyroid Surgery, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
- Department of Breast and Thyroid Surgery, Chongqing Health Center for Women and Children, Chongqing, China
| | - Pan Liu
- Department of Rheumatology, Daping Hospital, the Third Affiliated Hospital of Third Military Medical University, Chongqing, China
| | - Zhongxu Duan
- Department of Breast and Thyroid Surgery, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
- Department of Breast and Thyroid Surgery, Chongqing Health Center for Women and Children, Chongqing, China
| | - Han Gao
- Department of Breast and Thyroid Surgery, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
- Department of Breast and Thyroid Surgery, Chongqing Health Center for Women and Children, Chongqing, China
| | - Liyuan Shen
- Department of Obstetrics and Gynecology, Women and Children’s Hospital of Chongqing Medical University, Chongqing, China
- Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children, Chongqing, China
| |
Collapse
|
5
|
Li TF, Hwang IH, Tsai CH, Hwang SJ, Wu TP, Chen FP. To explore the effects of herbal medicine among cancer patients in Taiwan: A cohort study. J Chin Med Assoc 2023; 86:767-774. [PMID: 37273198 DOI: 10.1097/jcma.0000000000000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Traditional Chinese medicine (TCM) is widely used by ethnic Chinese communities. TCM is covered by Taiwan's National Health Insurance (NHI) program. We evaluated the efficacy and outcomes of complementary Chinese herbal medicine (CHM) therapy in patients with cancer. METHODS This population-based cohort study was conducted using the data of patients who received a cancer diagnosis between 2005 and 2015 in Taiwan. Eligible patients were divided into standard and complementary CHM therapy groups. The complementary CHM therapy group was further divided into low cumulative dosage (LCD), medium cumulative dosage (MCD), and high cumulative dosage (HCD) subgroups. Overall survival (OS), mortality risk, cancer recurrence, and metastasis were analyzed for all cancers and five major cancers (lung, liver, breast, colorectal, and oral cancers). RESULTS We included 5707 patients with cancer (standard therapy, 4797 [84.1%]; complementary CHM therapy, 910 [15.9%]; LCD, 449 [7.9%]; MCD, 374 [6.6%], and HCD, 87 [1.5%]). For the LCD, MCD, and HCD subgroups, the mortality risk was 0.83, 0.64, and 0.45, and the 11-year OS, 5-year cumulative cancer recurrence, and 5-year cumulative cancer metastasis rates were 6.1 ± 0.2, 6.9 ± 0.2, and 8.2 ± 0.4 years; 39.2%, 31.5%, and 18.8%; and 39.5%, 32.8%, and 16.6%, respectively. The cumulative cancer recurrence and metastasis rates of the standard therapy group were 40.9% and 32.8%, respectively. The cumulative recurrence and metastasis rates of all cancers, lung cancer, and liver cancer and all cancers, colorectal cancer, and breast cancer, respectively, were significantly lower in the HCD subgroup than in the other subgroups and standard therapy group ( p < 0.05). CONCLUSION Patients receiving complementary CHM therapy may have prolonged OS and reduced risks of mortality, recurrence, and metastasis. A dose-response relationship was noted between CHM therapy and mortality risk: increased dosage was associated with improved OS and reduced mortality risk.
Collapse
Affiliation(s)
- Tsai-Feng Li
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
| | - I-Hsuan Hwang
- Center for Quality Control, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
| | - Cheng-Hung Tsai
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Shinn-Jang Hwang
- Family Medicine Division, En Chu Kong Hospital, New Taipei, Taiwan, ROC
| | - Ta-Peng Wu
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| | - Fang-Pey Chen
- Institute of Traditional Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan, ROC
- Center for Traditional Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC
| |
Collapse
|
6
|
DiVincenzo MJ, Latchana N, Abrams Z, Moufawad M, Regan-Fendt K, Courtney NB, Howard JH, Gru AA, Zhang X, Fadda P, Carson WE. Tissue microRNA expression profiling in hepatic and pulmonary metastatic melanoma. Melanoma Res 2020; 30:455-464. [PMID: 32804708 PMCID: PMC7484309 DOI: 10.1097/cmr.0000000000000692] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Malignant melanoma has a propensity for the development of hepatic and pulmonary metastases. MicroRNAs (miRs) are small, noncoding RNA molecules containing about 22 nucleotides that mediate protein expression and can contribute to cancer progression. We aim to identify clinically useful differences in miR expression in metastatic melanoma tissue. RNA was extracted from formalin-fixed, paraffin-embedded samples of hepatic and pulmonary metastatic melanoma, benign, nevi, and primary cutaneous melanoma. Assessment of miR expression was performed on purified RNA using the NanoString nCounter miRNA assay. miRs with greater than twofold change in expression when compared to other tumor sites (P value ≤ 0.05, modified t-test) were identified as dysregulated. Common gene targets were then identified among dysregulated miRs unique to each metastatic site. Melanoma metastatic to the liver had differential expression of 26 miRs compared to benign nevi and 16 miRs compared to primary melanoma (P < 0.048). Melanoma metastatic to the lung had differential expression of 19 miRs compared to benign nevi and 10 miRs compared to primary melanoma (P < 0.024). Compared to lung metastases, liver metastases had greater than twofold upregulation of four miRs, and 4.2-fold downregulation of miR-200c-3p (P < 0.0081). These findings indicate that sites of metastatic melanoma have unique miR profiles that may contribute to their development and localization. Further investigation of the utility of these miRs as diagnostic and prognostic biomarkers and their impact on the development of metastatic melanoma is warranted.
Collapse
Affiliation(s)
| | | | - Zachary Abrams
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH
| | - Maribelle Moufawad
- The Arthur G. James Comprehensive Cancer Center and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH
| | - Kelly Regan-Fendt
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH
| | - Nicholas B. Courtney
- The Arthur G. James Comprehensive Cancer Center and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH
| | | | - Alejandro A. Gru
- Department of Pathology, University of Virginia, Charlottesville, VA
| | - Xiaoli Zhang
- Department of Biomedical Informatics, The Ohio State University, Columbus, OH
| | - Paolo Fadda
- The Arthur G. James Comprehensive Cancer Center and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH
| | - William E. Carson
- The Arthur G. James Comprehensive Cancer Center and Richard J. Solove Research Institute, The Ohio State University, Columbus, OH
- Department of Surgery, The Ohio State University, Columbus, OH
| |
Collapse
|
7
|
Jang S, Poretta T, Bhagnani T, Harshaw Q, Burke M, Rao S. Real-World Recurrence Rates and Economic Burden in Patients with Resected Early-Stage Melanoma. Dermatol Ther (Heidelb) 2020; 10:985-999. [PMID: 32548707 PMCID: PMC7477064 DOI: 10.1007/s13555-020-00404-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Indexed: 01/27/2023] Open
Abstract
Introduction Real-world data on recurrence and economic burden in patients with resected early-stage melanoma are limited. The objective of this study was to assess real-world recurrence rates, risk factors for recurrence, and costs of recurrence in patients with resected stage IIB, IIC, or IIIA melanoma in the USA. Methods This retrospective analysis included patients with resected stage IIB, IIC, or IIIA melanoma (American Joint Committee on Cancer staging manual, seventh edition) in the Surveillance, Epidemiology, and End Results (SEER) program–Medicare database of the National Cancer Institute. Recurrence rates and healthcare costs (2018 USD) after recurrence were assessed. Results Two-year recurrence rates for stages IIB, IIC, and IIIA melanoma were 29, 44, and 46%, respectively. In patients with stage IIB or IIC disease, the odds of recurrence were significantly higher in those aged > 75 years [odds ratio (OR) 1.853, 95% confidence interval (CI) 1.416, 2.425], with ulceration (OR 1.771; 95% CI 1.293, 2.425), or with a higher Charlson Comorbidity Index (OR 1.244; 95% CI 1.129, 1.372); however, the odds of recurrence were significantly lower in those with T3 staging (OR 0.522; 95% CI 0.393, 0.695). In those with stage IIIA melanoma, superficial spreading was associated with significantly lower odds of recurrence (OR 0.178; 95% CI 0.053, 0.601). Following recurrence, mean healthcare costs at 1 year were $31,870 for patients with stage IIB or IIC melanoma and $29,224 for those with stage IIIA melanoma. Conclusion The SEER data show that a substantial proportion of adults with early-stage melanoma experience a recurrence within 2 years following resection, resulting in a significant economic burden to the US healthcare system. Dermatologists can distinguish patients with resected early-stage melanoma who are at a high risk for recurrence and consider referrals to medical oncologists for approved adjuvant therapy or enrollment in clinical trials after surgical resection to reduce the recurrence of melanoma. Melanoma is the sixth most common type of cancer in the USA. In the past several years, the US Food and Drug Administration has approved several novel therapies for patients with high-risk melanoma following surgery. However, these therapies are not approved for the treatment of patients with earlier-stage or intermediate-risk melanoma. In these patients, treatment choices include enrollment in clinical trials or observation. We have assessed recurrence rates, risk factors for recurrence, and costs of recurrence in patients with early-stage melanoma. This analysis included patients with resected early-stage melanoma in the US Surveillance, Epidemiology, and End Results (SEER) program–Medicare database. The results show that a substantial proportion of adults with early-stage melanoma experienced a recurrence within 2 years after surgical removal of their tumor, resulting in a significant economic burden to the healthcare system. Dermatologists can use information in the published literature to distinguish patients with resected early-stage melanoma who are at a high risk for recurrence and consider referrals to medical oncologists for approved therapy or enrollment in clinical trials after surgery to reduce recurrence and substantial economic consequences.
Collapse
Affiliation(s)
- Sekwon Jang
- Melanoma and Cutaneous Oncology Therapeutics, Inova Schar Cancer Institute, Fairfax, VA, USA.
| | - Tayla Poretta
- Health Economics and Outcomes Research, Bristol Myers Squibb, Princeton, NJ, USA
| | - Tarun Bhagnani
- Health Economics and Outcomes Research, EPI-Q Inc., Oakbrook, IL, USA
| | - Qing Harshaw
- Health Economics and Outcomes Research, EPI-Q Inc., Oakbrook, IL, USA
| | - Matthew Burke
- Health Economics and Outcomes Research, Bristol Myers Squibb, Princeton, NJ, USA
| | - Sumati Rao
- Health Economics and Outcomes Research, Bristol Myers Squibb, Princeton, NJ, USA
| |
Collapse
|
8
|
Tucci M, D'Oronzo S, Mannavola F, Felici C, Lovero D, Cafforio P, Palmirotta R, Silvestris F. Dual-procedural separation of CTCs in cutaneous melanoma provides useful information for both molecular diagnosis and prognosis. Ther Adv Med Oncol 2020; 12:1758835920905415. [PMID: 32206092 PMCID: PMC7074504 DOI: 10.1177/1758835920905415] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 01/15/2019] [Indexed: 12/25/2022] Open
Abstract
Background: Circulating tumor cells (CTCs) have recently emerged as a new dynamic soluble marker for several malignancies including cutaneous melanoma (CM) and are suitable for prognostic evaluations and treatment monitoring. However, to date many limitations still hamper the wide-scale application of CTCs in CM setting, including the lack of standardized methods as well as both low levels and heterogeneity of these cells. Methods: We developed a protocol for CTC detection in CM based on immune-magnetic sorting to deplete CD45-, CD31- or CD34-positive cells, followed by dielectrophoretic DEPArray separation according to cell morphology and immunophenotype. To this end, we explored the expression of melanoma stem cell antigens (CD271, ABCB5, and RANK) and the epithelial-to-mesenchymal transition markers (N-Cad, -CD44, and -MCAM/CD146) on CTCs from 17 stage IV CM patients, and investigated their BRAF mutational status by droplet digital PCR. Results: The number of CTCs isolated from CM patients ranged from 2 to 91 cells (38 ± 6.4) with respect to healthy donors (p < 0.0002). To confirm the melanoma origin of isolated cells, we observed an 80% agreement between their BRAFV600 mutational status and matched primary tumors. The characterization of the immune phenotype of isolated cells revealed high interindividual and intraindividual heterogeneity that was found to correlate with the clinical outcome. Conclusions: The dual-step protocol of immune-magnetic sorting and subsequent dielectrophoretic DEPArray separation, turned out to be a suitable method to isolate viable CTCs from stage IV melanoma patients and enabled quantitative and qualitative analyses on these cells, which may deserve prospective evaluation for potential use in the clinical practice.
Collapse
Affiliation(s)
- Marco Tucci
- DIMO, Department of Biomedical Sciences and Clinical Oncology, University of Bari 'Aldo Moro', P.za Giulio Cesare, 11, Bari, 70124, Italy
| | - Stella D'Oronzo
- DIMO, Department of Biomedical Sciences and Clinical Oncology, University of Bari 'Aldo Moro' Italy
| | - Francesco Mannavola
- DIMO, Department of Biomedical Sciences and Clinical Oncology, University of Bari 'Aldo Moro' Italy
| | - Claudia Felici
- DIMO, Department of Biomedical Sciences and Clinical Oncology, University of Bari 'Aldo Moro' Italy
| | - Domenica Lovero
- DIMO, Department of Biomedical Sciences and Clinical Oncology, University of Bari 'Aldo Moro' Italy
| | - Paola Cafforio
- DIMO, Department of Biomedical Sciences and Clinical Oncology, University of Bari 'Aldo Moro' Italy
| | - Raffaele Palmirotta
- DIMO, Department of Biomedical Sciences and Clinical Oncology, University of Bari 'Aldo Moro' Italy
| | - Franco Silvestris
- DIMO, Department of Biomedical Sciences and Clinical Oncology, University of Bari 'Aldo Moro' Italy
| |
Collapse
|
9
|
Song LB, Zhang QJ, Hou XY, Xiu YY, Chen L, Song NH, Lu Y. A twelve-gene signature for survival prediction in malignant melanoma patients. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:312. [PMID: 32355756 PMCID: PMC7186619 DOI: 10.21037/atm.2020.02.132] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Melanoma is defined as a highly mutational heterogeneous disease containing numerous alternations of the molecule. However, due to the phenotypically and genetically heterogeneity of malignant melanoma, conventional clinical characteristics remain restricted or limited in the ability to accurately predict individual outcomes and survival. This study aimed to establish an accurate gene expression signature to predict melanoma prognosis. Methods In this study, we established an RNA sequencing-based 12-gene signature data of melanoma patients obtained from 2 independent databases: the Cancer Genome Atlas (TCGA) database and the Gene Expression Omnibus (GEO) database. We evaluated the quality of each gene to predict survival conditions in each database by employing univariate and multivariate regression models. A prognostic risk score based on a prognostic signature was determined. This prognostic gene signature further classified patients into low-risk and high-risk groups. Results Based on a prognostic signature, a prognostic risk score was determined. This prognostic gene signature further divided the patients into low-risk and high-risk groups. In the chemotherapy and radiotherapy groups of the TCGA cohort and V-raf murine sarcoma viral oncogene homolog B1 (BRAF) expression group in the GEO cohort, patients in the low-risk group had a longer survival duration compared to patients in the high-risk group. Nevertheless, the immunotherapy group in the TCGA database and neuroblastoma RAS viral oncogene homolog (NRAS) expression group in the GEO database had no significant differences in statistics. Moreover, this gene signature was associated with patient prognosis regardless of whether the Breslow depth was greater than or less than 3.75 mm. Stratified gene set enrichment analysis (GSEA) revealed that certain immune-related pathways, such as the T-cell signaling pathway, chemokine signaling pathway, and primary immunodeficiency, were significantly enriched in the low-risk group of both TCGA and GEO cohorts. This information implied the immune-related properties of the 12-gene signature. Conclusions Our study emphasizes the significance of the gene expression signature in that it may be an indispensable prognostic predictor in melanoma and has great potential for application in personalized treatment.
Collapse
Affiliation(s)
- Le-Bin Song
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Qi-Jie Zhang
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Xiao-Yuan Hou
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yan-Yan Xiu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Lin Chen
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ning-Hong Song
- Department of Urology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yan Lu
- Department of Dermatology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China
| |
Collapse
|