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Challenges in the Complex Management of Neglected Cutaneous Melanomas in the Head and Neck Area: A Single Center Experience. J Clin Med 2023; 12:jcm12051910. [PMID: 36902697 PMCID: PMC10004111 DOI: 10.3390/jcm12051910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Revised: 02/16/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
Familiar controversies in the management of head and neck melanomas are more remarkable in locally advanced cases, and they represent a treatment challenge both surgically and oncologically. In our retrospective study, patients with surgically treated primary malignant melanoma of the head and neck region larger than 3 cm in diameter were included. Five patients met our inclusion criteria. In all cases, wide excision and immediate reconstruction were performed without sentinel lymph node biopsy. The defect on the scalp was covered by a split skin graft, with local flaps chosen for reconstruction on the face on an individual basis. After a 2-6 year follow-up, a good oncological, functional, and esthetic result was achieved. Our results show that in the case of large, locally advanced melanomas, surgical treatment still plays a crucial role that can provide long-term local control and support the effect of systemic treatment.
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2
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Banik I, Ghosh A, Beebe E, Burja B, Frank Bertoncelj M, Dooley CM, Markkanen E, Dummer R, Busch-Nentwich EM, Levesque MP. P38 Mediates Tumor Suppression through Reduced Autophagy and Actin Cytoskeleton Changes in NRAS-Mutant Melanoma. Cancers (Basel) 2023; 15:877. [PMID: 36765834 PMCID: PMC9913513 DOI: 10.3390/cancers15030877] [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: 11/21/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 02/04/2023] Open
Abstract
Hotspot mutations in the NRAS gene are causative genetic events associated with the development of melanoma. Currently, there are no FDA-approved drugs directly targeting NRAS mutations. Previously, we showed that p38 acts as a tumor suppressor in vitro and in vivo with respect to NRAS-mutant melanoma. We observed that because of p38 activation through treatment with the protein synthesis inhibitor, anisomycin leads to a transient upregulation of several targets of the cAMP pathway, representing a stressed cancer cell state that is often observed by therapeutic doses of MAPK inhibitors in melanoma patients. Meanwhile, genetically induced p38 or its stable transduction leads to a distinct cellular transcriptional state. Contrary to previous work showing an association of invasiveness with high p38 levels in BRAF-mutated melanoma, there was no correlation of p38 expression with NRAS-mutant melanoma invasion, highlighting the difference in BRAF and NRAS-driven melanomas. Although the role of p38 has been reported to be that of both tumor suppressor and oncogene, we show here that p38 specifically plays the role of a tumor suppressor in NRAS-mutant melanoma. Both the transient and stable activation of p38 elicits phosphorylation of mTOR, reported to be a master switch in regulating autophagy. Indeed, we observed a correlation between elevated levels of phosphorylated mTOR and a reduction in LC3 conversion (LCII/LCI), indicative of suppressed autophagy. Furthermore, a reduction in actin intensity in p38-high cells strongly suggests a role of mTOR in regulating actin and a remodeling in the NRAS-mutant melanoma cells. Therefore, p38 plays a tumor suppressive role in NRAS-mutant melanomas at least partially through the mechanism of mTOR upregulation, suppressed autophagy, and reduced actin polymerization. One or more combinations of MEK inhibitors with either anisomycin, rapamycin, chloroquine/bafilomycin, and cytochalasin modulate p38 activation, mTOR phosphorylation, autophagy, and actin polymerization, respectively, and they may provide an alternate route to targeting NRAS-mutant melanoma.
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Affiliation(s)
- Ishani Banik
- Department of Dermatology, University of Zurich Hospital, University of Zurich, 8091 Zurich, Switzerland
- Department of Dermatology, University of San Francisco California, San Francisco, CA 94117, USA
| | - Adhideb Ghosh
- Functional Genomics Center Zurich, ETH/University of Zurich, 8057 Zurich, Switzerland
| | - Erin Beebe
- Institute of Veterinary Pharmacology and Toxicology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Blaž Burja
- Center of Experimental Rheumatology, Department of Rheumatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
| | - Mojca Frank Bertoncelj
- Center of Experimental Rheumatology, Department of Rheumatology, University Hospital Zurich, University of Zurich, 8091 Zurich, Switzerland
- Team Integrative Biology of Immune-Mediated Inflammatory Diseases, BioMed X Institute, 69120 Heidelberg, Germany
| | | | - Enni Markkanen
- Institute of Veterinary Pharmacology and Toxicology, Vetsuisse Faculty, University of Zurich, 8057 Zurich, Switzerland
| | - Reinhard Dummer
- Department of Dermatology, University of Zurich Hospital, University of Zurich, 8091 Zurich, Switzerland
- Department of Dermatology, University of San Francisco California, San Francisco, CA 94117, USA
| | | | - Mitchell P. Levesque
- Department of Dermatology, University of Zurich Hospital, University of Zurich, 8091 Zurich, Switzerland
- Department of Dermatology, University of San Francisco California, San Francisco, CA 94117, USA
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3
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Familial Melanoma and Susceptibility Genes: A Review of the Most Common Clinical and Dermoscopic Phenotypic Aspect, Associated Malignancies and Practical Tips for Management. J Clin Med 2021; 10:jcm10163760. [PMID: 34442055 PMCID: PMC8397216 DOI: 10.3390/jcm10163760] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/13/2021] [Accepted: 08/18/2021] [Indexed: 12/11/2022] Open
Abstract
A family history of melanoma greatly increases the risk of developing cutaneous melanoma, a highly aggressive skin cancer whose incidence has been steadily increasing worldwide. Familial melanomas account for about 10% of all malignant melanomas and display an inheritance pattern consistent with the presence of pathogenic germline mutations, among which those involving CDKN2A are the best characterized. In recent years, a growing number of genes, such as MC1R, MITF, CDK4, POT1, TERT, ACD, TERF2IP, and BAP1, have been implicated in familial melanoma. The fact that individuals harboring these germline mutations along with their close blood relatives have a higher risk of developing multiple primary melanomas as well as other internal organ malignancies, especially pancreatic cancer, makes cascade genetic testing and surveillance of these families of the utmost importance. Unfortunately, due to a polygenic inheritance mechanism involving multiple low-risk alleles, genetic modifiers, and environmental factors, it is still very difficult to predict the presence of these mutations. It is, however, known that germline mutation carriers can sometimes develop specific clinical traits, such as high atypical nevus counts and specific dermoscopic features, which could theoretically help clinicians predict the presence of these mutations in prone families. In this review, we provide a comprehensive overview of the high- and intermediate-penetrance genes primarily linked to familial melanoma, highlighting their most frequently associated non-cutaneous malignancies and clinical/dermoscopic phenotypes.
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Manganelli M, Guida S, Ferretta A, Pellacani G, Porcelli L, Azzariti A, Guida G. Behind the Scene: Exploiting MC1R in Skin Cancer Risk and Prevention. Genes (Basel) 2021; 12:1093. [PMID: 34356109 PMCID: PMC8305013 DOI: 10.3390/genes12071093] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 02/06/2023] Open
Abstract
Melanoma and non-melanoma skin cancers (NMSCs) are the most frequent cancers of the skin in white populations. An increased risk in the development of skin cancers has been associated with the combination of several environmental factors (i.e., ultraviolet exposure) and genetic background, including melanocortin-1 receptor (MC1R) status. In the last few years, advances in the diagnosis of skin cancers provided a great impact on clinical practice. Despite these advances, NMSCs are still the most common malignancy in humans and melanoma still shows a rising incidence and a poor prognosis when diagnosed at an advanced stage. Efforts are required to underlie the genetic and clinical heterogeneity of melanoma and NMSCs, leading to an optimization of the management of affected patients. The clinical implications of the impact of germline MC1R variants in melanoma and NMSCs' risk, together with the additional risk conferred by somatic mutations in other peculiar genes, as well as the role of MC1R screening in skin cancers' prevention will be addressed in the current review.
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Affiliation(s)
- Michele Manganelli
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari-“Aldo Moro”, 70125 Bari, Italy; (M.M.); (A.F.)
- DMMT-Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy
| | - Stefania Guida
- Department of Surgical-Medical-Dental and Morphological Science with Interest Transplant-Oncological and Regenerative Medicine, University of Modena and Reggio Emilia, 41124 Modena, Italy;
| | - Anna Ferretta
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari-“Aldo Moro”, 70125 Bari, Italy; (M.M.); (A.F.)
| | - Giovanni Pellacani
- Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Dermatology Clinic, Sapienza University of Rome, 00161 Rome, Italy;
| | - Letizia Porcelli
- Laboratory of Experimental Pharmacology, IRCCS Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy; (L.P.); (A.A.)
| | - Amalia Azzariti
- Laboratory of Experimental Pharmacology, IRCCS Istituto Tumori Giovanni Paolo II, 70124 Bari, Italy; (L.P.); (A.A.)
| | - Gabriella Guida
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari-“Aldo Moro”, 70125 Bari, Italy; (M.M.); (A.F.)
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5
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Zanna I, Caini S, Raimondi S, Saieva C, Masala G, Massi D, Cocorocchio E, Queirolo P, Stanganelli I, Gandini S. Germline MC1R variants and frequency of somatic BRAF, NRAS, and TERT mutations in melanoma: Literature review and meta-analysis. Mol Carcinog 2021; 60:167-171. [PMID: 33444485 DOI: 10.1002/mc.23280] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 01/27/2023]
Abstract
Germline variants of the melanocortin-1-receptor (MC1R) gene are the most common genetic trait predisposing to cutaneous melanoma (CM). Here, we performed a literature review and meta-analysis of the association between MC1R gene variants and the frequency of somatic mutations of the BRAF, NRAS, and TERT genes in CM patients. We included studies published until January 2020 in MEDLINE, EMBASE, Ovid Medline, and two grey literature databases. Random effect models were used to pool study-specific estimates into summary odds ratio (SOR) and 95% confidence intervals (CIs). Subgroup and sensitivity analyses were conducted to identify potential sources of heterogeneity and assess the robustness of pooled estimates. Twelve studies published between 2006 and 2018 (encompassing 3566 CM, mostly on nonacral sites) were included. MC1R gene variants were not significantly associated with the frequency of somatic mutations of the BRAF and NRAS genes. Only three studies focused on somatic mutations of the TERT gene promoter, all of which reported moderate-to-strong positive associations with MC1R germline variants. MC1R gene variants appear to make only moderate changes, if any, to the risk of BRAF- or NRAS-mutant CM. The association with TERT promoter mutations is suggestive, yet it warrants confirmation as it is based on a still limited number of studies.
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Affiliation(s)
- Ines Zanna
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Sara Raimondi
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
| | - Calogero Saieva
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Giovanna Masala
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network, Florence, Italy
| | - Daniela Massi
- Department of Health Sciences, Section of Pathological Anatomy, University of Florence, Florence, Italy
| | - Emilia Cocorocchio
- Division of Medical Oncology of Melanoma, Sarcoma and Rare Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Paola Queirolo
- Division of Medical Oncology of Melanoma, Sarcoma and Rare Tumors, European Institute of Oncology, IRCCS, Milan, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, Scientific Institute of Romagna for the Study and Treatment of Cancer, IRCSS, Meldola, Italy
- Department of Dermatology, University of Parma, Parma, Italy
| | - Sara Gandini
- Department of Experimental Oncology, European Institute of Oncology, IRCCS, Milan, Italy
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Brito C, Barral DC, Pojo M. Subversion of Ras Small GTPases in Cutaneous Melanoma Aggressiveness. Front Cell Dev Biol 2020; 8:575223. [PMID: 33072757 PMCID: PMC7538714 DOI: 10.3389/fcell.2020.575223] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/28/2020] [Indexed: 12/25/2022] Open
Abstract
The rising incidence and mortality rate associated with the metastatic ability of cutaneous melanoma represent a major public health concern. Cutaneous melanoma is one of the most invasive human cancers, but the molecular mechanisms are poorly understood. Moreover, currently available therapies are not efficient in avoiding melanoma lethality. In this context, new biomarkers of prognosis, metastasis, and response to therapy are necessary to better predict the disease outcome. Additionally, the knowledge about the molecular alterations and dysregulated pathways involved in melanoma metastasis may provide new therapeutic targets. Members of the Ras superfamily of small GTPases regulate various essential cellular activities, from signaling to membrane traffic and cytoskeleton dynamics. Therefore, it is not surprising that they are differentially expressed, and their functions subverted in several types of cancer, including melanoma. Indeed, Ras small GTPases were found to regulate melanoma progression and invasion. Hence, a better understanding of the mechanisms regulated by Ras small GTPases that are involved in melanoma tumorigenesis and progression may provide new therapeutic strategies to block these processes. Here, we review the current knowledge on the role of Ras small GTPases in melanoma aggressiveness and the molecular mechanisms involved. Furthermore, we summarize the known involvement of these proteins in melanoma metastasis and how these players influence the response to therapy.
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Affiliation(s)
- Cheila Brito
- Unidade de Investigação em Patobiologia Molecular (UIPM) do Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Lisbon, Portugal
| | - Duarte C Barral
- CEDOC, Faculdade de Ciências Médicas, NOVA Medical School, Universidade NOVA de Lisboa, Lisbon, Portugal
| | - Marta Pojo
- Unidade de Investigação em Patobiologia Molecular (UIPM) do Instituto Português de Oncologia de Lisboa Francisco Gentil E.P.E., Lisbon, Portugal
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Lavelle TJ, Alver TN, Heintz KM, Wernhoff P, Nygaard V, Nakken S, Øy GF, Bøe SL, Urbanucci A, Hovig E. Dysregulation of MITF Leads to Transformation in MC1R-Defective Melanocytes. Cancers (Basel) 2020; 12:cancers12071719. [PMID: 32605315 PMCID: PMC7408466 DOI: 10.3390/cancers12071719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 06/20/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022] Open
Abstract
The MC1R/cAMP/MITF pathway is a key determinant for growth, differentiation, and survival of melanocytes and melanoma. MITF-M is the melanocyte-specific isoform of Microphthalmia-associated Transcription Factor (MITF) in human melanoma. Here we use two melanocyte cell lines to show that forced expression of hemagglutinin (HA) -tagged MITF-M through lentiviral transduction represents an oncogenic insult leading to consistent cell transformation of the immortalized melanocyte cell line Hermes 4C, being a melanocortin-1 receptor (MC1R) compound heterozygote, while not causing transformation of the MC1R wild type cell line Hermes 3C. The transformed HA-tagged MITF-M transduced Hermes 4C cells form colonies in soft agar and tumors in mice. Further, Hermes 4C cells display increased MITF chromatin binding, and transcriptional reprogramming consistent with an invasive melanoma phenotype. Mechanistically, forced expression of MITF-M drives the upregulation of the AXL tyrosine receptor kinase (AXL), with concomitant downregulation of phosphatase and tensin homolog (PTEN), leading to increased activation of the PI3K/AKT pathway. Treatment with AXL inhibitors reduces growth of the transformed cells by reverting AKT activation. In conclusion, we present a model system of melanoma development, driven by MITF-M in the context of MC1R loss of function, and independent of UV exposure. This model provides a basis for further studies of critical changes in the melanocyte transformation process.
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Affiliation(s)
- Timothy J. Lavelle
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0424 Oslo, Norway; (T.J.L.); (T.N.A.); (K.-M.H.); (P.W.); (V.N.); (S.N.); (G.F.Ø.)
| | - Tine Norman Alver
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0424 Oslo, Norway; (T.J.L.); (T.N.A.); (K.-M.H.); (P.W.); (V.N.); (S.N.); (G.F.Ø.)
| | - Karen-Marie Heintz
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0424 Oslo, Norway; (T.J.L.); (T.N.A.); (K.-M.H.); (P.W.); (V.N.); (S.N.); (G.F.Ø.)
| | - Patrik Wernhoff
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0424 Oslo, Norway; (T.J.L.); (T.N.A.); (K.-M.H.); (P.W.); (V.N.); (S.N.); (G.F.Ø.)
| | - Vegard Nygaard
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0424 Oslo, Norway; (T.J.L.); (T.N.A.); (K.-M.H.); (P.W.); (V.N.); (S.N.); (G.F.Ø.)
| | - Sigve Nakken
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0424 Oslo, Norway; (T.J.L.); (T.N.A.); (K.-M.H.); (P.W.); (V.N.); (S.N.); (G.F.Ø.)
- Centre for Cancer Cell Reprogramming, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, 0424 Oslo, Norway
| | - Geir Frode Øy
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0424 Oslo, Norway; (T.J.L.); (T.N.A.); (K.-M.H.); (P.W.); (V.N.); (S.N.); (G.F.Ø.)
| | - Sigurd Leinæs Bøe
- Department of Medical Biochemistry, Oslo University Hospital, Radiumhospitalet, 0424 Oslo, Norway;
| | - Alfonso Urbanucci
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0424 Oslo, Norway; (T.J.L.); (T.N.A.); (K.-M.H.); (P.W.); (V.N.); (S.N.); (G.F.Ø.)
- Correspondence: (A.U.); (E.H.)
| | - Eivind Hovig
- Department of Tumor Biology, Institute for Cancer Research, Oslo University Hospital, 0424 Oslo, Norway; (T.J.L.); (T.N.A.); (K.-M.H.); (P.W.); (V.N.); (S.N.); (G.F.Ø.)
- Department of Informatics, University of Oslo, 0316 Oslo, Norway
- Correspondence: (A.U.); (E.H.)
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Dalmasso B, Ghiorzo P. Evolution of approaches to identify melanoma missing heritability. Expert Rev Mol Diagn 2020; 20:523-531. [PMID: 32124637 DOI: 10.1080/14737159.2020.1738221] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Introduction: Around 10% of melanoma patients have a positive family history of melanoma and/or related cancers. Although a germline pathogenic variant in a high-risk gene can be identified in up to 40% of these patients, the remaining part of melanoma heritability remains largely unexplained.Areas covered: The aim of this review is to provide an overview of the impact that new technologies and new research approaches had and are having on finding more efficient ways to unravel the missing heritability in melanoma.Expert opinion: High-throughput sequencing technologies have been crucial in increasing the number of genes/loci that might be implicated in melanoma predisposition. However, results from these approaches may have been inferior to the expectations, due to an increase in quantitative information which hasn't been followed at the same speed by an improvement of the methods to correctly interpret these data. Optimal approaches for improving our knowledge on melanoma heritability are currently based on segregation analysis coupled with functional assessment of candidate genes. An improvement of computational methods to infer genotype-phenotype correlations could help address the issue of missing heritability.
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Affiliation(s)
- Bruna Dalmasso
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties, University of Genoa, Genova, Italy.,IRCCS Ospedale Policlinico San Martino, Genetics of Rare Cancers, Genoa, Italy
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9
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Hay JL, Zielaskowski K, Meyer White K, Kaphingst K, Robers E, Guest D, Sussman A, Talamantes Y, Schwartz M, Rodríguez VM, Li Y, Schofield E, Bigney J, Hunley K, Buller D, Berwick M. Interest and Uptake of MC1R Testing for Melanoma Risk in a Diverse Primary Care Population: A Randomized Clinical Trial. JAMA Dermatol 2019; 154:684-693. [PMID: 29801061 DOI: 10.1001/jamadermatol.2018.0592] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Germline variants in the MC1R gene are common and confer moderate melanoma risk in those with varied skin types. Approaches to precision skin cancer prevention that include genetic information may promote risk awareness and risk reduction in the general population, including Hispanics. Objective To examine prevalence of interest in and uptake of MC1R testing in the general population and examine patterns across demographic and skin cancer risk factors. Design, Setting, and Participants A randomized clinical trial examined interest in and uptake of MC1R testing among patients at University of New Mexico General Internal Medicine clinics. Study participants were randomized to either a usual-care condition (National Cancer Institute skin cancer pamphlet for diverse skin types) or an MC1R test offer. Participants were registered clinic patients (≥6 months) and English or Spanish fluent. Of the 600 participants recruited to the overall trial, the present study included those 499 participants randomized to the MC1R test offer. Interventions Participants were presented with the option to log onto the study website to read 3 educational modules presenting the rationale, benefits, and drawbacks of MC1R testing. Main Outcomes and Measures Main outcomes include website log on (yes vs no), saliva test kit request (yes vs no), and saliva test kit return for MC1R testing (yes vs no). Demographic and skin cancer risk factors were examined as potential predictors of test interest and uptake. Results Of the 499 participants (220 [44%] non-Hispanic white, 242 [48%] Hispanic, 396 [79%] female; mean [SD] age, 54 [14.3] years), 232 (46%) elected to learn about MC1R testing by logging onto the website; 204 (88%) of those who logged on decided to request testing; and 167 (82%) of those who requested testing returned the kit. The strongest predictors of website log on were race/ethnicity and education (non-Hispanic whites were more likely to log on [odds ratio for Hispanics vs non-Hispanic whites, 0.5; 95% CI, 0.3-0.7], as were more highly educated individuals [odds ratio for more than high school vs high school or less, 2.7; 95% CI, 1.7-4.3]). The strongest predictor of ordering the test was sunburn history (odds ratio, 5.4; 95% CI, 2.3-12.9 vs no sunburn history). Conclusions and Relevance There were moderately high levels of MC1R test interest and uptake in this diverse sample. Addressing potential barriers to testing may be warranted as genomic information becomes integrated into general population approaches to the precision prevention of skin cancer. Trial Registration ClinicalTrials.gov identifier: NCT03130569.
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Affiliation(s)
- Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kate Zielaskowski
- Clinical Research Finance, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kirsten Meyer White
- Division of Epidemiology, Department of Internal Medicine, University of New Mexico, Albuquerque
| | - Kimberly Kaphingst
- Department of Communication, University of Utah, Salt Lake City.,Huntsman Cancer Institute, University of Utah, Salt Lake City
| | - Erika Robers
- New Mexico Translation and Transcription, Albuquerque
| | - Dolores Guest
- CRTC Population Sciences Academic Unit, University of New Mexico, Albuquerque
| | - Andrew Sussman
- Department of Family and Community Medicine, University of New Mexico, Albuquerque
| | - Yvonne Talamantes
- CRTC Population Sciences Academic Unit, University of New Mexico, Albuquerque
| | - Matthew Schwartz
- CRTC Population Sciences Academic Unit, University of New Mexico, Albuquerque
| | | | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jessica Bigney
- Department of General Internal Medicine, University of New Mexico, Albuquerque
| | - Keith Hunley
- Department of Anthropology, University of New Mexico, Albuquerque
| | | | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque.,Department of Dermatology, University of New Mexico, Albuquerque
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Analysis of KRAS and NRAS mutations in Greek patients with metastatic Colorectal Cancer (mCRC) on the registry of the Gastro-intestinal Cancer Study Group (GIC-SG). FORUM OF CLINICAL ONCOLOGY 2019. [DOI: 10.2478/fco-2018-0005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Abstract
Introduction
Several studies show that mutational profiles could influence treatment decisions in patients with metastatic CRC (mCRC). KRAS mutational status was the first step in biomarkers development in the era of molecular targeted therapies. Recently, NRAS mutational status was identified as an independent prognostic factor for the response to treatment with anti-EGFR moAbs. The aim of this observational study was to assess the feasibility of the KRAS/NRAS mutational analysis in patients with metastatic colorectal cancer in Greece and to identify any correlations with known clinical characteristics and histopathologic features.
Methods
From January 2014 until September 2014 all patients registered to the GIC-SG database with newly diagnosed metastatic disease from colon or rectal cancer were included and tumor samples were analyzed for kras/nras mutations in 9 different certified laboratories in Greece.
Results
Samples from 510 patients were analyzed. Mutations’ distribution was as follows: 173 (33,9%) KRAS exon 2, 10 (2%) KRAS exon 3, 25 (4,9%) KRAS exon 4, 22 (4,3%) NRAS exon 2, 11 (2,2%) NRAS exon 3 and 3 (0,6%) NRAS exon 4. The only factor significantly associated with RAS mutational status was primary tumor location, with right sided tumors exhibiting higher rates of mutations.
Discussion
The incidence and distribution of KRAS or NRAS exon 2-4 mutations are in accordance with those reported in the literature. The most significant clinical or pathological parameter revealed from the analysis is the location of the primary tumor.
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11
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Ahmad F, Avabhrath N, Natarajan S, Parikh J, Patole K, Das BR. Molecular evaluation of BRAF V600 mutation and its association with clinicopathological characteristics: First findings from Indian malignant melanoma patients. Cancer Genet 2019; 231-232:46-53. [PMID: 30803557 DOI: 10.1016/j.cancergen.2019.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 12/04/2018] [Accepted: 01/07/2019] [Indexed: 12/24/2022]
Abstract
Mutations in the BRAF gene have been described to occur in two-third of melanomas. The objective of the study was to establish the frequency of BRAF V600E/K/R mutation in a series of melanomas from Indian origin and to correlate mutation status with clinicopathological features. Seventy melanoma cases were evaluated for BRAF V600 mutation by pyrosequencing. Overall, BRAF mutations were detected in 30% of the patients. All mutations observed were missense type (GTG > GAG) resulting in p.V600E, while none showed V600K/R mutation. The frequency of BRAF V600E mutations were more in patients with onset age of 50 years. BRAF mutations were significantly associated with tumor site wherein more mutations were seen in tumors from head and neck and extremities region. Acral and mucosal tumor subtype showed a mutation frequency of 31% and 20%, respectively. Epithelial cell morphology tends to harbor frequent BRAF V600E mutation (36%) than other morphological subtypes. Tumors with ulceration and necrosis showed increased BRAF mutation rate (32.5% and 33%) respectively. In conclusion, this is the first study to report a mutation frequency of 30% in this cohort. Our results demonstrated that the BRAF V600E mutation is a frequent event in Indian melanomas, and represents an important molecular target for novel therapeutic approaches.
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Affiliation(s)
- Firoz Ahmad
- Research and Development, Division, SRL Ltd, Plot no.1, Prime Square building, S.V.Road, Goregaon (W), Mumbai, India
| | - Nagashree Avabhrath
- Research and Development, Division, SRL Ltd, Plot no.1, Prime Square building, S.V.Road, Goregaon (W), Mumbai, India
| | - Sripriya Natarajan
- Research and Development, Division, SRL Ltd, Plot no.1, Prime Square building, S.V.Road, Goregaon (W), Mumbai, India
| | - Jeenal Parikh
- Histopathology Division, Division, SRL Ltd, Plot no.1, Prime Square building, S.V.Road, Goregaon (W), Mumbai, India
| | - Kamlakar Patole
- Histopathology Division, Division, SRL Ltd, Plot no.1, Prime Square building, S.V.Road, Goregaon (W), Mumbai, India
| | - Bibhu Ranjan Das
- Research and Development, Division, SRL Ltd, Plot no.1, Prime Square building, S.V.Road, Goregaon (W), Mumbai, India.
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12
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Thomas NE, Edmiston SN, Orlow I, Kanetsky PA, Luo L, Gibbs DC, Parrish EA, Hao H, Busam KJ, Armstrong BK, Kricker A, Cust AE, Anton-Culver H, Gruber SB, Gallagher RP, Zanetti R, Rosso S, Sacchetto L, Dwyer T, Ollila DW, Begg CB, Berwick M, Conway K. Inherited Genetic Variants Associated with Melanoma BRAF/NRAS Subtypes. J Invest Dermatol 2018; 138:2398-2404. [PMID: 29753029 PMCID: PMC6200630 DOI: 10.1016/j.jid.2018.04.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 04/08/2018] [Indexed: 10/16/2022]
Abstract
BRAF and NRAS mutations arise early in melanoma development, but their associations with low-penetrance melanoma susceptibility loci remain unknown. In the Genes, Environment and Melanoma Study, 1,223 European-origin participants had their incident invasive primary melanomas screened for BRAF/NRAS mutations and germline DNA genotyped for 47 single-nucleotide polymorphisms identified as low-penetrant melanoma-risk variants. We used multinomial logistic regression to simultaneously examine each single-nucleotide polymorphism's relationship to BRAF V600E, BRAF V600K, BRAF other, and NRAS+ relative to BRAF-/NRAS- melanoma adjusted for study features. IRF4 rs12203592*T was associated with BRAF V600E (odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.43-0.79) and V600K (OR = 0.65, 95% CI = 0.41-1.03), but not BRAF other or NRAS+ melanoma. A global test of etiologic heterogeneity (Pglobal = 0.001) passed false discovery (Pglobal = 0.0026). PLA2G6 rs132985*T was associated with BRAF V600E (OR = 1.32, 95% CI = 1.05-1.67) and BRAF other (OR = 1.82, 95% CI = 1.11-2.98), but not BRAF V600K or NRAS+ melanoma. The test for etiologic heterogeneity (Pglobal) was 0.005. The IRF4 rs12203592 associations were slightly attenuated after adjustment for melanoma-risk phenotypes. The PLA2G6 rs132985 associations were independent of phenotypes. IRF4 and PLA2G6 inherited genotypes may influence melanoma BRAF/NRAS subtype development.
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Affiliation(s)
- Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.
| | - Sharon N Edmiston
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - David C Gibbs
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Eloise A Parrish
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Honglin Hao
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Bruce K Armstrong
- School of Public and Global Health, The University of Western Australia, Perth, Australia
| | - Anne Kricker
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anne E Cust
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Melanoma Institute Australia, The University of Sydney, North Sydney, Australia
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, California, USA
| | - Stephen B Gruber
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - Richard P Gallagher
- British Columbia Cancer and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Lidia Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy; Politecnico di Torino, Turin, Italy
| | - Terence Dwyer
- George Institute for Global Health, Nuffield Department of Obstetrics and Gynecology, University of Oxford, Oxford, UK
| | - David W Ollila
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Kathleen Conway
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
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13
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Pellegrini C, Di Nardo L, Cipolloni G, Martorelli C, De Padova M, Antonini A, Maturo MG, Del Regno L, Strafella S, Micantonio T, Leocata P, Peris K, Fargnoli MC. Heterogeneity of BRAF, NRAS, and TERT Promoter Mutational Status in Multiple Melanomas and Association with MC1R Genotype. J Mol Diagn 2018; 20:110-122. [DOI: 10.1016/j.jmoldx.2017.10.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 12/12/2022] Open
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14
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Li ZZ, Wang F, Zhang ZC, Wang F, Zhao Q, Zhang DS, Wang FH, Wang ZQ, Luo HY, He MM, Wang DS, Jin Y, Ren C, Qiu MZ, Ren J, Pan ZZ, Li YH, Shao JY, Xu RH. Mutation profiling in chinese patients with metastatic colorectal cancer and its correlation with clinicopathological features and anti-EGFR treatment response. Oncotarget 2017; 7:28356-68. [PMID: 27050078 PMCID: PMC5053731 DOI: 10.18632/oncotarget.8541] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 03/16/2016] [Indexed: 02/06/2023] Open
Abstract
An increasing number of studies reveal the significance of genetic markers in guiding target treatment and refining prognosis. This retrospective observational study aims to assess the mutation profile of metastatic colorectal cancer (mCRC) in Chinese population with the help of MassARRAY® technique platform and OncoCarta™ Panel. 322 Chinese patients with mCRC who received clinical molecular testing as part of their standard care were investigated. 80 patients received cetuximab palliative treatment. 238 common hot-spot mutations of 19 cancer related genes in the OncoCarta™ Panel were tested. 44 mutations in 11 genes were detected in 156 cases (48.4%). At least one mutation was identified in 38.5% (124/322) of all tested cases, two concomitant mutations in 9.0% (29/322) and three mutations in 3 cases (<1%). KRAS was the most frequently mutated gene (34.8%), followed by PIK3CA (9.6%), NRAS (4.3%), BRAF (3.4%), EGFR (2.5%) and HRAS (1.2%). Less frequent mutations were detected in PDGFRA, RET, AKT1, FGFR1, and ERBB2. Co-mutation of RAS family subtypes was observed in 5 patients, and KRAS and BRAF concurrent mutation in 1 patient. KRAS, NRAS, BRAF and PIK3CA mutations had association with some clinicopathological features statistically. Patients identified as wild-type in all 19 genes had better objective response rate when treated with cetuximab. The clinical molecular testing with OncoCarta™ Panel supplemented the limited data of mCRC in Chinese population, and offered a clearer landscape of multiple gene mutational profile in not only clinically prognostic KRAS, NRAS, BRAF and PIK3CA genes, but also less frequent mutated genes. Knowledge of these multiple gene mutation patterns may give clues in exploring interesting accompanying co-occurrence relationship or mutually exclusive relationship between mutated genes, as well as in predicting benefit of all-wild-type patients from anti-EGFR treatment.
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Affiliation(s)
- Zhe-Zhen Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Feng Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Zi-Chen Zhang
- Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Fang Wang
- Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Qi Zhao
- State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, P. R. China
| | - Dong-Sheng Zhang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Feng-Hua Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Zhi-Qiang Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Hui-Yan Luo
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Ming-Ming He
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - De-Shen Wang
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Ying Jin
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Chao Ren
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Miao-Zhen Qiu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Jian Ren
- State Key Laboratory of Biocontrol, School of Life Sciences, Sun Yat-sen University, Guangzhou, P. R. China
| | - Zhi-Zhong Pan
- Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Yu-Hong Li
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Jiao-Yong Shao
- Department of Molecular Diagnostics, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
| | - Rui-Hua Xu
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, P. R. China
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15
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Thomas NE, Edmiston SN, Kanetsky PA, Busam KJ, Kricker A, Armstrong BK, Cust AE, Anton-Culver H, Gruber SB, Luo L, Orlow I, Reiner AS, Gallagher RP, Zanetti R, Rosso S, Sacchetto L, Dwyer T, Parrish EA, Hao H, Gibbs DC, Frank JS, Ollila DW, Begg CB, Berwick M, Conway K. Associations of MC1R Genotype and Patient Phenotypes with BRAF and NRAS Mutations in Melanoma. J Invest Dermatol 2017; 137:2588-2598. [PMID: 28842324 PMCID: PMC5701875 DOI: 10.1016/j.jid.2017.07.832] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Revised: 07/08/2017] [Accepted: 07/23/2017] [Indexed: 11/21/2022]
Abstract
Associations of MC1R with BRAF mutations in melanoma have been inconsistent between studies. We sought to determine for 1,227 participants in the international population-based Genes, Environment, and Melanoma (GEM) study whether MC1R and phenotypes were associated with melanoma BRAF/NRAS subtypes. We used logistic regression adjusted by age, sex, and study design features and examined effect modifications. BRAF+ were associated with younger age, blond/light brown hair, increased nevi, and less freckling, and NRAS+ with older age relative to the wild type (BRAF-/NRAS-) melanomas (all P < 0.05). Comparing specific BRAF subtypes to the wild type, BRAF V600E was associated with younger age, blond/light brown hair, and increased nevi and V600K with increased nevi and less freckling (all P < 0.05). MC1R was positively associated with BRAF V600E cases but only among individuals with darker phototypes or darker hair (Pinteraction < 0.05) but inversely associated with BRAF V600K (Ptrend = 0.006) with no significant effect modification by phenotypes. These results support distinct etiologies for BRAF V600E, BRAF V600K, NRAS+, and wild-type melanomas. MC1R's associations with BRAF V600E cases limited to individuals with darker phenotypes indicate that MC1R genotypes specifically provide information about BRAF V600E melanoma risk in those not considered high risk based on phenotype. Our results also suggest that melanin pathways deserve further study in BRAF V600E melanomagenesis.
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Affiliation(s)
- Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.
| | - Sharon N Edmiston
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Anne Kricker
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Bruce K Armstrong
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Anne E Cust
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia; Melanoma Institute Australia, North Sydney, Australia
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, California, USA
| | - Stephen B Gruber
- Univeristy of Southern California Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Anne S Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | | | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Lidia Sacchetto
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Politecnico di Torino, Turin, Italy
| | - Terence Dwyer
- George Institute for Global Health, Nuffield Department of Obstetrics and Gynecology, University of Oxford
| | - Eloise A Parrish
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Honglin Hao
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - David C Gibbs
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Jill S Frank
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - David W Ollila
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Kathleen Conway
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
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16
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Farland LV, Lorrain S, Missmer SA, Dartois L, Cervenka I, Savoye I, Mesrine S, Boutron-Ruault MC, Kvaskoff M. Endometriosis and the risk of skin cancer: a prospective cohort study. Cancer Causes Control 2017; 28:1011-1019. [PMID: 28799019 DOI: 10.1007/s10552-017-0939-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Accepted: 08/03/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE Endometriosis has been associated with an increased risk of skin melanoma. However, associations with other skin cancer types and how they compare with melanoma are unclear. Our objective was to prospectively investigate the relationships between endometriosis and risk of non-melanoma and melanoma skin cancers. METHODS E3N is a prospective cohort of 98,995 French women aged 40-65 years in 1990. Data on surgically confirmed endometriosis and skin cancer diagnoses were collected every 2-3 years through self-report, with skin cancer cases confirmed through pathology reports. Hazard Ratios (HR) and 95% confidence intervals (CIs) were calculated using Cox regression models. RESULTS Between 1990 and 2008, 535 melanoma, 247 squamous-cell carcinoma (SCC), and 1,712 basal-cell carcinoma (BCC) cases were ascertained. Endometriosis was associated with an increased overall risk of skin cancer (HR 1.28, 95% CI 1.05-1.55). When considering skin cancer type, endometriosis was associated with melanoma risk (HR 1.64, 95% CI 1.15-2.35), but not with SCC (HR 1.21, 95% CI 0.62-2.36) or BCC (HR 1.16, 95% CI 0.91-1.48) (non-melanoma skin cancers combined: HR 1.17, 95% CI 0.93-1.46), although no heterogeneity was detected across skin cancer types (Phomogeneity = 0.13). CONCLUSION These data support an association between a personal history of endometriosis and the risk of skin cancer and suggest that the association is strongest for melanoma.
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Affiliation(s)
- Leslie V Farland
- Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA, 02115, USA.,Department of Obstetrics, Gynaecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
| | - Simon Lorrain
- Univ. Bordeaux, ISPED, Centre INSERM U897-Epidémiologie-Biostatistique, 33000, Bordeaux, France
| | - Stacey A Missmer
- Department of Epidemiology, Harvard T.H Chan School of Public Health, Boston, MA, 02115, USA.,Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, 02115, Boston, MA, USA.,Department of Obstetrics, Gynecology, and Reproductive Biology, College of Human Medicine, Michigan State University, Grand Rapids, MI, 49503, USA
| | - Laureen Dartois
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Iris Cervenka
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Isabelle Savoye
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Sylvie Mesrine
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Marie-Christine Boutron-Ruault
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France.,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France
| | - Marina Kvaskoff
- CESP, Fac. de médecine - Univ. Paris-Sud, Fac. de médecine - UVSQ, INSERM, Université Paris-Saclay, 94805, Villejuif Cedex, France. .,Gustave Roussy, Espace Maurice Tubiana, 114 rue Edouard Vaillant, 94805, Villejuif Cedex, France.
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17
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Hennessey RC, Holderbaum AM, Bonilla A, Delaney C, Gillahan JE, Tober KL, Oberyszyn TM, Zippin JH, Burd CE. Ultraviolet radiation accelerates NRas-mutant melanomagenesis: A cooperative effect blocked by sunscreen. Pigment Cell Melanoma Res 2017; 30:477-487. [PMID: 28544727 DOI: 10.1111/pcmr.12601] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 05/17/2017] [Indexed: 11/28/2022]
Abstract
To mitigate melanoma risk, sunscreen use is widely advocated; yet, the ability of sunscreens to prevent melanoma remains controversial. Here, we test the tenet that sunscreens limit melanoma risk by blocking ultraviolet radiation (UV)-induced DNA damage using murine models that recapitulate the genetics and spontaneous evolution of human melanoma. We find that a single, non-erythematous dose of UV dramatically accelerates melanoma onset and increases tumor multiplicity in mice carrying an endogenous, melanocyte-specific NRas61R allele. By contrast, transient UV exposure does not alter tumor onset in mice lacking p16INK4a or harboring an NRas12D allele. To block the rapid onset of melanoma cooperatively caused by UV and NRas61R , we employed a variety of aerosol sunscreens. While all sunscreens delayed melanoma formation and blocked UV-induced DNA damage, differences in aerosol output (i.e., amount applied/cm2 ) caused variability in the cancer preventative efficacy of products with identical sunburn protection factor (SPF) ratings.
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Affiliation(s)
- Rebecca C Hennessey
- Department of Cancer Biology and Genetics, Biomedical Research Tower, The Ohio State University, Columbus, OH, USA
| | - Andrea M Holderbaum
- Department of Cancer Biology and Genetics, Biomedical Research Tower, The Ohio State University, Columbus, OH, USA.,Department of Molecular Genetics, Biomedical Research Tower, The Ohio State University, Columbus, OH, USA
| | - Anamaria Bonilla
- Department of Cancer Biology and Genetics, Biomedical Research Tower, The Ohio State University, Columbus, OH, USA.,Department of Molecular Genetics, Biomedical Research Tower, The Ohio State University, Columbus, OH, USA
| | - Conor Delaney
- Department of Cancer Biology and Genetics, Biomedical Research Tower, The Ohio State University, Columbus, OH, USA
| | - James E Gillahan
- Department of Cancer Biology and Genetics, Biomedical Research Tower, The Ohio State University, Columbus, OH, USA
| | - Kathleen L Tober
- Department of Pathology, The Ohio State University, Columbus, OH, USA
| | | | - Jonathan H Zippin
- Department of Dermatology, Joan and Sanford I. Weill Medical College of Cornell University, New York, NY, USA
| | - Christin E Burd
- Department of Cancer Biology and Genetics, Biomedical Research Tower, The Ohio State University, Columbus, OH, USA.,Department of Molecular Genetics, Biomedical Research Tower, The Ohio State University, Columbus, OH, USA
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18
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Mutational Status of NRAS and BRAF Genes and Protein Expression Analysis in a Series of Primary Oral Mucosal Melanoma. Am J Dermatopathol 2017; 39:104-110. [DOI: 10.1097/dad.0000000000000605] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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19
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Hacker E, Olsen CM, Kvaskoff M, Pandeya N, Yeo A, Green AC, Williamson RM, Triscott J, Wood D, Mortimore R, Hayward NK, Whiteman DC. Histologic and Phenotypic Factors and MC1R Status Associated with BRAF(V600E), BRAF(V600K), and NRAS Mutations in a Community-Based Sample of 414 Cutaneous Melanomas. J Invest Dermatol 2016; 136:829-837. [PMID: 26807515 DOI: 10.1016/j.jid.2015.12.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Revised: 11/26/2015] [Accepted: 12/18/2015] [Indexed: 11/23/2022]
Abstract
Cutaneous melanomas arise through causal pathways involving interplay between exposure to UV radiation and host factors, resulting in characteristic patterns of driver mutations in BRAF, NRAS, and other genes. To gain clearer insights into the factors contributing to somatic mutation genotypes in melanoma, we collected clinical and epidemiologic data, performed skin examinations, and collected saliva and tumor samples from a community-based series of 414 patients aged 18 to 79, newly diagnosed with cutaneous melanoma. We assessed constitutional DNA for nine common polymorphisms in melanocortin-1 receptor gene (MC1R). Tumor DNA was assessed for somatic mutations in 25 different genes. We observed mutually exclusive mutations in BRAF(V600E) (26%), BRAF(V600K) (8%), BRAF(other) (5%), and NRAS (9%). Compared to patients with BRAF wild-type melanomas, those with BRAF(V600E) mutants were significantly younger, had more nevi but fewer actinic keratoses, were more likely to report a family history of melanoma, and had tumors that were more likely to harbor neval remnants. BRAF(V600K) mutations were also associated with high nevus counts. Both BRAF(V600K) and NRAS mutants were associated with older age but not with high sun exposure. We also found no association between MC1R status and any somatic mutations in this community sample of cutaneous melanomas, contrary to earlier reports.
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Affiliation(s)
- Elke Hacker
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Queensland University of Technology, Institute of Health and Biomedical Innovation, Brisbane, Queensland, Australia
| | - Catherine M Olsen
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Marina Kvaskoff
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Nirmala Pandeya
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Abrey Yeo
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Adèle C Green
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia; Cancer Research UK Manchester Institute & University of Manchester, Manchester, UK
| | - Richard M Williamson
- Anatomical Pathology, Sullivan Nicolaides Pathology, Taringa, Queensland, Australia
| | - Joe Triscott
- Anatomical Pathology, IQ Pathology, West End, Queensland, Australia
| | - Dominic Wood
- Anatomical Pathology, IQ Pathology, West End, Queensland, Australia
| | - Rohan Mortimore
- Anatomical Pathology, Queensland Medical Laboratory, Murarrie, Queensland, Australia
| | - Nicholas K Hayward
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - David C Whiteman
- Cancer Division, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia.
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Frauchiger AL, Mangana J, Rechsteiner M, Moch H, Seifert B, Braun RP, Dummer R, Goldinger SM. Prognostic relevance of lactate dehydrogenase and serum S100 levels in stage IV melanoma with known BRAF mutation status. Br J Dermatol 2016; 174:823-30. [PMID: 26659191 DOI: 10.1111/bjd.14347] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND Activating mutations of BRAF provide an important treatment target in patients with melanoma. The prognostic role of several biochemical markers in relation to mutation status is not clear. OBJECTIVES To analyse the prognostic significance of BRAF mutation in patients with melanoma and correlate it to different markers. METHODS In total, 162 patients with stage IV melanoma and known BRAF mutation status were included. Clinical, histopathological and laboratory information was collected and compared between patients with BRAF mutant (BRAFm) and wild-type (BRAFwt) melanoma at the time of first distant metastasis. RESULTS In total, 88 patients (54%) had BRAFm melanoma (V600E/V600K). At the first distant metastasis, S100B levels in BRAFm patients were more frequently elevated (P = 0·01) and significantly higher (P = 0·02). Median overall survival (mOS) was significantly longer in BRAFwt patients with normal compared with patients with elevated S100B levels (P < 0·01). In BRAFm melanoma, elevated S100B levels showed no prognostic influence (P = 0·18). Elevated lactate dehydrogenase (LDH) levels had a significantly negative impact on mOS in both groups. mOS was increased for BRAFm patients treated with a BRAF inhibitor (BRAFi) compared with BRAFm patients not receiving BRAFi (P = 0·01). No difference in mOS between BRAFm patients who did not receive BRAFi treatment and BRAFwt patients was observed. CONCLUSIONS Better mOS was observed in BRAFm patients treated with BRAFi. BRAFm patients not treated with BRAFi show similar survival curves to BRAFwt patients. Elevated LDH is a BRAF-independent prognostic parameter; S100B has prognostic significance in BRAFwt melanoma only.
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Affiliation(s)
- A L Frauchiger
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - J Mangana
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - M Rechsteiner
- Department of Pathology, University Hospital Zurich, Schmelzbergstrasse 12, 8091, Zurich, Switzerland
| | - H Moch
- Department of Pathology, University Hospital Zurich, Schmelzbergstrasse 12, 8091, Zurich, Switzerland
| | - B Seifert
- Epidemiology, Biostatistics and Prevention Institute, Department of Biostatistics, University of Zurich, Zurich, Switzerland
| | - R P Braun
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - R Dummer
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
| | - S M Goldinger
- Department of Dermatology, University Hospital Zurich, Gloriastrasse 31, 8091, Zurich, Switzerland
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21
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Berwick M, Buller DB, Cust A, Gallagher R, Lee TK, Meyskens F, Pandey S, Thomas NE, Veierød MB, Ward S. Melanoma Epidemiology and Prevention. Cancer Treat Res 2016; 167:17-49. [PMID: 26601858 DOI: 10.1007/978-3-319-22539-5_2] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The epidemiology of melanoma is complex, and individual risk depends on sun exposure, host factors, and genetic factors, and in their interactions as well. Sun exposure can be classified as intermittent, chronic, or cumulative (overall) exposure, and each appears to have a different effect on type of melanoma. Other environmental factors, such as chemical exposures-either through occupation, atmosphere, or food-may increase risk for melanoma, and this area warrants further study. Host factors that are well known to be important are the numbers and types of nevi and the skin phenotype. Genetic factors are classified as high-penetrant genes, moderate-risk genes, or low-risk genetic polymorphisms. Subtypes of tumors, such as BRAF-mutated tumors, have different risk factors as well as different therapies. Prevention of melanoma has been attempted using various strategies in specific subpopulations, but to date optimal interventions to reduce incidence have not emerged.
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Affiliation(s)
- Marianne Berwick
- Department of Internal Medicine, University of New Mexico, MSC10-5550, Albuquerque, NM, 87131-0001, USA.
| | - David B Buller
- Klein Buendel, Inc., 1667 Cole Boulevard, Suite 225, Golden, CO, 80401, USA.
| | - Anne Cust
- Sydney School of Public Health, Sydney Medical School, University of Sydney, Level 6, 119-143 Missenden Road, Camperdown, NSW, 2050, Australia.
| | - Richard Gallagher
- Cancer Control Research Program, BC Cancer Agency, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada.
| | - Tim K Lee
- Cancer Control Research Program, BC Cancer Agency, 675 West 10th Avenue, Vancouver, BC, V5Z 1L3, Canada.
| | - Frank Meyskens
- Public Health and Epidemiology, University of California, Irvine, USA.
| | - Shaily Pandey
- Mount Sinai School of Medicine, One Gustave L. Levy Place, New York, NY, 10029, USA.
| | - Nancy E Thomas
- University of North Carolina, 413 Mary Ellen Jones Bldg. CB#7287, Chapel Hill, NC, 275992, USA.
| | - Marit B Veierød
- Department of Biostatistics, Institute of Basic Medical Sciences, P.O. Box 1122 Blindern, 0317, Oslo, Norway.
| | - Sarah Ward
- Centre for Genetic Origins of Health and Disease (GOHaD), The University of Western Australia, M409, 35 Stirling Hwy, Crawley, WA, 6009, Australia.
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22
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Kim SY, Kim SN, Hahn HJ, Lee YW, Choe YB, Ahn KJ. Metaanalysis of BRAF mutations and clinicopathologic characteristics in primary melanoma. J Am Acad Dermatol 2015; 72:1036-46.e2. [PMID: 25819940 DOI: 10.1016/j.jaad.2015.02.1113] [Citation(s) in RCA: 72] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Revised: 02/08/2015] [Accepted: 02/13/2015] [Indexed: 10/23/2022]
Abstract
BACKGROUND BRAF mutations occur in some melanomas. We hypothesized that BRAF mutation rates may differ in melanomas found in Asian compared to white populations. OBJECTIVE We performed a metaanalysis of BRAF mutations and their associations with the clinicopathologic characteristics of primary melanoma (PM), with a subgroup analysis to compare Asian and white patients with PM. METHODS The PubMed, EMBASE, and Cochrane databases were searched up to November 2013. The incidence rates and odds ratios (ORs) of BRAF mutations were calculated using a fixed or random effects model. RESULTS BRAF mutation was associated with younger age (OR = 1.734; P < .001), trunk location (OR = 2.272; P < .001), non-chronically sun damaged skin (OR = 2.833; P < .001), superficial spreading melanoma (OR = 2.081; P < .001), and advanced melanoma stage (OR = 1.551; P = .003). The incidence of BRAF mutations in Asian patients with PM was half that of white patients with PM, but it was linked to the same clinicopathologic characteristics. LIMITATIONS Only a small number of studies have been conducted on Asian patients with PMs. CONCLUSIONS The BRAF mutation in PM was associated with age, anatomic site based on ultraviolet radiation exposure, histologic subtype, and advanced stage of melanoma. The clinicopathologic associations with BRAF mutations were similar in Asian and white patients with PM.
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Affiliation(s)
- Soo Young Kim
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea
| | - Soo Nyung Kim
- Department of Obstetrics and Gynecology, Konkuk University School of Medicine, Seoul, Korea
| | - Hyung Jin Hahn
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea
| | - Yang Won Lee
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea; Research Institute of Medical Science, Konkuk University, Seoul, Korea.
| | - Yong Beom Choe
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea; Research Institute of Medical Science, Konkuk University, Seoul, Korea
| | - Kyu Joong Ahn
- Department of Dermatology, Konkuk University School of Medicine, Seoul, Korea; Research Institute of Medical Science, Konkuk University, Seoul, Korea
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23
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Saridaki Z, Asimakopoulou N, Boukovinas I, Souglakos J. How to Identify the Right Patients for the Right Treatment in Metastatic Colorectal Cancer (mCRC). CURRENT COLORECTAL CANCER REPORTS 2015. [DOI: 10.1007/s11888-015-0270-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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24
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García-Casado Z, Traves V, Bañuls J, Niveiro M, Gimeno-Carpio E, Jimenez-Sanchez A, Moragón M, Onrubia J, Oliver V, Kumar R, Nagore E. BRAF,NRASandMC1Rstatus in a prospective series of primary cutaneous melanoma. Br J Dermatol 2015; 172:1128-31. [DOI: 10.1111/bjd.13521] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Z. García-Casado
- Laboratory of Molecular Biology; Instituto Valenciano de Oncología; Valencia Spain
| | - V. Traves
- Department of Pathology; Instituto Valenciano de Oncología; Valencia Spain
| | - J. Bañuls
- Department of Dermatology; Hospital General Universitario de Alicante; Alicante Spain
| | - M. Niveiro
- Department of Pathology; Hospital General Universitario de Alicante; Alicante Spain
| | - E. Gimeno-Carpio
- Department of Dermatology; Hospital Arnau de Vilanova; Valencia Spain
| | | | - M. Moragón
- Department of Dermatology; Hospital Universitario San Joan; Alicante Spain
| | - J.A. Onrubia
- Department of Pathology; Hospital Universitario San Joan; Alicante Spain
| | - V. Oliver
- Department of Dermatology; Consorcio Hospital General Universitario; Valencia Spain
| | - R. Kumar
- Division of Molecular Genetic Epidemiology; German Cancer Research Center; Heidelberg Germany
| | - E. Nagore
- Department of Dermatology; Instituto Valenciano de Oncología; Valencia Spain
- Universidad Católica ‘San Vicente Ferrer’ de Valencia; Valencia Spain
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25
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Haddadeen C, Lai C, Cho SY, Healy E. Variants of the melanocortin-1 receptor: do they matter clinically? Exp Dermatol 2014; 24:5-9. [DOI: 10.1111/exd.12540] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2014] [Indexed: 01/04/2023]
Affiliation(s)
- Ciara Haddadeen
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton UK
- Dermatology; University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - Chester Lai
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton UK
- Dermatology; University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - Shin-Young Cho
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton UK
- Dermatology; University Hospital Southampton NHS Foundation Trust; Southampton UK
| | - Eugene Healy
- Dermatopharmacology; Sir Henry Wellcome Laboratories; Faculty of Medicine; University of Southampton; Southampton UK
- Dermatology; University Hospital Southampton NHS Foundation Trust; Southampton UK
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26
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Fargnoli MC, Sera F, Suppa M, Piccolo D, Landi MT, Chiarugi A, Pellegrini C, Seidenari S, Peris K. Dermoscopic features of cutaneous melanoma are associated with clinical characteristics of patients and tumours and with MC1R genotype. J Eur Acad Dermatol Venereol 2014; 28:1768-75. [PMID: 24588892 DOI: 10.1111/jdv.12411] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2013] [Accepted: 01/25/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Several algorithms are available for the dermoscopic diagnosis of pigmented skin lesions. The MC1R gene is a key determinant of pigmentation characteristics that are established host-related melanoma risk factors. OBJECTIVES To investigate the association of dermoscopic features of sporadic cutaneous melanomas with clinical characteristics of patients and corresponding tumours and with genetic changes in the MC1R and BRAF genes. METHODS A total of 64 dermoscopic images of 62 patients were scored by ABCD rule and modified pattern analysis. Detailed patients' and melanomas' characteristics were collected. Patients were screened for germline MC1R variants and related melanomas for somatic V600 BRAF mutations. RESULTS A lower total dermoscopic score (TDS) was observed in melanomas of patients with red hair (P = 0.019), due to reduced dermoscopic structures (P < 0.0001). Thicker melanomas showed higher TDS values (P = 0.021) due to sharper borders (P < 0.0001) and higher number of colors (P = 0.004). An atypical pigment network was prevalent in superficial spreading melanomas (P = 0.010), in individuals with dark skin (P = 0.043) and hair color (P = 0.001). An atypical vascular pattern was more frequent in nodular (P < 0.0001) and thick (P < 0.0001) melanomas, in individuals with skin type I-II (P = 0.037), blond or red hair color (P = 0.032) and blue or green eyes (P = 0.014). Melanomas of MC1R R carriers showed lower TDS value (P = 0.037), reduced dermoscopic structures (P = 0.001) and lower prevalence of atypical pigment network (P = 0.001). No differences were identified between BRAF-mutated or wild-type melanomas. CONCLUSIONS We suggest a phenotypic/MC1R profile for melanoma patients and their tumours. Melanomas of MC1R R carriers show a significant lower TDS value, with reduced dermoscopic structures, and a lower prevalence of an atypical pigment network. Non-carriers of MC1R R variants develop melanomas dermoscopically characterized by an atypical pigment network which is prevalent in superficial spreading melanomas, in patients with dark complexion and less frequent in red-haired individuals.
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Affiliation(s)
- M C Fargnoli
- Department of Dermatology, University of L'Aquila, L'Aquila, Italy
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27
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Heidenreich B, Nagore E, Rachakonda PS, Garcia-Casado Z, Requena C, Traves V, Becker J, Soufir N, Hemminki K, Kumar R. Telomerase reverse transcriptase promoter mutations in primary cutaneous melanoma. Nat Commun 2014; 5:3401. [PMID: 24569790 DOI: 10.1038/ncomms4401] [Citation(s) in RCA: 145] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 02/06/2014] [Indexed: 01/06/2023] Open
Abstract
We previously reported a disease segregating causal germline mutation in a melanoma family and recurrent somatic mutations in metastasized tumours from unrelated patients in the core promoter region of the telomerase reverse transcriptase (TERT) gene. Here we show that the TERT promoter mutations, besides causing an increased gene expression, associate with increased patient age, increased Breslow thickness and tumour ulceration in 287 primary melanomas. The mutations are more frequent at both intermittently and chronically sun-exposed sites than non-exposed sites and tend to co-occur with BRAF and CDKN2A alterations. The association with parameters generally connected with poor outcome, coupled with high recurrence and mechanistic relevance, raises the possibility of the eventual use of TERT promoter mutations in the disease management.
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Affiliation(s)
- Barbara Heidenreich
- 1] Division of Molecular Genetic Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany [2]
| | - Eduardo Nagore
- 1] Department of Dermatology, Instituto Valenciano de Oncologia, Valencia 46009, Spain [2] Universidad Catolica de Valencia, Valencia 46001, Spain [3]
| | | | - Zaida Garcia-Casado
- Laboratory of Molecular Biology, Instituto Valenciano de Oncologia, Valencia 46009, Spain
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia 46009, Spain
| | - Victor Traves
- Department of Pathology, Instituto Valenciano de Oncologia, Valencia 46009, Spain
| | - Jürgen Becker
- Department of General Dermatology, Medical University of Graz, Graz 8036, Austria
| | - Nadem Soufir
- Departement de Genetique, Hôpital Bichat-Claude Bernard, APHP, Paris 75877, France
| | - Kari Hemminki
- 1] Division of Molecular Genetic Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany [2] Center for Primary Health Care Research, Lund University, Malmö, Lund 221 00, Sweden
| | - Rajiv Kumar
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, 69120 Heidelberg, Germany
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28
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Russo AL, Borger DR, Szymonifka J, Ryan DP, Wo JY, Blaszkowsky LS, Kwak EL, Allen JN, Wadlow RC, Zhu AX, Murphy JE, Faris JE, Dias-Santagata D, Haigis KM, Ellisen LW, Iafrate AJ, Hong TS. Mutational analysis and clinical correlation of metastatic colorectal cancer. Cancer 2014; 120:1482-90. [PMID: 24500602 DOI: 10.1002/cncr.28599] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 12/03/2013] [Accepted: 12/10/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND Early identification of mutations may guide patients with metastatic colorectal cancer toward targeted therapies that may be life prolonging. The authors assessed tumor genotype correlations with clinical characteristics to determine whether mutational profiling can account for clinical similarities, differences, and outcomes. METHODS Under Institutional Review Board approval, 222 patients with metastatic colon adenocarcinoma (n = 158) and rectal adenocarcinoma (n = 64) who underwent clinical tumor genotyping were reviewed. Multiplexed tumor genotyping screened for >150 mutations across 15 commonly mutated cancer genes. The chi-square test was used to assess genotype frequency by tumor site and additional clinical characteristics. Cox multivariate analysis was used to assess the impact of genotype on overall survival. RESULTS Broad-based tumor genotyping revealed clinical and anatomic differences that could be linked to gene mutations. NRAS mutations were associated with rectal cancer versus colon cancer (12.5% vs 0.6%; P < .001) and with age ≥56 years (7% vs 0.9%; P = .02). Conversely, v-raf murine sarcoma viral oncogene homolog B (BRAF) mutations were associated with colon cancer (13% vs 3%; P = .024) and older age (15.8% vs 4.6%; P = .006). TP53 mutations were associated with rectal cancer (30% vs 18%; P = .048), younger age (14% vs 28.7%; P = .007), and men (26.4% vs 14%; P = .03). Lung metastases were associated with PIK3CA mutations (23% vs 8.7%; P = .004). Only mutations in BRAF were independently associated with decreased overall survival (hazard ratio, 2.4; 95% confidence interval, 1.09-5.27; P = .029). CONCLUSIONS The current study suggests that underlying molecular profiles can differ between colon and rectal cancers. Further investigation is warranted to assess whether the differences identified are important in determining the optimal treatment course for these patients.
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Affiliation(s)
- Andrea L Russo
- Harvard Radiation Oncology Program, Boston, Massachusetts
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Nagore E, Requena C, Traves V, Guillen C, Hayward NK, Whiteman DC, Hacker E. Prognostic value of BRAF mutations in localized cutaneous melanoma. J Am Acad Dermatol 2014; 70:858-62.e1-2. [PMID: 24388723 DOI: 10.1016/j.jaad.2013.10.064] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2013] [Revised: 10/15/2013] [Accepted: 10/28/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND BRAF mutations are frequent in melanoma but their prognostic significance remains unclear. OBJECTIVE We sought to further evaluate the prognostic value of BRAF mutations in localized cutaneous melanoma. METHODS We undertook an observational retrospective study of 147 patients with localized invasive (stages I and II) cutaneous melanomas to determine the prognostic value of BRAF mutation status. RESULTS After a median follow-up of 48 months, patients with localized melanomas with BRAF-mutant melanomas exhibited poorer disease-free survival than those with BRAF-wt genotype (hazard ratio 2.2, 95% confidence interval 1.1-4.3) even after adjustment for Breslow thickness, tumor ulceration, location, age, sex, and tumor mitotic rate. LIMITATIONS The retrospective design and the small number of events are limitations. CONCLUSIONS Our findings suggest that reappraisal of clinical treatment approaches for patients with localized melanoma harboring tumors with BRAF mutation might be warranted.
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Affiliation(s)
- Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain; Universidad Católica de Valencia, Valencia, Spain.
| | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Víctor Traves
- Department of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Carlos Guillen
- Department of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Nicholas K Hayward
- Genetics and Computational Biology Department, Queensland Institute of Medical Research, Brisbane, Australia
| | - David C Whiteman
- Population Health Department, Queensland Institute of Medical Research, Brisbane, Australia
| | - Elke Hacker
- Genetics and Computational Biology Department, Queensland Institute of Medical Research, Brisbane, Australia; Center for Research Excellence in Sun and Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
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Bastian BC. The molecular pathology of melanoma: an integrated taxonomy of melanocytic neoplasia. ANNUAL REVIEW OF PATHOLOGY 2014; 9:239-71. [PMID: 24460190 PMCID: PMC4831647 DOI: 10.1146/annurev-pathol-012513-104658] [Citation(s) in RCA: 313] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Melanomas comprise multiple biologically distinct categories, which differ in cell of origin, age of onset, clinical and histologic presentation, pattern of metastasis, ethnic distribution, causative role of UV radiation, predisposing germ-line alterations, mutational processes, and patterns of somatic mutations. Neoplasms are initiated by gain-of-function mutations in one of several primary oncogenes, which typically lead to benign melanocytic nevi with characteristic histologic features. The progression of nevi is restrained by multiple tumor-suppressive mechanisms. Secondary genetic alterations override these barriers and promote intermediate or overtly malignant tumors along distinct progression trajectories. The current knowledge about the pathogenesis and clinical, histologic, and genetic features of primary melanocytic neoplasms is reviewed and integrated into a taxonomic framework.
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Affiliation(s)
- Boris C Bastian
- Departments of Dermatology and Pathology, Cardiovascular Research Institute, University of California, San Francisco, California 94158-9001;
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31
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Boursault L, Haddad V, Vergier B, Cappellen D, Verdon S, Bellocq JP, Jouary T, Merlio JP. Tumor homogeneity between primary and metastatic sites for BRAF status in metastatic melanoma determined by immunohistochemical and molecular testing. PLoS One 2013; 8:e70826. [PMID: 23976959 PMCID: PMC3748080 DOI: 10.1371/journal.pone.0070826] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Accepted: 06/23/2013] [Indexed: 02/07/2023] Open
Abstract
BRAF inhibitors have demonstrated improvement of overall survival in patients with metastatic melanoma and BRAFV600 mutations. In order to evaluate BRAF tumor heterogeneity between primary and metastatic site, we have evaluated the performance of immunohistochemistry (IHC) with an anti-BRAFV600E antibody in both localization by comparison with high resolution melting analysis followed by Sanger sequencing in a parallel blinded study. A total of 230 samples distributed as primary melanoma (n = 88) and different types of metastatic samples (n = 142) were studied in 99 patients with advanced or metastatic melanoma (stage III or IV). The prevalence of each BRAF mutation was c.1799T>A, BRAFV600E (45.2%), c.1799_1800TG>AA, BRAFV600E2 (3.0%), c.1798_1799GT>AA, BRAFV600K (3.0%), c.1801 A>G, BRAFK601E (1.3%), c.1789_1790CT>TC, BRAFL597S (0.4%), c.1780G>A, BRAFD594N (0.9%) respectively. IHC was positive in 109/112 samples harboring BRAFV600E/E2 mutations and negative in other cases. The cytoplasmic staining was either strongly positive in tumor cells of BRAFV600E mutated cases. It appeared strong brown, different from the vesicular grey cytoplasmic pigmentation of melanophages. Concordance between the two techniques was 96.4%. Sensitivity of IHC for detecting the BRAFV600E/E2 mutations was 97.3%, while specificity was 100%. Both our IHC and molecular study demonstrated homogeneity between primary and metastatic sites for BRAF status in melanoma. This study also provides evidence that IHC may be a cost-effective first-line method for BRAFV600E detection. Thereafter, molecular techniques should be used in negative, ambiguous or non-contributive cases.
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Affiliation(s)
| | - Véronique Haddad
- Tumor Bank and Tumor Biology Laboratory, CHU Bordeaux, Pessac, France
| | | | - David Cappellen
- Tumor Bank and Tumor Biology Laboratory, CHU Bordeaux, Pessac, France
| | - Severine Verdon
- Tumor Bank and Tumor Biology Laboratory, CHU Bordeaux, Pessac, France
| | | | - Thomas Jouary
- Department of Dermatology, CHU Bordeaux, Bordeaux, France
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Stadelmeyer E, Heitzer E, Resel M, Cerroni L, Wolf P, Dandachi N. The BRAF V600K mutation is more frequent than the BRAF V600E mutation in melanoma in situ of lentigo maligna type. J Invest Dermatol 2013; 134:548-550. [PMID: 24026210 DOI: 10.1038/jid.2013.338] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Elke Stadelmeyer
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Ellen Heitzer
- Institute of Human Genetics, Medical University of Graz, Graz, Austria
| | - Margit Resel
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Lorenzo Cerroni
- Research Unit for Dermatopathology, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria
| | - Peter Wolf
- Research Unit for Photodermatology, Department of Dermatology and Venereology, Medical University of Graz, Graz, Austria.
| | - Nadia Dandachi
- Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
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Abstract
In this issue, Hacker et al. (2012) report the largest study to date on the association between MC1R variants and BRAF mutant melanoma. Although they did not observe a significant overall correlation, there was a significant negative association between BRAF and MC1R mutations for head/neck melanomas. This suggests a fundamental difference in pathogenesis between head/neck and truncal melanomas, which could contribute to their divergent prognoses.
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Affiliation(s)
- Emma C Fink
- Department of Dermatology, Harvard Medical School, Boston, MA, USA
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