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Ferguson R, Chat V, Morales L, Simpson D, Monson KR, Cohen E, Zusin S, Madonna G, Capone M, Simeone E, Pavlick A, Luke JJ, Gajewski TF, Osman I, Ascierto P, Weber J, Kirchhoff T. Germline immunomodulatory expression quantitative trait loci (ieQTLs) associated with immune-related toxicity from checkpoint inhibition. Eur J Cancer 2023; 189:112923. [PMID: 37301715 PMCID: PMC11000635 DOI: 10.1016/j.ejca.2023.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/11/2023] [Accepted: 05/13/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Immune checkpoint inhibition (ICI) has improved clinical outcomes for metastatic melanoma patients; however, 65-80% of patients treated with ICI experience immune-related adverse events (irAEs). Given the plausible link of irAEs with underlying host immunity, we explored whether germline genetic variants controlling the expression of 42 immunomodulatory genes were associated with the risk of irAEs in melanoma patients treated with the single-agent anti-CTLA-4 antibody ipilimumab (IPI). METHODS We identified 42 immunomodulatory expression quantitative trait loci (ieQTLs) most significantly associated with the expression of 382 immune-related genes. These germline variants were genotyped in IPI-treated melanoma patients, collected as part of a multi-institutional collaboration. We tested the association of ieQTLs with irAEs in a discovery cohort of 95 patients, followed by validation in an additional 97 patients. RESULTS We found that the alternate allele of rs7036417, a variant linked to increased expression of SYK, was strongly associated with an increased risk of grade 3-4 toxicity [odds ratio (OR) = 7.46; 95% confidence interval (CI) = 2.65-21.03; p = 1.43E-04]. This variant was not associated with response (OR = 0.90; 95% CI = 0.37-2.21; p = 0.82). CONCLUSION We report that rs7036417 is associated with increased risk of severe irAEs, independent of IPI efficacy. SYK plays an important role in B-cell/T-cell expansion, and increased pSYK has been reported in patients with autoimmune disease. The association between rs7036417 and IPI irAEs in our data suggests a role of SYK overexpression in irAE development. These findings support the hypothesis that inherited variation in immune-related pathways modulates ICI toxicity and suggests SYK as a possible future target for therapies to reduce irAEs.
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Affiliation(s)
- Robert Ferguson
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; Departments of Population Health and Environmental Medicine, New York University-Grossman School of Medicine, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA
| | - Vylyny Chat
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; Departments of Population Health and Environmental Medicine, New York University-Grossman School of Medicine, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA
| | - Leah Morales
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; Departments of Population Health and Environmental Medicine, New York University-Grossman School of Medicine, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA
| | - Danny Simpson
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; Departments of Population Health and Environmental Medicine, New York University-Grossman School of Medicine, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA
| | - Kelsey R Monson
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; Departments of Population Health and Environmental Medicine, New York University-Grossman School of Medicine, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA
| | - Elisheva Cohen
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; Departments of Population Health and Environmental Medicine, New York University-Grossman School of Medicine, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA
| | - Sarah Zusin
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; Departments of Population Health and Environmental Medicine, New York University-Grossman School of Medicine, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA
| | - Gabriele Madonna
- Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Mariaelena Capone
- Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Ester Simeone
- Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Anna Pavlick
- Division of Hematology & Medical Oncology, the Cutaneous Oncology Program, Weill Cornell Medicine and New York-Presbyterian, New York, USA
| | - Jason J Luke
- Department of Immunology, University of Pittsburgh, Pittsburgh, PA 15213, USA; UPMC Hillman Cancer Center, Pittsburgh, PA 15232, USA
| | - Thomas F Gajewski
- Department of Pathology, University of Chicago, Chicago, IL, USA; Section of Hematology/Oncology, Department of Medicine, University of Chicago, Chicago, IL, USA; Ben May Department for Cancer Research, University of Chicago, Chicago, IL, USA
| | - Iman Osman
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA; Department of Medicine, New York University-Grossman School of Medicine, New York, NY, USA; Ronald O. Perelman Department of Dermatology, New York University-Grossman School of Medicine, New York, NY, USA
| | - Paolo Ascierto
- Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione G. Pascale, Napoli, Italy
| | - Jeffrey Weber
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA; Department of Medicine, New York University-Grossman School of Medicine, New York, NY, USA
| | - Tomas Kirchhoff
- Laura and Isaac Perlmutter Cancer Center, New York University Langone Health, New York, NY, USA; Departments of Population Health and Environmental Medicine, New York University-Grossman School of Medicine, New York, NY, USA; The Interdisciplinary Melanoma Cooperative Group, New York University-Grossman School of Medicine, New York, NY, USA.
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Palacios-Diaz RD, de Unamuno-Bustos B, Abril-Pérez C, Pozuelo-Ruiz M, Sánchez-Arraez J, Torres-Navarro I, Botella-Estrada R. Multiple Primary Melanomas: Retrospective Review in a Tertiary Care Hospital. J Clin Med 2022; 11:2355. [PMID: 35566480 PMCID: PMC9105033 DOI: 10.3390/jcm11092355] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/05/2022] [Accepted: 04/19/2022] [Indexed: 11/23/2022] Open
Abstract
Multiple primary melanomas (MPM) refer to the occurrence of more than one synchronous or metachronous melanoma in the same individual. The aim of this study was to identify the frequency of MPM and describe the clinical and histopathologic characteristics of patients with MPM. An observational single-center retrospective study was designed based on a cohort of melanoma patients followed in a tertiary care hospital. Fifty-eight (8.9%) patients developed MPM. Most patients were men (65.5%) and the median age at the time of diagnosis of the first melanoma was 71 years old. The median time of diagnosis of the second melanoma from the first melanoma was 10.9 months, and 77.6% of second melanomas were diagnosed within the first 5 years. In total, 29 (50%) and 28 (48.3%) first and second melanomas were located in the trunk, respectively. Concordance of anatomic site between primary and subsequent melanoma was found in 46.6% of the patients. Proportion of in situ melanomas was increasingly higher in subsequent melanomas (from 36.21% of first melanomas to 100% of fifth melanomas). An increasing rate of melanomas with histological regression was observed within subsequent melanomas (from 60.3% of first melanomas to 80% of third melanomas). Our results support the importance of careful long-term follow-up with total body examination in melanoma patients.
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Affiliation(s)
- Rodolfo David Palacios-Diaz
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Blanca de Unamuno-Bustos
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Carlos Abril-Pérez
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Mónica Pozuelo-Ruiz
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Javier Sánchez-Arraez
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Ignacio Torres-Navarro
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
| | - Rafael Botella-Estrada
- Department of Dermatology, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain; (R.D.P.-D.); (C.A.-P.); (M.P.-R.); (J.S.-A.); (I.T.-N.); (R.B.-E.)
- Department of Medicine, Universitat de València, 46010 Valencia, Spain
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Chat V, Ferguson R, Morales L, Kirchhoff T. Ultra Low-Coverage Whole-Genome Sequencing as an Alternative to Genotyping Arrays in Genome-Wide Association Studies. Front Genet 2022; 12:790445. [PMID: 35251117 PMCID: PMC8889143 DOI: 10.3389/fgene.2021.790445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022] Open
Abstract
An array-based genotyping approach has been the standard practice for genome-wide association studies (GWASs); however, as sequencing costs plummet over the past years, ultra low-coverage whole-genome sequencing (ulcWGS <0.5× coverage) has emerged as a promising alternative that provides superior genomic coverage with substantial reduction of genotyping cost. To evaluate the potential utility of ulcWGS, we performed a whole-genome sequencing (WGS) of 72 European individuals to a target coverage of 0.4× and compared its performance with the widely used Infinium Global Screening Multi-Disease Array (GSA-MD). We showed that the number of variants captured by ulcWGS is comparable with imputed GSA-MD platform, particularly for low-frequency (95.5%) and common variants (99.9%), with high imputation R2 accuracy (mean 0.93 for SNPs and 0.86 for indels). Using deep-coverage 30× WGS as the “truth” genotypes, we found that ulcWGS has higher overall nonreference genotype concordance compared with imputed GSA-MD for both SNPs (0.90 vs. 0.88) and indels (0.86 vs. 0.83). In addition, ulcWGS proved to be as sensitive as the genotyping-based method in sex imputation and ancestry prediction producing similar principal component (PC) scores. Our findings provide important evidence that the cost efficient ulcWGS of <0.5× generates high genotype accuracy, outperforming the standard genotyping arrays, making it an attractive alternative to the array-based method in next-generation GWAS design.
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Affiliation(s)
- Vylyny Chat
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, United States
- The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States
| | - Robert Ferguson
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, United States
- The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States
| | - Leah Morales
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, United States
- The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States
| | - Tomas Kirchhoff
- Perlmutter Cancer Center, New York University School of Medicine, New York, NY, United States
- Departments of Population Health and Environmental Medicine, New York University School of Medicine, New York, NY, United States
- The Interdisciplinary Melanoma Cooperative Group, New York University School of Medicine, New York, NY, United States
- *Correspondence: Tomas Kirchhoff,
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Truderung OAH, Sagi JC, Semsei AF, Szalai C. Melanoma susceptibility: an update on genetic and epigenetic findings. INTERNATIONAL JOURNAL OF MOLECULAR EPIDEMIOLOGY AND GENETICS 2021; 12:71-89. [PMID: 34853632 PMCID: PMC8611230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Malignant melanoma is one of the most highly ranked cancers in terms of years of life lost. Hereditary melanoma with its increased familial susceptibility is thought to affect up to 12% of all melanoma patients. In the past, only a few high-penetrance genes associated with familial melanoma, such as CDKN2A and CDK4, have been clinically tested. However, findings now indicate that melanoma is a cancer most likely to develop not only due to high-penetrance variants but also due to polygenic inheritance patterns, leaving no clear division between the hereditary and sporadic development of malignant melanoma. Various pathogenic low-penetrance variants were recently discovered through genome-wide association studies, and are now translated into polygenic risk scores. These can show superior sensitivity rates for the prediction of melanoma susceptibility and related mixed cancer syndromes than risk scores based on phenotypic traits of the patients, with odds ratios of up to 5.7 for patients in risk groups. In addition to describing genetic findings, we also review the first results of epigenetic research showing constitutional methylation changes that alter the susceptibility to cutaneous melanoma and its risk factors.
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Affiliation(s)
- Ole AH Truderung
- Department of Genetics, Cell- and Immunobiology, Semmelweis UniversityH-1089 Budapest, Hungary
| | - Judit C Sagi
- Department of Genetics, Cell- and Immunobiology, Semmelweis UniversityH-1089 Budapest, Hungary
| | - Agnes F Semsei
- Department of Genetics, Cell- and Immunobiology, Semmelweis UniversityH-1089 Budapest, Hungary
| | - Csaba Szalai
- Department of Genetics, Cell- and Immunobiology, Semmelweis UniversityH-1089 Budapest, Hungary
- Heim Pal Children’s HospitalH-1089 Budapest, Hungary
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Salgüero Fernández I, Palma Marti L, Nájera Botello L, Roustan Gullón G. Clinical and Histologic Features of Multiple Primary Melanoma in a Series of 31 Patients. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:52-58. [PMID: 32950483 DOI: 10.1016/j.ad.2020.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND We reviewed all cases of multiple primary melanoma diagnosed at our department over a 32-year period (1987-2019) to better characterize this subgroup of patients and develop a tailored protocol to offer them closer follow-up. METHODS Retrospective, observational, descriptive study of patients diagnosed with multiple primary melanoma at a tertiary care hospital between January 1987 and March 2019. We collected clinical, epidemiologic, and histologic characteristics of primary and subsequent melanomas and performed a descriptive analysis. RESULTS Thirty-one patients (15 men and 16 women) with a median age of 67years (range, 36-85years) were included. Second primary melanomas were diagnosed after a median of 2years (range, 0-4years). The median number of melanomas per patient was 2 (range, 2-6). Twenty-three of the 31 patients, 25 had 2 primary melanomas (80%), 4 had 3 melanomas (13%), and 2 patients each had 5 and 6 primary melanomas. Subsequent melanomas were less invasive than the initial primary melanomas. Median Breslow thickness was 1mm (range, 0.67-4mm) for the first primary melanoma and 0.5mm (range, 0.32-2.42mm) for subsequent melanomas. CONCLUSIONS Subsequent melanomas are thinner than primary melanomas. We observed an increase in the number of cases of multiple primary melanoma diagnosed in the last 2years of our study. Our findings highlight the importance of close, long-term follow-up of patients.
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Affiliation(s)
- I Salgüero Fernández
- Servicio de Dermatología, Hospital Puerta de Hierro, Majadahonda, Madrid, España.
| | - L Palma Marti
- Hospital Puerta de Hierro, Majadahonda, Madrid, España
| | - L Nájera Botello
- Servicio de Anatomía Patológica, Hospital Puerta de Hierrro, Majadahonda, Madrid, España
| | - G Roustan Gullón
- Servicio de Dermatología, Hospital Puerta de Hierro, Majadahonda, Madrid, España
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