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Bezrookove V, Kianian S, McGeever L, Jones R, Caressi C, Nosrati M, Kim KB, Leong SP, Miller JR, Desprez PY, Kashani-Sabet M. The Molecular Evolution of Melanoma Distant Metastases. J Invest Dermatol 2024:S0022-202X(24)00271-9. [PMID: 38582370 DOI: 10.1016/j.jid.2024.03.029] [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: 12/19/2023] [Revised: 02/26/2024] [Accepted: 03/14/2024] [Indexed: 04/08/2024]
Abstract
The evolution of primary melanoma to lymph node and distant metastasis is incompletely understood. We examined the genomic diversity in melanoma progression in matched primary melanomas and lymph node and distant metastases from 17 patients. FISH analysis revealed cancer cell fractions with monotonic copy number alterations, including PHIP gain and PTEN loss, in the metastatic cascade. By contrast, the cancer cell fraction with copy number alterations for BPTF and MITF was reduced in lymph node metastases but increased in distant metastases. Separately, the cancer cell fraction with NCOA3 copy number alteration was comparable between primary tumors and lymph node metastases yet increased in distant metastases. These results suggest enrichment of the phosphoinositide 3-kinase and MITF pathways in the transition through the metastatic cascade. By contrast, next-generation sequencing analysis did not identify a consistent pattern of changes in variant allele frequency while revealing several intriguing findings, including decreased variant allele frequency in distant metastases and distinct drivers in lymph node versus distant metastases. These results provide evidence that distant melanoma metastasis does not always emanate from lymph node metastasis. These results enhance our understanding of clonal patterns of melanoma metastasis, with possible implications for targeted therapy and metastasis competency.
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Affiliation(s)
- Vladimir Bezrookove
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California, USA; California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Sara Kianian
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California, USA; California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Lea McGeever
- California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Robyn Jones
- California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Chongshan Caressi
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California, USA; California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Mehdi Nosrati
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California, USA; California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Kevin B Kim
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California, USA; California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Stanley P Leong
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California, USA; California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - James R Miller
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California, USA; California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Pierre-Yves Desprez
- California Pacific Medical Center Research Institute, San Francisco, California, USA
| | - Mohammed Kashani-Sabet
- Center for Melanoma Research and Treatment, California Pacific Medical Center, San Francisco, California, USA; California Pacific Medical Center Research Institute, San Francisco, California, USA.
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Jaeger ZJ, Raval NS, Maverakis NKA, Chen DY, Ansstas G, Hardi A, Cornelius LA. Objective response to immune checkpoint inhibitor therapy in NRAS-mutant melanoma: A systematic review and meta-analysis. Front Med (Lausanne) 2023; 10:1090737. [PMID: 36873887 PMCID: PMC9979544 DOI: 10.3389/fmed.2023.1090737] [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: 11/05/2022] [Accepted: 01/25/2023] [Indexed: 02/18/2023] Open
Abstract
Introduction NRAS mutations are common in melanoma and confer a worse prognosis. Although most patients with metastatic melanoma receive immune checkpoint inhibitors (ICIs), the impact of NRAS mutational status on their efficacy remains under debate. Methods We performed a comprehensive literature search across several large databases. Inclusion criteria were trials, cohorts, and large case series that analyzed the primary outcome of objective response rate by NRAS mutational status in patients with melanoma treated with any line of ICI. At least two reviewers independently screened studies using Covidence software, extracted data, and assessed risk of bias. Standard meta-analysis was performed in R with sensitivity analysis and tests for bias. Results Data on 1770 patients from ten articles were pooled for meta-analysis, and the objective response rate to ICIs was calculated to compare NRAS-mutant and NRAS-wildtype melanoma. The objective response rate was 1.28 (95% confidence interval: 1.01-1.64). Sensitivity analysis identified the study by Dupuis et al. with influential impact on the pooled effect size and heterogeneity, favoring NRAS-mutant melanoma. Discussion In this meta-analysis evaluating the impact of NRAS mutational status on objective response to ICIs in metastatic melanoma, NRAS-mutant cutaneous melanoma demonstrated an increased likelihood of partial or complete tumor response, relative to NRAS-wildtype cutaneous melanoma. Genomic screening for NRAS mutations in patients with metastatic melanoma may improve predictive ability when initiating ICIs.
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Affiliation(s)
- Zachary J Jaeger
- Office of Medical Student Education, Washington University School of Medicine, St. Louis, MO, United States
| | - Neel S Raval
- Office of Medical Student Education, Washington University School of Medicine, St. Louis, MO, United States
| | | | - David Y Chen
- Alvin J. Siteman Comprehensive Cancer Center, Washington University School of Medicine, St. Louis, MO, United States.,Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
| | - George Ansstas
- Alvin J. Siteman Comprehensive Cancer Center, Washington University School of Medicine, St. Louis, MO, United States
| | - Angela Hardi
- Office of Medical Student Education, Washington University School of Medicine, St. Louis, MO, United States
| | - Lynn A Cornelius
- Alvin J. Siteman Comprehensive Cancer Center, Washington University School of Medicine, St. Louis, MO, United States.,Division of Dermatology, Department of Medicine, Washington University School of Medicine, St. Louis, MO, United States
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Mao L, Guo J, Zhu L, Jiang Y, Yan W, Zhang J, Hui AM, Yang Y, Diao L, Tan Y, Zhao H, Jiang Y, Wu Z, Si L. A first-in-human, phase 1a dose-escalation study of the selective MEK1/2 inhibitor FCN-159 in patients with advanced NRAS-mutant melanoma. Eur J Cancer 2022; 175:125-135. [PMID: 36113242 DOI: 10.1016/j.ejca.2022.08.005] [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: 06/22/2022] [Revised: 08/03/2022] [Accepted: 08/05/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND A phase 1a first-in-human study evaluated the safety/tolerability, preliminary antitumour activity and pharmacokinetics of the oral MEK1/2 inhibitor FCN-159 in Chinese patients with advanced, NRAS-mutant melanoma. PATIENTS AND METHODS Patients received a single FCN-159 dose at assigned levels, proceeding to continuous dosing (once daily [QD] for 28-day cycles) if no dose-limiting toxicities (DLTs) occurred within the next 3 days. Dose escalation was initiated after review of data for the previous dose level. The primary end-point was incidence of DLTs after the first dose. RESULTS Thirty-three patients were enrolled across nine FCN-159 dose groups (0.2-15 mg QD). One DLT occurred: grade 3 folliculitis in the 15-mg group. There was one grade >3 treatment-emergent adverse event (TEAE), death of unknown aetiology (not FCN-159 related). The most common FCN-159-related TEAE was rash (36.4%), and the incidence of grade ≥3 FCN-159-related TEAEs was 15.2%. Antitumour activity at QD doses <6 mg was limited; therefore, efficacy data are presented only for doses ≥6 mg (n = 21). The objective response and clinical benefit rates were 19.0% (four partial responses) and 52.4%, respectively. Median (95% confidence interval) duration of response and progression-free survival were 4.8 months (2.8-not reached) and 3.8 months (1.8-5.6), respectively. FCN-159 exposure increased dose-proportionately; geometric mean terminal half-life was 29.9-56.9 h. CONCLUSIONS FCN-159 was well tolerated and demonstrated promising antitumour activity at doses ≥6 mg QD in patients with advanced, NRAS-mutant melanoma. The recommended phase 2 dose was 12 mg QD. CLINICALTRIALS GOV IDENTIFIER NCT03932253. https://clinicaltrials.gov/ct2/show/NCT03932253.
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Affiliation(s)
- Lili Mao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma and Sarcoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Jun Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma and Sarcoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - Lingjun Zhu
- Jiangsu Province Hospital, Nanjing, Jiangsu Province, China
| | - Yu Jiang
- West China Hospital of Sichuan University, Chengdu, Sichuan Province, China
| | - Wangjun Yan
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Jian Zhang
- Fudan University Shanghai Cancer Center, Shanghai, China
| | - Ai-Min Hui
- Fosun Pharma USA Inc., Lexington, MA, USA
| | - Yuchen Yang
- Fosun Pharmaceutical Co., Ltd., Shanghai, China
| | - Lei Diao
- Fosun Pharmaceutical Co., Ltd., Shanghai, China
| | - Yan Tan
- Fosun Pharmaceutical Co., Ltd., Shanghai, China
| | - Han Zhao
- Fosun Pharmaceutical Co., Ltd., Shanghai, China
| | | | - Zhuli Wu
- Fosun Pharmaceutical Co., Ltd., Shanghai, China.
| | - Lu Si
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma and Sarcoma, Peking University Cancer Hospital & Institute, Beijing, China.
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Miyamoto S, Tanaka T, Hirosuna K, Nishie R, Ueda S, Hashida S, Terada S, Konishi H, Kogata Y, Taniguchi K, Komura K, Ohmichi M. Validation of a Patient-Derived Xenograft Model for Cervical Cancer Based on Genomic and Phenotypic Characterization. Cancers (Basel) 2022; 14:cancers14122969. [PMID: 35740635 PMCID: PMC9221029 DOI: 10.3390/cancers14122969] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary The rate of total tumor engraftment of patient-derived xenografts is 50% in cervical cancer. These cancers retain their histopathological characteristics. The gene mutations and expression patterns associated with carcinogenesis and infiltration and the expression levels of genes in extracellular vesicles released from the tumors are similar between patient-derived xenograft models and primary tumors. Patient-derived xenograft models of cervical cancer could be potentially useful tools for translational research. Abstract Patient-derived xenograft (PDX) models are useful tools for preclinical drug evaluation, biomarker identification, and personalized medicine strategies, and can be developed by the heterotopic or orthotopic grafting of surgically resected tumors into immunodeficient mice. We report the PDX models of cervical cancer and demonstrate the similarities among original and different generations of PDX tumors. Fresh tumor tissues collected from 22 patients with primary cervical cancer were engrafted subcutaneously into NOD.CB17-PrkdcSCID/J mice. Histological and immunohistochemical analyses were performed to compare primary and different generations of PDX tumors. DNA and RNA sequencing were performed to verify the similarity between the genetic profiles of primary and PDX tumors. Total RNA in extracellular vesicles (EVs) released from primary and PDX tumors was also quantified to evaluate gene expression. The total tumor engraftment rate was 50%. Histologically, no major differences were observed between the original and PDX tumors. Most of the gene mutations and expression patterns related to carcinogenesis and infiltration were similar between the primary tumor and xenograft. Most genes associated with carcinogenesis and infiltration showed similar expression levels in the primary tumor and xenograft EVs. Therefore, compared with primary tumors, PDX models could be potentially more useful for translational research.
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Affiliation(s)
- Shunsuke Miyamoto
- Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (S.M.); (R.N.); (S.U.); (S.H.); (S.T.); (H.K.); (Y.K.); (M.O.)
- Translational Research Program, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (K.H.); (K.T.); (K.K.)
| | - Tomohito Tanaka
- Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (S.M.); (R.N.); (S.U.); (S.H.); (S.T.); (H.K.); (Y.K.); (M.O.)
- Translational Research Program, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (K.H.); (K.T.); (K.K.)
- Correspondence: ; Tel.: +81-726-83-1221
| | - Kensuke Hirosuna
- Translational Research Program, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (K.H.); (K.T.); (K.K.)
| | - Ruri Nishie
- Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (S.M.); (R.N.); (S.U.); (S.H.); (S.T.); (H.K.); (Y.K.); (M.O.)
| | - Shoko Ueda
- Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (S.M.); (R.N.); (S.U.); (S.H.); (S.T.); (H.K.); (Y.K.); (M.O.)
| | - Sousuke Hashida
- Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (S.M.); (R.N.); (S.U.); (S.H.); (S.T.); (H.K.); (Y.K.); (M.O.)
| | - Shinichi Terada
- Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (S.M.); (R.N.); (S.U.); (S.H.); (S.T.); (H.K.); (Y.K.); (M.O.)
| | - Hiromi Konishi
- Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (S.M.); (R.N.); (S.U.); (S.H.); (S.T.); (H.K.); (Y.K.); (M.O.)
| | - Yuhei Kogata
- Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (S.M.); (R.N.); (S.U.); (S.H.); (S.T.); (H.K.); (Y.K.); (M.O.)
| | - Kohei Taniguchi
- Translational Research Program, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (K.H.); (K.T.); (K.K.)
| | - Kazumasa Komura
- Translational Research Program, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (K.H.); (K.T.); (K.K.)
| | - Masahide Ohmichi
- Department of Obstetrics and Gynecology, Educational Foundation of Osaka Medical and Pharmaceutical University, 2-7, Daigaku-machi, Takatsuki 569-8686, Osaka, Japan; (S.M.); (R.N.); (S.U.); (S.H.); (S.T.); (H.K.); (Y.K.); (M.O.)
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