1
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Baggio D, Chung E, Wellard C, Waters N, Cushion T, Chong G, Cochrane T, Cull G, Giri P, Hamad N, Johnston A, Lee D, Murali A, Morgan S, Mulligan S, Talaulikar D, Ratnasingam S, Wood E, Hawkes E, Opat S. Australians with chronic lymphocytic leukaemia continue to have high rates of second primary malignancies in the modern era. Intern Med J 2024; 54:1223-1227. [PMID: 38973146 DOI: 10.1111/imj.16445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 05/26/2024] [Indexed: 07/09/2024]
Abstract
Population-based studies have demonstrated a high risk of second cancers, especially of the skin, among patients with chronic lymphocytic leukaemia (CLL). We describe age-standardised incidence ratios (SIRs) of second primary malignancies (SPM) in Australian patients with relapsed/refractory CLL treated with at least two lines of therapy, including ibrutinib. From December 2014 to November 2017, 156 patients were identified from 13 sites enrolled in the Australasian Lymphoma and Related Diseases Registry, and 111 had follow-up data on rates of SPM. At 38.4 months from ibrutinib therapy commencement, 25% experienced any SPM. SIR for melanoma and all cancers (excluding nonmelanomatous skin cancers) were 15.8 (95% confidence interval (CI): 7.0-35.3) and 4.6 (95% CI: 3.1-6.9) respectively. These data highlight the importance of primary preventive interventions and surveillance, particularly as survival from CLL continues to improve.
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Affiliation(s)
- Diva Baggio
- Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Victoria, Australia
- Monash University, Melbourne, Victoria, Australia
| | - Eliza Chung
- Monash University, Melbourne, Victoria, Australia
| | | | - Neil Waters
- Monash University, Melbourne, Victoria, Australia
| | - Tania Cushion
- Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Victoria, Australia
| | - Geoffrey Chong
- Ballarat Regional Integrated Cancer Centre, Ballarat, Victoria, Australia
| | - Tara Cochrane
- Gold Coast University Hospital, Gold Coast, Queensland, Australia
| | - Gavin Cull
- Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Pratyush Giri
- Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Nada Hamad
- St Vincent's Health, Sydney, New South Wales, Australia
| | - Anna Johnston
- Royal Hobart Hospital, Hobart, Tasmania, Australia
- University of Tasmania, Hobart, Tasmania, Australia
| | - Denise Lee
- Eastern Health, Melbourne, Victoria, Australia
| | - Aarya Murali
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | | | | | - Dipti Talaulikar
- Canberra Health Services, Australian National University, Canberra, Australian Capital Territory, Australia
| | | | - Erica Wood
- Monash University, Melbourne, Victoria, Australia
| | - Eliza Hawkes
- Olivia Newton-John Cancer Research and Wellness Centre, Austin Health, Melbourne, Victoria, Australia
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2
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Zhao Y, Amorrortu RP, Stewart SC, Ghia KM, Williams VL, Sondak VK, Tsai KY, Pinilla-Ibarz J, Chavez JC, Rollison DE. Melanoma and CLL co-occurrence and survival: role of KC history. BMC Cancer 2023; 23:1084. [PMID: 37946198 PMCID: PMC10636833 DOI: 10.1186/s12885-023-11573-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND Survival following melanoma and chronic lymphocytic leukemia (CLL) have both been individually associated with previous history of non-melanoma skin cancers (specifically keratinocyte carcinomas [KC]). Furthermore, melanoma and CLL have been reported to occur within the same patients. The survival experience of patients with both cancers is understudied, and the role of history of KC is unknown. Additional research is needed to tease apart the independent associations between KC and CLL survival, KC and melanoma survival, and the co-occurrence of all three cancers. METHODS A retrospective cohort study was conducted among patients who were diagnosed with melanoma and/or CLL at a comprehensive cancer center between 2008 and 2020. Multivariable Cox regression models were used to examine the association between history of KC and survival following melanoma and/or CLL with careful consideration of calendar year of diagnosis, treatment regimens and other risk factors. A nested case-control study comparing patients with both CLL and melanoma to those with only CLL or only melanoma was conducted to compare blood parameters across the three groups. RESULTS A time-dependent association was observed between history of KC and favorable melanoma survival within 4 years following diagnosis and poorer survival post 7 years after melanoma diagnosis. History of KC was not significantly associated with survival following the diagnosis of CLL, after adjustment for clinical factors including historical/concurrent melanoma. Patients with co-occurring melanoma and CLL tended to be diagnosed with melanoma first and had elevated blood parameters including white blood cell and lymphocyte counts as compared with patients who were diagnosed with only melanoma. CONCLUSIONS History of KC was an independent predictor of survival following melanoma but not of CLL. Additional studies are needed to determine if blood parameters obtained at the time of melanoma diagnosis could be used as a cost-effective way to identify those at high risk of asymptomatic CLL for the promotion of earlier CLL diagnosis.
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Affiliation(s)
- Yayi Zhao
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Sandra C Stewart
- Department of Cancer Registry, Moffitt Cancer Center, Tampa, FL, USA
| | - Kavita M Ghia
- Collaborative Data Services Core, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA
| | - Kenneth Y Tsai
- Department of Anatomic Pathology, Moffitt Cancer Center, Tampa, FL, USA
| | | | - Julio C Chavez
- Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL, USA
| | - Dana E Rollison
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA.
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3
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Cass SH, Tobin JWD, Seo YD, Gener-Ricos G, Keung EZ, Burton EM, Davies MA, McQuade JL, Lazar AJ, Mason R, Millward M, Sandhu S, Khoo C, Warburton L, Guerra V, Haydon A, Dearden H, Menzies AM, Carlino MS, Smith JL, Mollee P, Burgess M, Mapp S, Keane C, Atkinson V, Parikh SA, Markovic SN, Ding W, Call TG, Hampel PJ, Long GV, Wargo JA, Ferrajoli A. Efficacy of immune checkpoint inhibitors for the treatment of advanced melanoma in patients with concomitant chronic lymphocytic leukemia. Ann Oncol 2023; 34:796-805. [PMID: 37414216 PMCID: PMC11289780 DOI: 10.1016/j.annonc.2023.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/25/2023] [Accepted: 06/20/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Immune checkpoint inhibitors (ICIs) have revolutionized the management of advanced melanoma (AM). However, data on ICI effectiveness have largely been restricted to clinical trials, thereby excluding patients with co-existing malignancies. Chronic lymphocytic leukemia (CLL) is the most prevalent adult leukemia and is associated with increased risk of melanoma. CLL alters systemic immunity and can induce T-cell exhaustion, which may limit the efficacy of ICIs in patients with CLL. We, therefore, sought to examine the efficacy of ICI in patients with these co-occurring diagnoses. PATIENTS AND METHODS In this international multicenter study, a retrospective review of clinical databases identified patients with concomitant diagnoses of CLL and AM treated with ICI (US-MD Anderson Cancer Center, N = 24; US-Mayo Clinic, N = 15; AUS, N = 19). Objective response rates (ORRs), assessed by RECIST v1.1, and survival outcomes [overall survival (OS) and progression-free survival (PFS)] among patients with CLL and AM were assessed. Clinical factors associated with improved ORR and survival were explored. Additionally, ORR and survival outcomes were compared between the Australian CLL/AM cohort and a control cohort of 148 Australian patients with AM alone. RESULTS Between 1997 and 2020, 58 patients with concomitant CLL and AM were treated with ICI. ORRs were comparable between AUS-CLL/AM and AM control cohorts (53% versus 48%, P = 0.81). PFS and OS from ICI initiation were also comparable between cohorts. Among CLL/AM patients, a majority were untreated for their CLL (64%) at the time of ICI. Patients with prior history of chemoimmunotherapy treatment for CLL (19%) had significantly reduced ORRs, PFS, and OS. CONCLUSIONS Our case series of patients with concomitant CLL and melanoma demonstrate frequent, durable clinical responses to ICI. However, those with prior chemoimmunotherapy treatment for CLL had significantly worse outcomes. We found that CLL disease course is largely unchanged by treatment with ICI.
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Affiliation(s)
- S H Cass
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - J W D Tobin
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - Y D Seo
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - G Gener-Ricos
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston
| | - E Z Keung
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA
| | - E M Burton
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - M A Davies
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - J L McQuade
- Department of Melanoma Medical Oncology, University of Texas MD Anderson Cancer Center, Houston
| | - A J Lazar
- Departments of Pathology and Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston, USA
| | - R Mason
- Gold Coast University Hospital, Southport
| | | | - S Sandhu
- Peter Macallum Cancer Centre, Melbourne
| | - C Khoo
- Peter Macallum Cancer Centre, Melbourne
| | - L Warburton
- Fiona Stanley Hospital, Perth; Edith Cowan University, Joondalup; Future Health Research and Innovation Fund/Raine Clinician Research Fellowship
| | - V Guerra
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston
| | | | - H Dearden
- Melanoma Institute Australia, The University of Sydney, Sydney
| | - A M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney; Faculty of Medicine and Health, The University of Sydney, Sydney; The University of Sydney Charles Perkins Centre, Sydney; The University of Sydney Royal North Shore and Mater Hospitals, Sydney
| | - M S Carlino
- Melanoma Institute Australia, The University of Sydney, Sydney; Westmead Hospital, Sydney, Australia
| | - J L Smith
- Westmead Hospital, Sydney, Australia
| | - P Mollee
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - M Burgess
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - S Mapp
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - C Keane
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | - V Atkinson
- Haematology Department, Princess Alexandra Hospital, Woolloongabba; University of Queensland, Brisbane, Australia
| | | | | | - W Ding
- Mayo Clinic, Rochester, USA
| | | | | | - G V Long
- Melanoma Institute Australia, The University of Sydney, Sydney; Faculty of Medicine and Health, The University of Sydney, Sydney; The University of Sydney Charles Perkins Centre, Sydney; The University of Sydney Royal North Shore and Mater Hospitals, Sydney
| | - J A Wargo
- Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston, USA.
| | - A Ferrajoli
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston
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4
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Killeen TF, Shanley R, Ramesh V, Giubellino A. Malignant Melanoma in a Retrospective Cohort of Immunocompromised Patients: A Statistical and Pathologic Analysis. Cancers (Basel) 2023; 15:3600. [PMID: 37509262 PMCID: PMC10377403 DOI: 10.3390/cancers15143600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/30/2023] [Accepted: 07/06/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND Malignant melanoma is the leading cause of death due to cutaneous malignancy. Immunocompromised individuals have an elevated risk of developing melanoma. We aimed to provide histopathologic and statistical characterization of melanoma development in immunocompromised patients. METHODS We reviewed our institution's databases to identify all patients with a confirmed history of immunosuppression who subsequently developed melanoma, focusing on diagnoses during the follow-up period of 2011-2019. A total of 93 patients with a combined 111 melanoma lesions were identified. RESULTS Common causes of immunosuppression included transplantation and lymphoproliferative disorders. Superficial spreading and lentigo malignant melanoma were the most common malignant melanoma subtypes. Median Breslow depth was 0.7 mm, and the most common primary tumor stage was T1a. Our transplant sub-cohort had an overall melanoma incidence of 0.9 per 1000 person-years (95% CI 0.66 to 1.20) and a standardized incidence ratio (SIR) of 1.53 (95% CI 1.12 to 2.04) relative to a general population cohort from the Surveillance, Epidemiology, and End Results Program (SEER). CONCLUSIONS We report histopathologic characteristics of immunocompromised patients developing melanoma at a large academic tertiary-care center. Differences in age, sex, time since transplantation, and transplant type may play a significant role in melanoma SIR in this patient demographic.
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Affiliation(s)
- Trevor F Killeen
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Ryan Shanley
- Masonic Cancer Center-Biostatistics Core, University of Minnesota, Minneapolis, MN 55455, USA
| | - Vidhyalakshmi Ramesh
- Masonic Cancer Center-Clinical Informatics Shared Services, University of Minnesota, Minneapolis, MN 55455, USA
| | - Alessio Giubellino
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN 55455, USA
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA
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5
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Fisher R, Ji-Xu A, Abbott R, Basu T, Brown A, Foley C, Glen C, Gupta G, Hasan Z, Ismail F, Khalid A, Khoo A, Koumaki D, Lally A, Lear JT, McGrath E, McKenna K, Milligan A, Mulholland O, Tasker F, Harwood CA, Proby CM, Matin RN. Clinicopathological characteristics of individuals with co-existing melanoma and chronic lymphocytic leukaemia: a multicentre cohort study. Clin Exp Dermatol 2022; 47:1976-1981. [PMID: 35801421 DOI: 10.1111/ced.15324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Individuals with a prior diagnosis of chronic lymphocytic leukaemia (CLL) have a higher risk of developing melanoma (MM) and exhibit poorer outcomes when compared to patients without CLL. However, there are limited data reporting the clinicopathological features of MM diagnosed in patients with CLL. OBJECTIVES To review clinicopathological characteristics of patients with co-existing diagnoses of MM and CLL. METHODS A retrospective review was undertaken for patients with co-existing diagnoses of MM and CLL between 2005-2015 in 11 centres in the UK and Ireland. RESULTS Overall, 46 cutaneous MM identified in 45 patients were included. In 28 (62.2%) patients, MM was diagnosed after an existing diagnosis of CLL. In this group, mean Breslow thickness was 2.7 mm (range = 0.2-25 mm). Ten (35.7%) tumors developed locoregional recurrence and 8 (28.6%) developed distant metastases. Melanoma-specific mortality was 5/28 (17.9%) and all-cause mortality was 13/28 (46.4%). In 17 patients, MM was diagnosed before CLL. In this group, mean BT was 2.9 mm (range = 0.4-14 mm), 5 (29.4%) developed locoregional recurrence and 3 (17.6%) distant metastases. Melanoma-specific mortality was 1/17 (5.8%) and all-cause mortality was 5/17 (29.4%) in this group. CONCLUSIONS To our knowledge, this is the first and largest cohort study to report clinicopathological data of co-existing melanoma and CLL in the UK and Ireland. Although the thickness of primary melanoma was not different before or after a CLL diagnosis, melanoma recurrence and melanoma-specific mortality appear to be more common in patients with a prior diagnosis of CLL.
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Affiliation(s)
- Rachel Fisher
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Antonio Ji-Xu
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Department of Dermatology, University of California, Davis, Sacramento, California, USA
| | - Rachel Abbott
- Department of Dermatology, Cardiff and Vale University Health Board, Cardiff, UK
| | - Tanya Basu
- Department of Dermatology, King's College Hospital NHS Foundation Trust, London, UK
| | - Alistair Brown
- Charles Centre Department of Dermatology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Catherine Foley
- Department of Dermatology, St Vincent's University Hospital, Dublin, Republic of Ireland
| | - Catriona Glen
- Department of Dermatology, NHS Lanarkshire, Lanarkshire, UK
| | - Girish Gupta
- Department of Dermatology, NHS Lanarkshire, Lanarkshire, UK
| | - Zeeshaan Hasan
- Department of Dermatology, Barts Health NHS Trust, London, UK
| | - Ferina Ismail
- Department of Dermatology, Royal Free London NHS Foundation Trust, London, UK
| | - Amina Khalid
- Department of Dermatology, Ninewells Hospital and Medical School, Dundee, UK
| | - Andre Khoo
- Department of Dermatology, Salford Royal NHS Foundation Trust, Manchester, UK
| | - Dimtra Koumaki
- Department of Dermatology, Royal Free London NHS Foundation Trust, London, UK
| | - Aoife Lally
- Department of Dermatology, St Vincent's University Hospital, Dublin, Republic of Ireland
| | - John T Lear
- Department of Dermatology, Salford Royal NHS Foundation Trust, Manchester, UK
| | - Emily McGrath
- Charles Centre Department of Dermatology, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Kevin McKenna
- Department of Dermatology, Belfast Trust Hospitals, Belfast, UK
| | - Alan Milligan
- Department of Dermatology, Royal Free London NHS Foundation Trust, London, UK
| | | | - Fiona Tasker
- Department of Dermatology, King's College Hospital NHS Foundation Trust, London, UK
| | | | - Charlotte M Proby
- Department of Dermatology, Ninewells Hospital and Medical School, Dundee, UK
| | - Rubeta N Matin
- Department of Dermatology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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6
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Păsărică MA, Curcă PF, Dragosloveanu CDM, Tătaru CI, Manole IR, Murgoi GE, Grigorescu AC. Underlying Ciliary Body Uveal Melanoma in a Patient with Chronic Lymphocytic Leukemia Presenting for Hyphema. Diagnostics (Basel) 2022; 12:diagnostics12061312. [PMID: 35741122 PMCID: PMC9221604 DOI: 10.3390/diagnostics12061312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/16/2022] [Accepted: 05/24/2022] [Indexed: 11/29/2022] Open
Abstract
(1) Background: Ciliary body uveal melanoma is a rare subtype of uveal melanoma which comprises 3–5% of melanomas, an immunogenic cancer, and can present multifaceted initial clinical manifestations, masquerading as various ocular pathologies. Chronic lymphocytic leukemia (CLL) presents immunodeficiency and risk for the development of a secondary malignancy, with Bruton’s tyrosine kinase inhibitor treatment having a mutagenic effect and a secondary anti-platelet aggregation effect. We present the case of a 65-year-old patient undergoing treatment for CLL with ibrutinib who presented with recurrent hyphema that masked an underlying, inferiorly situated, ciliary body uveal melanoma; (2) Methods: Retrospective case review; (3) Results: An ophthalmological examination together with imaging via mode B ultrasound and contrast-enhanced magnetic resonance imaging resulted in the clinical and imagistic diagnosis of a ciliary body uveal melanoma. A pathological examination of the enucleated eye confirmed the diagnosis. Postoperative tumoral reoccurrence was not detected for 1½ years, however, CLL immunosuppression worsened with admission for severe COVID-19 disease. (4) Conclusions: CLL patient screening for melanoma should also include detailed ophthalmological examinations, which could also include ultrasound ophthalmological imaging. The avoidance of uveal melanoma metastatic disease is paramount for patient survival. CLL manifests additional profound immunosuppression.
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Affiliation(s)
- Mihai Adrian Păsărică
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Paul Filip Curcă
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
- Correspondence: ; Tel.: +40-72-015-4452
| | - Christiana Diana Maria Dragosloveanu
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Cătălina Ioana Tătaru
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Ioana Roxana Manole
- Department of Ophthalmology, Clinical Hospital for Ophthalmological Emergencies, 010464 Bucharest, Romania;
| | - Gabriela Elisabeta Murgoi
- Department of Oncology, Institute of Oncology Prof. Dr. Alexandru Trestioreanu, 022328 Bucharest, Romania;
| | - Alexandru Călin Grigorescu
- Clinical Department of Ophthalmology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania; (M.A.P.); (C.D.M.D.); (C.I.T.); (A.C.G.)
- Department of Oncology, Clinical Hospital of Nephrology Dr. Carol Davila, 010731 Bucharest, Romania
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7
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Perez M, Abisaad JA, Rojas KD, Marchetti MA, Jaimes N. Skin Cancer: Primary, Secondary, and Tertiary Prevention. Part I. J Am Acad Dermatol 2022; 87:255-268. [DOI: 10.1016/j.jaad.2021.12.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 12/03/2021] [Accepted: 12/15/2021] [Indexed: 10/19/2022]
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8
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Newcomer K, Robbins KJ, Perone J, Hinojosa FL, Chen D, Jones S, Kaufman CK, Weiser R, Fields RC, Tyler DS. Malignant melanoma: evolving practice management in an era of increasingly effective systemic therapies. Curr Probl Surg 2022; 59:101030. [PMID: 35033317 PMCID: PMC9798450 DOI: 10.1016/j.cpsurg.2021.101030] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/12/2021] [Indexed: 01/03/2023]
Affiliation(s)
- Ken Newcomer
- Department of Surgery, Barnes-Jewish Hospital, Washington University, St. Louis, MO
| | | | - Jennifer Perone
- Department of Surgery, University of Texas Medical Branch, Galveston, TX
| | | | - David Chen
- e. Department of Medicine, Washington University, St. Louis, MO
| | - Susan Jones
- f. Department of Pediatrics, Washington University, St. Louis, MO
| | | | - Roi Weiser
- University of Texas Medical Branch, Galveston, TX
| | - Ryan C Fields
- Department of Surgery, Washington University, St. Louis, MO
| | - Douglas S Tyler
- Department of Surgery, University of Texas Medical Branch, Galveston, TX.
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9
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Li Z, Zheng W, Wang H, Cheng Y, Fang Y, Wu F, Sun G, Sun G, Lv C, Hui B. Application of Animal Models in Cancer Research: Recent Progress and Future Prospects. Cancer Manag Res 2021; 13:2455-2475. [PMID: 33758544 PMCID: PMC7979343 DOI: 10.2147/cmar.s302565] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 02/25/2021] [Indexed: 12/18/2022] Open
Abstract
Animal models refers to the animal experimental objects and related materials that can simulate human body established in medical research. As the second-largest disease in terms of morbidity and mortality after cardiovascular disease, cancer has always been the focus of human attention all over the world, which makes it a research hotspot in the medical field. At the same time, more and more animal models have been constructed and used in cancer research. With the deepening of research, the construction methods of cancer animal models are becoming more and more diverse, including chemical induction, xenotransplantation, gene programming, and so on. In recent years, patient-derived xenotransplantation (PDX) model has become a research hotspot because it can retain the microenvironment of the primary tumor and the basic characteristics of cells. Animal models can be used not only to study the biochemical and physiological processes of the occurrence and development of cancer in objects but also for the screening of cancer drugs and the exploration of gene therapy. In this paper, several main tumor animal models and the application progress of animal models in tumor research are systematically reviewed. Finally, combined with the latest progress and development trend in this field, the future research of tumor animal model was prospected.
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Affiliation(s)
- Zhitao Li
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Wubin Zheng
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Hanjin Wang
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Ye Cheng
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Yijiao Fang
- Department of Anesthesiology, Fudan University Shanghai Cancer Center, Fudan University, Shanghai, 200032, People's Republic of China.,Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, 200032, People's Republic of China
| | - Fan Wu
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Guoqiang Sun
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Guangshun Sun
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Chengyu Lv
- Department of General Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Bingqing Hui
- Department of Oncology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
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10
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Spallone G, Ventura A, Mazzeo M, DI Raimondo C, Lombardo P, Silvaggio D, Bianchi L. Cancer duplicity: a case of chronic lymphocytic leukemia and metastatic melanoma treated with Ipilimumab. Ital J Dermatol Venerol 2020; 156:112-113. [PMID: 33084263 DOI: 10.23736/s2784-8671.20.06585-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Giulia Spallone
- Department of Dermatology, Tor Vergata University, Rome, Italy
| | | | - Mauro Mazzeo
- Department of Dermatology, Tor Vergata University, Rome, Italy
| | | | - Paolo Lombardo
- Department of Dermatology, Tor Vergata University, Rome, Italy -
| | | | - Luca Bianchi
- Department of Dermatology, Tor Vergata University, Rome, Italy
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11
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Dirilenoglu F, Yukselen OO, Mocan G. Spindle cell melanoma coexisting with chronic lymphocytic leukemia/small lymphocytic lymphoma: a rare collision tumor in multiple sites. J Cutan Pathol 2020; 47:1215-1219. [PMID: 32959377 DOI: 10.1111/cup.13878] [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: 06/09/2020] [Revised: 09/07/2020] [Accepted: 09/12/2020] [Indexed: 11/28/2022]
Abstract
A strong association has been reported between chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL) and malignant melanoma (MM). In rare cases of MM, lymphoid malignancies may be detected incidentally during sentinel lymph node biopsies. In this case, we found a unique collision of MM and CLL infiltration in the skin. An 88-year-old male patient presented with a mass on the nasal root. Histopathological examination of the skin biopsy specimen revealed a deeply infiltrative, atypical spindle cell proliferation in the background of a collagenous stroma. Accompanying this lesion, there were foci of monotonous lymphoid cell populations involving skin appendages. In the immunohistochemical studies, the spindle cells were diffusely positive for S100, and focally positive for Melan-A and HMB45; the lymphoid cells were positive for CD20, CD5, and Bcl-2 and negative for CD3, Bcl-6, CD10, and Cyclin D1. Histopathological and immunohistochemical findings were consistent with diagnoses of spindle cell melanoma and CLL. Interestingly, these two tumors together in their same morphological appearance were confirmed in a subsequent liver biopsy. Active skin surveillance of patients with CLL may be important to detect MM at an early stage that correlates with a better prognosis.
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Affiliation(s)
- Fikret Dirilenoglu
- Department of Pathology, Faculty of Medicine, Near East University, Nicosia, Cyprus
| | - Ozen Ozden Yukselen
- Department of Pathology, Faculty of Medicine, University of Kyrenia, Kyrenia, Cyprus
| | - Gamze Mocan
- Department of Pathology, Faculty of Medicine, Near East University, Nicosia, Cyprus
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12
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Landego I, Hewitt D, Hibbert I, Dhaliwal D, Pieterse W, Grenier D, Wong R, Johnston J, Banerji V. PD-1 inhibition in malignant melanoma and lack of clinical response in chronic lymphocytic leukemia in the same patients: a case series. ACTA ACUST UNITED AC 2020; 27:169-172. [PMID: 32669928 DOI: 10.3747/co.27.5371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Chronic lymphocytic leukemia (cll) is the most common adult leukemia in the Western world. Unfortunately, affected patients are often immunosuppressed and at increased risk of infection and secondary malignancy. Previous meta-analysis has found that patients with cll have a risk of melanoma that is increased by a factor of 4 compared with the general population. Recent advances in the understanding of the PD receptor pathway have led to immunotherapies that target cancer cells. The use of PD-1 inhibitors is now considered first-line treatment for BRAF wild-type metastatic melanoma. Interestingly, early preclinical data suggest that inhibition of that pathway could also be used in the treatment of cll; however, recent clinical data did not support the effectiveness of that approach. In this case series, we highlight 2 cases in which patients with cll and concurrent malignant melanoma underwent treatment with PD-1 inhibitors and were found to experience reductions in their white blood cell counts without improvement in their hemoglobin. Those cases further illustrate that treatment of cll with PD-1 inhibitors is ineffective.
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Affiliation(s)
- I Landego
- Department of Internal Medicine, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB
| | - D Hewitt
- Research Institute of Oncology and Hematology, CancerCare Manitoba and the University of Manitoba, Winnipeg, MB
| | - I Hibbert
- Department of Nursing, CancerCare Manitoba, Winnipeg, MB
| | - D Dhaliwal
- Section of Hematology and Oncology, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB
| | - W Pieterse
- Russell Health Centre, Community Oncology Program, Winnipeg, MB
| | - D Grenier
- Section of Hematology and Oncology, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB
| | - R Wong
- Section of Hematology and Oncology, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB
| | - J Johnston
- Research Institute of Oncology and Hematology, CancerCare Manitoba and the University of Manitoba, Winnipeg, MB.,Section of Hematology and Oncology, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB
| | - V Banerji
- Research Institute of Oncology and Hematology, CancerCare Manitoba and the University of Manitoba, Winnipeg, MB.,Section of Hematology and Oncology, Rady College of Medicine, Max Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB
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13
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Austin J, Wright FC, Cheng SY, Sutradhar R, Baxter NN, Look Hong NJ. Outcomes of Immunosuppressed Patients Who Develop Melanoma: A Population-Based Propensity-Matched Cohort Study. Ann Surg Oncol 2020; 27:2927-2948. [PMID: 32248374 DOI: 10.1245/s10434-020-08265-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Few studies have examined outcomes in immunosuppressed patients who develop melanoma. The purpose of this study is to compare survival in immunosuppressed patients who developed melanoma with that in patients with melanoma who are not immunosuppressed. METHODS Immunosuppressed patients were defined as having solid organ transplant, lymphoma, leukemia, or human immunodeficiency virus prior to diagnosis of melanoma. Patients with cutaneous melanoma with and without immunosuppression were identified retrospectively from the Ontario Cancer Registry (2007-2015) and linked with administrative databases to identify demographics, treatment, and outcomes. Immunosuppressed patients were matched with non-immunosuppressed patients based on age at diagnosis, sex, birth year, stage at diagnosis, and propensity score. The primary outcome was overall survival. Multivariable Cox proportional hazard regression was used to identify factors associated with survival. RESULTS Baseline characteristics were well balanced in 218 immunosuppressed patients matched to 436 controls. Of the patients, 186 (28.4%) were female, and median age at melanoma diagnosis was 69 (interquartile range, IQR 59-78) years. Three-year overall survival (OS) was 65% for immunosuppressed patients and 79% for non-immunosuppressed patients. Melanoma was the leading cause of death for both groups. On multivariable analysis, immunosuppression was associated with increased mortality [hazard ratio (HR) 1.70, 95% confidence interval (CI) 1.30-2.23]. Adequate treatment (HR 0.36, 95% CI 0.22-0.58) and dermatologist visits either before (HR 0.52, 95% CI 0.36-0.73) or after (HR 0.61, 95% CI 0.41-0.90) melanoma diagnosis were associated with improved OS. CONCLUSIONS Immunosuppressed patients who develop melanoma have worse outcomes when matched to non-immunosuppressed patients. This decrease in survival appears related to the underlying condition rather than diagnosis of melanoma.
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Affiliation(s)
- Janice Austin
- Department of Surgery, University of Toronto, Toronto, ON, Canada
| | - Frances C Wright
- Department of Surgery, University of Toronto, Toronto, ON, Canada.,Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | | | - Nancy N Baxter
- Department of Surgery, University of Toronto, Toronto, ON, Canada.,Division of General Surgery, St. Michael's Hospital, Toronto, ON, Canada
| | - Nicole J Look Hong
- Department of Surgery, University of Toronto, Toronto, ON, Canada. .,Division of Surgical Oncology, Sunnybrook Health Sciences Centre, Toronto, ON, Canada.
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14
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Cybulska-Stopa B, Gruchała A, Niemiec M. Immune-Related Pancytopenia Induced by Anti-PD-1 Therapy - Interrupt or Continue Treatment - The Role of Immunohistochemical Examination. Case Rep Oncol 2019; 12:820-828. [PMID: 31762755 PMCID: PMC6873039 DOI: 10.1159/000504130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 10/15/2019] [Indexed: 01/24/2023] Open
Abstract
Immune checkpoint inhibitors (ICIs), including anti-cytotoxic T-lymphocyte antigen 4 (anti-CTLA-4) and anti-programmed death receptor-1/ligand-1 (anti-PD-1/anti-PD-L1) caused a breakthrough in oncology and significantly improved therapeutic outcomes in cancer patients. ICIs generate a specific reaction in T cells, directed against antigens on cancer cells, leading to their damage and death. Through similar or the same antigens, activated lymphocytes may also have a cytotoxic effect on healthy cells, causing development of specific adverse effects – so-called immune-related adverse events (irAEs). We present the case report of a 56 year old patient with disseminated melanoma. During treatment with immunotherapy (anti PD-1), neutropenic fever and pancytopenia occurred. Trepanobiopsy of the bone marrow was performed to determine the cause of pancytopenia. Histopathological assessment of bone marrow combined with immunophenotype investigations may explain the cause of hematological disorders occurring in the course of treatment with ICIs, and support the choice of an appropriate treatment, directly translated into positive outcomes.
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Affiliation(s)
| | - Andrzej Gruchała
- Maria Skłodowska-Curie Institute, Oncology Center, Krakow Branch, Cracow, Poland
| | - Maciej Niemiec
- Krakowski Szpital Specjalistyczny im. Jana Pawła II, Cracow, Poland
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15
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Archibald WJ, Meacham PJ, Williams AM, Baran AM, Victor AI, Barr PM, Sahasrahbudhe DM, Zent CS. Management of melanoma in patients with chronic lymphocytic leukemia. Leuk Res 2018; 71:43-46. [DOI: 10.1016/j.leukres.2018.07.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 07/05/2018] [Accepted: 07/05/2018] [Indexed: 12/30/2022]
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16
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Harrop GA, Al-Khatib R, Khalid A, Gelly K, Green C. Sun-protection awareness in patients with chronic lymphocytic leukaemia. Clin Exp Dermatol 2018; 43:821-822. [PMID: 29777537 DOI: 10.1111/ced.13613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2017] [Indexed: 11/29/2022]
Affiliation(s)
- G A Harrop
- Department of Dermatology, Ninewells Hospital, Dundee, UK
| | - R Al-Khatib
- Department of Haematology, Ninewells Hospital, Dundee, UK
| | - A Khalid
- Department of Dermatology, Ninewells Hospital, Dundee, UK
| | - K Gelly
- Department of Haematology, Ninewells Hospital, Dundee, UK
| | - C Green
- Department of Dermatology, Ninewells Hospital, Dundee, UK
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17
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Luo C, Shen J. Research progress in advanced melanoma. Cancer Lett 2017; 397:120-126. [DOI: 10.1016/j.canlet.2017.03.037] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/27/2017] [Accepted: 03/28/2017] [Indexed: 12/12/2022]
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18
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Belbasis L, Stefanaki I, Stratigos AJ, Evangelou E. Non-genetic risk factors for cutaneous melanoma and keratinocyte skin cancers: An umbrella review of meta-analyses. J Dermatol Sci 2016; 84:330-339. [PMID: 27663092 DOI: 10.1016/j.jdermsci.2016.09.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 08/25/2016] [Accepted: 09/08/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Skin cancers have a complex disease mechanism, involving both genetic and non-genetic risk factors. Numerous meta-analyses have been published claiming statistically significant associations between non-genetic risk factors and skin cancers without applying a thorough methodological assessment. OBJECTIVE The present study maps the literature on the non-genetic risk factors of skin cancers, assesses the presence of statistical biases and identifies the associations with robust evidence. METHODS We searched PubMed up to January 20, 2016 to identify systematic reviews and meta-analyses of observational studies that examined associations between non-genetic factors and skin cancers. For each meta-analysis, we estimated the summary effect size by random-effects and fixed-effects models, the 95% confidence interval and the 95% prediction interval. We also assessed the between-study heterogeneity (I2 metric), evidence for small-study effects and excess significance bias. RESULTS Forty-four eligible papers were identified and included a total of 85 associations. Twenty-one associations were significant at P<10-6. Fifty-two associations had large or very large heterogeneity. Evidence for small-study effects and excess significance bias was found in fifteen and thirteen associations, respectively. Overall, thirteen associations (actinic keratosis, serum vitamin D, sunburns, and hair color for basal cell carcinoma and density of freckles, eye color, hair color, history of melanoma, skin type, sunburns, premalignant skin lesions, common and atypical nevi for melanoma) presented high level of credibility. CONCLUSION The majority of meta-analyses on non-genetic risk factors for skin cancers suffered from large between-study heterogeneity and small-study effects or excess significance bias. The associations with convincing and highly suggestive evidence were mainly focused on skin photosensitivity and phenotypic characteristics.
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Affiliation(s)
- Lazaros Belbasis
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece
| | - Irene Stefanaki
- Department of Dermatology, Andreas Sygros Hospital, University of Athens Medical School, Athens, Greece
| | - Alexander J Stratigos
- Department of Dermatology, Andreas Sygros Hospital, University of Athens Medical School, Athens, Greece
| | - Evangelos Evangelou
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Greece; Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
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