1
|
Bourgeois W, Yang E, Chiarle R, Burns M. Activity of the MEK inhibitor trametinib in a patient with a BRAF mutation persisting from T-lymphoblastic lymphoma through lineage switch to CNS acute myeloid leukemia. Pediatr Blood Cancer 2024; 71:e30978. [PMID: 38532250 DOI: 10.1002/pbc.30978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 03/09/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024]
Affiliation(s)
- Wallace Bourgeois
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Edward Yang
- Department of Radiology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Roberto Chiarle
- Department of Pathology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Division of Haematopathology, European Institute of Oncology IRCCS, Milan, Italy
- Hematopathology division, IRCCS Istituto Europeo di Oncologia, Milan, Italy
| | - Melissa Burns
- Department of Pediatric Oncology, Dana-Farber Cancer Institute, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
2
|
Gosman LM, Țăpoi DA, Costache M. Cutaneous Melanoma: A Review of Multifactorial Pathogenesis, Immunohistochemistry, and Emerging Biomarkers for Early Detection and Management. Int J Mol Sci 2023; 24:15881. [PMID: 37958863 PMCID: PMC10650804 DOI: 10.3390/ijms242115881] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 10/30/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023] Open
Abstract
Cutaneous melanoma (CM) is an increasingly significant public health concern. Due to alarming mortality rates and escalating incidence, it is crucial to understand its etiology and identify emerging biomarkers for improved diagnosis and treatment strategies. This review aims to provide a comprehensive overview of the multifactorial etiology of CM, underscore the importance of early detection, discuss the molecular mechanisms behind melanoma development and progression, and shed light on the role of the potential biomarkers in diagnosis and treatment. The pathogenesis of CM involves a complex interplay of genetic predispositions and environmental exposures, ultraviolet radiation exposure being the predominant environmental risk factor. The emergence of new biomarkers, such as novel immunohistochemical markers, gene mutation analysis, microRNA, and exosome protein expressions, holds promise for improved early detection, and prognostic and personalized therapeutic strategies.
Collapse
Affiliation(s)
- Laura Maria Gosman
- Doctoral School, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Pathology, Saint Pantelimon Clinical Emergency Hospital, 021659 Bucharest, Romania
| | - Dana-Antonia Țăpoi
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
| | - Mariana Costache
- Department of Pathology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania;
- Department of Pathology, University Emergency Hospital, 050098 Bucharest, Romania
| |
Collapse
|
3
|
Singh A, Sonawane P, Kumar A, Singh H, Naumovich V, Pathak P, Grishina M, Khalilullah H, Jaremko M, Emwas AH, Verma A, Kumar P. Challenges and Opportunities in the Crusade of BRAF Inhibitors: From 2002 to 2022. ACS OMEGA 2023; 8:27819-27844. [PMID: 37576670 PMCID: PMC10413849 DOI: 10.1021/acsomega.3c00332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 02/27/2023] [Indexed: 08/15/2023]
Abstract
Serine/threonine-protein kinase B-Raf (BRAF; RAF = rapidly accelerated fibrosarcoma) plays an important role in the mitogen-activated protein kinase (MAPK) signaling cascade. Somatic mutations in the BRAF gene were first discovered in 2002 by Davies et al., which was a major breakthrough in cancer research. Subsequently, three different classes of BRAF mutants have been discovered. This class includes class I monomeric mutants (BRAFV600), class II BRAF homodimer mutants (non-V600), and class III BRAF heterodimers (non-V600). Cancers caused by these include melanoma, thyroid cancer, ovarian cancer, colorectal cancer, nonsmall cell lung cancer, and others. In this study, we have highlighted the major binding pockets in BRAF protein, their active and inactive conformations with inhibitors, and BRAF dimerization and its importance in paradoxical activation and BRAF mutation. We have discussed the first-, second-, and third-generation drugs approved by the Food and Drug Administration and drugs under clinical trials with all four different binding approaches with DFG-IN/OUT and αC-IN/OUT for BRAF protein. We have investigated particular aspects and difficulties with all three generations of inhibitors. Finally, this study has also covered recent developments in synthetic BRAF inhibitors (from their discovery in 2002 to 2022), their unique properties, and importance in inhibiting BRAF mutants.
Collapse
Affiliation(s)
- Ankit
Kumar Singh
- Department
of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda 151401, India
| | - Pankaj Sonawane
- Department
of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda 151401, India
| | - Adarsh Kumar
- Department
of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda 151401, India
| | - Harshwardhan Singh
- Department
of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda 151401, India
| | - Vladislav Naumovich
- Laboratory
of Computational Modeling of Drugs, Higher Medical and Biological
School, South Ural State University, Chelyabinsk 454008, Russia
| | - Prateek Pathak
- Laboratory
of Computational Modeling of Drugs, Higher Medical and Biological
School, South Ural State University, Chelyabinsk 454008, Russia
| | - Maria Grishina
- Laboratory
of Computational Modeling of Drugs, Higher Medical and Biological
School, South Ural State University, Chelyabinsk 454008, Russia
| | - Habibullah Khalilullah
- Department
of Pharmaceutical Chemistry and Pharmacognosy, Unaizah College of
Pharmacy, Qassim University, Unayzah 51911, Saudi Arabia
| | - Mariusz Jaremko
- Smart-Health
Initiative and Red Sea Research Center, Division of Biological and
Environmental Sciences and Engineering, King Abdullah University of Science and Technology, Thuwal 23955-6900, Saudi Arabia
| | - Abdul-Hamid Emwas
- Core
Laboratories, King Abdullah University of
Science and Technology, Thuwal 23955-6900, Saudi
Arabia
| | - Amita Verma
- Bioorganic
and Medicinal Chemistry Research Laboratory, Department of Pharmaceutical
Sciences, Sam Higginbottom University of
Agriculture, Technology and Sciences, Prayagraj 211007, India
| | - Pradeep Kumar
- Department
of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Ghudda, Bathinda 151401, India
| |
Collapse
|
4
|
Hagstrom M, Fumero-Velázquez M, Dhillon S, Olivares S, Gerami P. An update on genomic aberrations in Spitz naevi and tumours. Pathology 2023; 55:196-205. [PMID: 36631338 DOI: 10.1016/j.pathol.2022.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/28/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022]
Abstract
Spitz neoplasms continue to be a diagnostic challenge for dermatopathologists and are defined by distinctive morphological and genetic features. With the recent advancements in genomic sequencing, the classification, diagnosis, and prognostication of these tumours have greatly improved. Several subtypes of Spitz neoplasms have been identified based on their specific genomic aberrations, which often correlate with distinctive morphologies and biological behaviour. These genetic driver events can be classified into four major groups, including: (1) mutations [HRAS mutations (with or without 11p amplification) and 6q23 deletions]; (2) tyrosine kinase fusions (ROS1, ALK, NTRK1-3, MET and RET); (3) serine/threonine kinase fusions and mutations (BRAF, MAP3K8, and MAP2K1); and (4) other rare genomic aberrations. These driver genomic events are hypothesised to enable the initial proliferation of melanocytes and are often accompanied by additional genomic aberrations that affect biological behaviour. The discovery of theses genomic fusions has allowed for a more objective definition of a Spitz neoplasm. Further studies have shown that the majority of morphologically Spitzoid appearing melanocytic neoplasms with aggressive behaviour are in fact BRAF or NRAS mutated tumours mimicking Spitz. Truly malignant fusion driven Spitz neoplasms may occur but are relatively uncommon, and biomarkers such as homozygous 9p21 (CDKN2A) deletions or TERT-p mutations can have some prognostic value in such cases. In this review, we discuss the importance and various methods of identifying Spitz associated genomic fusions to help provide more definitive classification. We also discuss characteristic features of the various fusion subtypes as well as prognostic biomarkers.
Collapse
Affiliation(s)
- Michael Hagstrom
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Mónica Fumero-Velázquez
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Soneet Dhillon
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
| |
Collapse
|
5
|
Pathipaka R, Thyagarajan A, Sahu RP. Melatonin as a Repurposed Drug for Melanoma Treatment. Med Sci (Basel) 2023; 11:medsci11010009. [PMID: 36649046 PMCID: PMC9844458 DOI: 10.3390/medsci11010009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/05/2023] [Accepted: 01/11/2023] [Indexed: 01/18/2023] Open
Abstract
Melanoma is the most aggressive type of skin cancer, with a greater risk of metastasis and a higher prevalence and mortality rate. This cancer type has been demonstrated to develop resistance to the known treatment options such as conventional therapeutic agents and targeted therapy that are currently being used as the standard of care. Drug repurposing has been explored as a potential alternative treatment strategy against disease pathophysiologies, including melanoma. To that end, multiple studies have suggested that melatonin produced by the pineal gland possesses anti-proliferative and oncostatic effects in experimental melanoma models. The anticarcinogenic activity of melatonin is attributed to its ability to target a variety of oncogenic signaling pathways, including the MAPK pathways which are involved in regulating the behavior of cancer cells, including cell survival and proliferation. Additionally, preclinical studies have demonstrated that melatonin in combination with chemotherapeutic agents exerts synergistic effects against melanoma. The goal of this review is to highlight the mechanistic insights of melatonin as a monotherapy or combinational therapy for melanoma treatment.
Collapse
|
6
|
Luger AL, König S, Samp PF, Urban H, Divé I, Burger MC, Voss M, Franz K, Fokas E, Filipski K, Demes MC, Stenzinger A, Sahm F, Reuss DE, Harter PN, Wagner S, Hattingen E, Wichert J, Lapa C, Fröhling S, Steinbach JP, Ronellenfitsch MW. Molecular matched targeted therapies for primary brain tumors-a single center retrospective analysis. J Neurooncol 2022; 159:243-259. [PMID: 35864412 PMCID: PMC9424147 DOI: 10.1007/s11060-022-04049-w] [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: 03/17/2022] [Accepted: 05/27/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Molecular diagnostics including next generation gene sequencing are increasingly used to determine options for individualized therapies in brain tumor patients. We aimed to evaluate the decision-making process of molecular targeted therapies and analyze data on tolerability as well as signals for efficacy. METHODS Via retrospective analysis, we identified primary brain tumor patients who were treated off-label with a targeted therapy at the University Hospital Frankfurt, Goethe University. We analyzed which types of molecular alterations were utilized to guide molecular off-label therapies and the diagnostic procedures for their assessment during the period from 2008 to 2021. Data on tolerability and outcomes were collected. RESULTS 413 off-label therapies were identified with an increasing annual number for the interval after 2016. 37 interventions (9%) were targeted therapies based on molecular markers. Glioma and meningioma were the most frequent entities treated with molecular matched targeted therapies. Rare entities comprised e.g. medulloblastoma and papillary craniopharyngeoma. Molecular targeted approaches included checkpoint inhibitors, inhibitors of mTOR, FGFR, ALK, MET, ROS1, PIK3CA, CDK4/6, BRAF/MEK and PARP. Responses in the first follow-up MRI were partial response (13.5%), stable disease (29.7%) and progressive disease (46.0%). There were no new safety signals. Adverse events with fatal outcome (CTCAE grade 5) were not observed. Only, two patients discontinued treatment due to side effects. Median progression-free and overall survival were 9.1/18 months in patients with at least stable disease, and 1.8/3.6 months in those with progressive disease at the first follow-up MRI. CONCLUSION A broad range of actionable alterations was targeted with available molecular therapeutics. However, efficacy was largely observed in entities with paradigmatic oncogenic drivers, in particular with BRAF mutations. Further research on biomarker-informed molecular matched therapies is urgently necessary.
Collapse
Affiliation(s)
- Anna-Luisa Luger
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. .,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany. .,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany. .,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.
| | - Sven König
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Patrick Felix Samp
- Department of Neuroradiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Hans Urban
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Iris Divé
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Michael C Burger
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Martin Voss
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Kea Franz
- University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department of Neurosurgery, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Emmanouil Fokas
- Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department of Radiotherapy and Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Katharina Filipski
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Neurological Institute (Edinger Institute), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Melanie-Christin Demes
- Dr. Senckenberg Institute of Pathology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Albrecht Stenzinger
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Centers for Personalized Medicine (ZPM), Heidelberg Site, Heidelberg, Germany
| | - Felix Sahm
- German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, Heidelberg, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - David E Reuss
- German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Neuropathology, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology, Heidelberg, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - Patrick N Harter
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Neurological Institute (Edinger Institute), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Sebastian Wagner
- German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,Department of Medicine, Hematology/Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Elke Hattingen
- Department of Neuroradiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Jennifer Wichert
- Department of Nuclear Medicine, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Constantin Lapa
- Faculty of Medicine, Nuclear Medicine, University of Augsburg, Augsburg, Germany.,Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany
| | - Stefan Fröhling
- German Cancer Consortium (DKTK), Heidelberg, Germany.,Division of Translational Medical Oncology, National Center for Tumor Diseases (NCT) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Joachim P Steinbach
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Michael W Ronellenfitsch
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt/Mainz, Frankfurt am Main, Germany.,Frankfurt Cancer Institute (FCI), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany.,University Cancer Center Frankfurt (UCT), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| |
Collapse
|
7
|
Dal Pozzo CA, Cappellesso R. The Morpho-Molecular Landscape of Spitz Neoplasms. Int J Mol Sci 2022; 23:ijms23084211. [PMID: 35457030 PMCID: PMC9030540 DOI: 10.3390/ijms23084211] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/05/2022] [Accepted: 04/07/2022] [Indexed: 12/14/2022] Open
Abstract
Spitz neoplasms are a heterogeneous group of melanocytic proliferations with a great variability in the histological characteristics and in the biological behavior. Thanks to recent discoveries, the morpho-molecular landscape of Spitz lineage is becoming clearer, with the identification of subtypes with recurrent features thus providing the basis for a more solid and precise tumor classification. Indeed, specific mutually exclusive driver molecular events, namely HRAS or MAP2K1 mutations, copy number gains of 11p, and fusions involving ALK, ROS, NTRK1, NTRK2, NTRK3, MET, RET, MAP3K8, and BRAF genes, correlate with distinctive histological features. The accumulation of further molecular aberrations, instead, promotes the increasing malignant transformation of Spitz neoplasms. Thus, the detection of a driver genetic alteration can be achieved using the appropriate diagnostic tests chosen according to the histological characteristics of the lesion. This allows the recognition of subtypes with aggressive behavior requiring further molecular investigations. This review provides an update on the morpho-molecular correlations in Spitz neoplasms.
Collapse
Affiliation(s)
- Carlo Alberto Dal Pozzo
- Surgical Pathology and Cytopathology Unit, Department of Medicine (DIMED), University of Padua, 35121 Padua, Italy;
| | - Rocco Cappellesso
- Pathological Anatomy Unit, University Hospital of Padua, 35121 Padua, Italy
- Correspondence: ; Tel.: +39-049-8217962
| |
Collapse
|
8
|
Abstract
Modern therapy of advanced melanoma offers effective targeted therapeutic options in the form of BRAF plus MEK inhibition for patients with BRAF V600 mutations. For patients lacking these mutations, checkpoint inhibition remains the only first-line choice for treatment of metastatic disease. However, approximately half of patients do not respond to immunotherapy, requiring effective options for a second-line treatment. Advances in genetic profiling have found other possible target molecules, especially a wide array of rare non-V600 BRAF mutations which may respond to available targeted therapy. More information on the characteristics of such mutants is needed to further assess the efficacy of targeted therapies in the metastatic and adjuvant setting of advanced melanoma. Thus, it may be helpful to classify known BRAF mutations by their kinase activation status and dependence on alternative signaling pathways. While BRAF V600 mutations appear to have an overall more prominent role of kinase activity for tumor growth, non-V600 BRAF mutations show great differences in kinase activation and, hence, response to BRAF plus MEK inhibition. When BRAF-mutated melanomas rely on additional signaling molecules such as RAS for tumor growth, greater benefit may be expected from MEK inhibition than BRAF inhibition. In other cases, mutations of c-kit or NRAS may serve as important pharmacological targets in advanced melanoma. However, since benefit from currently available targeted therapies for non-V600 mutants is usually inferior regarding response and long-term outcome, checkpoint inhibitors remain the standard recommended first-line therapy for these patients. Herein, we review the current clinical data for characteristics and response to targeted therapy of melanomas lacking a V600 BRAF mutation.
Collapse
|
9
|
Awada G, Neyns B. Melanoma with genetic alterations beyond the BRAFV600 mutation: management and new insights. Curr Opin Oncol 2022; 34:115-122. [PMID: 35050937 DOI: 10.1097/cco.0000000000000817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Molecular-targeted therapy with BRAF-/MEK-inhibitors has shown impressive activity in patients with advanced BRAFV600 mutant melanoma. In this review, we aim to summarize recent data and possible future therapeutic strategies involving small-molecule molecular-targeted therapies for advanced BRAFV600 wild-type melanoma. RECENT FINDINGS In patients with NRASQ61 mutant melanoma, downstream MEK-inhibition has shown some albeit low activity. MEK-inhibitors combined with novel RAF dimer inhibitors, such as belvarafenib, or with CDK4/6-inhibitors have promising activity in NRAS mutant melanoma in early-phase trials. In patients with non-V600 BRAF mutant melanoma, MEK-inhibition with or without BRAF-inhibition appears to be effective, although large-scale prospective trials are lacking. As non-V600 BRAF mutants signal as dimers, novel RAF dimer inhibitors are also under investigation in this setting. MEK-inhibition is under investigation in NF1 mutant melanoma. Finally, in patients with BRAF/NRAS/NF1 wild-type melanoma, imatinib or nilotinib can be effective in cKIT mutant melanoma. Despite preclinical data suggesting synergistic activity, the combination of the MEK-inhibitor cobimetinib with the immune checkpoint inhibitor atezolizumab was not superior to the immune checkpoint inhibitor pembrolizumab. SUMMARY As of today, no molecular-targeted therapies have shown to improve survival in patients with advanced BRAFV600 wild-type melanoma. Combinatorial strategies, involving MEK-inhibitors, RAF dimer inhibitors and CDK4/6-inhibitors, are currently under investigation and have promising activity in advanced BRAFV600 wild-type melanoma.
Collapse
Affiliation(s)
- Gil Awada
- Department of Medical Oncology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Brussels, Belgium
| | | |
Collapse
|
10
|
Schrom S, Hebesberger T, Wallner SA, Anders I, Richtig E, Brandl W, Hirschmugl B, Garofalo M, Bernecker C, Schlenke P, Kashofer K, Wadsack C, Aigelsreiter A, Heitzer E, Riedl S, Zweytick D, Kretschmer N, Richtig G, Rinner B. MUG Mel3 Cell Lines Reflect Heterogeneity in Melanoma and Represent a Robust Model for Melanoma in Pregnancy. Int J Mol Sci 2021; 22:ijms222111318. [PMID: 34768746 PMCID: PMC8583216 DOI: 10.3390/ijms222111318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 12/22/2022] Open
Abstract
Melanomas are aggressive tumors with a high metastatic potential and an increasing incidence rate. They are known for their heterogeneity and propensity to easily develop therapy-resistance. Nowadays they are one of the most common cancers diagnosed during pregnancy. Due to the difficulty in balancing maternal needs and foetal safety, melanoma is challenging to treat. The aim of this study was to provide a potential model system for the study of melanoma in pregnancy and to illustrate melanoma heterogeneity. For this purpose, a pigmented and a non-pigmented section of a lymph node metastasis from a pregnant patient were cultured under different conditions and characterized in detail. All four culture conditions exhibited different phenotypic, genotypic as well as tumorigenic properties, and resulted in four newly established melanoma cell lines. To address treatment issues, especially in pregnant patients, the effect of synthetic human lactoferricin-derived peptides was tested successfully. These new BRAF-mutated MUG Mel3 cell lines represent a valuable model in melanoma heterogeneity and melanoma pregnancy research. Furthermore, treatment with anti-tumor peptides offers an alternative to conventionally used therapeutic options—especially during pregnancy.
Collapse
Affiliation(s)
- Silke Schrom
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
| | - Thomas Hebesberger
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
| | - Stefanie Angela Wallner
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
| | - Ines Anders
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
| | - Erika Richtig
- Department of Dermatology, Medical University of Graz, 8036 Graz, Austria;
| | - Waltraud Brandl
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (W.B.); (B.H.); (C.W.)
| | - Birgit Hirschmugl
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (W.B.); (B.H.); (C.W.)
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
| | - Mariangela Garofalo
- Department of Pharmaceutical and Pharmacological Sciences, University of Padova, 35122 Padova, Italy;
| | - Claudia Bernecker
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria; (C.B.); (P.S.)
| | - Peter Schlenke
- Department of Blood Group Serology and Transfusion Medicine, Medical University of Graz, 8036 Graz, Austria; (C.B.); (P.S.)
| | - Karl Kashofer
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8036 Graz, Austria; (K.K.); (A.A.)
| | - Christian Wadsack
- Department of Obstetrics and Gynecology, Medical University of Graz, 8036 Graz, Austria; (W.B.); (B.H.); (C.W.)
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
| | - Ariane Aigelsreiter
- Diagnostic and Research Institute of Pathology, Medical University of Graz, 8036 Graz, Austria; (K.K.); (A.A.)
| | - Ellen Heitzer
- Institute of Human Genetics, Diagnostic and Research Center for Molecular BioMedicine, Medical University of Graz, 8036 Graz, Austria;
| | - Sabrina Riedl
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
- Institute of Molecular Biosciences, Biophysics Division, University of Graz, 8010 Graz, Austria
- BioHealth, 8010 Graz, Austria
| | - Dagmar Zweytick
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
- Institute of Molecular Biosciences, Biophysics Division, University of Graz, 8010 Graz, Austria
- BioHealth, 8010 Graz, Austria
| | - Nadine Kretschmer
- Institute of Pharmaceutical Sciences, Department of Pharmacognosy, University of Graz, 8010 Graz, Austria;
| | - Georg Richtig
- Division of Oncology, Medical University of Graz, 8036 Graz, Austria;
| | - Beate Rinner
- Division of Biomedical Research, Medical University of Graz, 8036 Graz, Austria; (S.S.); (T.H.); (S.A.W.); (I.A.)
- BioTechMed-Graz, 8010 Graz, Austria; (S.R.); (D.Z.)
- Correspondence: ; Tel.: +43-316-3857-3524
| |
Collapse
|
11
|
Autophagy Inhibition in BRAF-Driven Cancers. Cancers (Basel) 2021; 13:cancers13143498. [PMID: 34298710 PMCID: PMC8306561 DOI: 10.3390/cancers13143498] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/10/2021] [Accepted: 07/11/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary BRAF is a protein kinase that is frequently mutationally activated in cancer. Mutant BRAF can be pharmacologically inhibited, which in combination with blockade of its direct effector, MEK1/2, is an FDA-approved therapeutic strategy for several BRAF-mutated cancer patients, such as melanoma, non-small-cell lung carcinoma, and thyroid cancer. However, therapy resistance is a major clinical challenge, highlighting the need for comprehensive investigations on the biological causes of such resistance, as well as to develop novel therapeutic strategies to improve patient survival. Autophagy is a cellular recycling process, which has been shown to allow cancer cells to escape from BRAF inhibition. Combined blockade of autophagy and BRAF signaling is a novel therapeutic strategy that is currently being tested in clinical trials. This review describes the relationship between BRAF-targeted therapy and autophagy regulation and discusses possible future treatment strategies. Abstract Several BRAF-driven cancers, including advanced BRAFV600E/K-driven melanoma, non-small-cell lung carcinoma, and thyroid cancer, are currently treated using first-line inhibitor combinations of BRAFV600E plus MEK1/2. However, despite the success of this vertical inhibition strategy, the durability of patient response is often limited by the phenomenon of primary or acquired drug resistance. It has recently been shown that autophagy, a conserved cellular recycling process, is increased in BRAF-driven melanoma upon inhibition of BRAFV600E signaling. Autophagy is believed to promote tumor progression of established tumors and also to protect cancer cells from the cytotoxic effects of chemotherapy. To this end, BRAF inhibitor (BRAFi)-resistant cells often display increased autophagy compared to responsive lines. Several mechanisms have been proposed for BRAFi-induced autophagy, such as activation of the endoplasmic reticulum (ER) stress gatekeeper GRP78, AMP-activated protein kinase, and transcriptional regulation of the autophagy regulating transcription factors TFEB and TFE3 via ERK1/2 or mTOR inhibition. This review describes the relationship between BRAF-targeted therapy and autophagy regulation, and discusses possible future treatment strategies of combined inhibition of oncogenic signaling plus autophagy for BRAF-driven cancers.
Collapse
|
12
|
Abstract
Malignant melanoma is a neoplasm originating in the melanocytes in the skin. Although malignant melanoma is the third most common cutaneous cancer, it is recognized as the main cause of skin cancer-related mortality, and its incidence is rising. The natural history of malignant melanoma involves an inconsistent and insidious skin cancer with great metastatic potential. Increased ultra-violet (UV) skin exposure is undoubtedly the greatest risk factor for developing cutaneous melanoma; however, a plethora of risk factors are now recognized as causative. Moreover, modern oncology now considers melanoma proliferation a complex, multifactorial process with a combination of genetic, epigenetic, and environmental factors all known to be contributory to tumorgenesis. Herein, we wish to outline the epidemiological, molecular, and biological processes responsible for driving malignant melanoma proliferation.
Collapse
Affiliation(s)
| | - Nicola Miller
- Surgery, National University of Ireland Galway, Galway, IRL
| | - Niall M McInerney
- Plastic, Aesthetic, and Reconstructive Surgery, Galway University Hospitals, Galway, IRL
| |
Collapse
|
13
|
Kadioglu O, Saeed MEM, Greten HJ, Mayr K, Schrama D, Roos WP, Efferth T. Identification of potential inhibitors targeting BRAF-V600E mutant melanoma cells. J Am Acad Dermatol 2020; 84:1086-1089. [PMID: 32707252 DOI: 10.1016/j.jaad.2020.07.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Onat Kadioglu
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany
| | - Mohamed E M Saeed
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany
| | - Henry J Greten
- Heidelberg Clinics for Integrative Diagnostics, Heidelberg, Germany
| | - Katharina Mayr
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany
| | - David Schrama
- Department of Dermatology, Julius-Maximilian University, Würzburg, Germany
| | - Wynand P Roos
- Institute of Toxicology, Medical University Center, Mainz, Germany
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany.
| |
Collapse
|
14
|
Mourad N, Lourenço N, Delyon J, Eftekhari P, Bertheau P, Allayous C, Ballon A, Pagès C, Allez M, Lebbé C, Baroudjian B. Severe gastrointestinal toxicity of MEK inhibitors. Melanoma Res 2020; 29:556-559. [PMID: 31095035 DOI: 10.1097/cmr.0000000000000618] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Gastrointestinal toxicities of MEK inhibitors in melanoma patients are frequent. In clinical trials, the most common digestive adverse events were nausea, vomiting, and diarrhoea. However, severe toxicities such as colitis and gastrointestinal perforation, some with fatal outcomes, have been reported. These rare but severe adverse events are not well described. We performed a retrospective analysis of all patients with stage IV and unresectable stage III melanoma treated with a MEK inhibitors at Saint-Louis Hospital, Paris, between 1 August 2013 and 15 October 2018. Among 119 patients exposed to MEK inhibitors, 78 were treated with trametinib, 19 with cobimetinib, four with binimetinib, and 18 patients with two different MEK inhibitors at separate times. All grade digestive adverse events were observed in 39 (32.7%) patients. Grade 3 and 4 adverse events occurred in 6 (5%) patients: 2 (1.7%) developed perforations, 3 (2.5%) had colitis and 1 (0.8%) had grade 4 diarrhoea. These adverse events were all reversible following a permanent discontinuation of the MEK inhibitors, or a temporary interruption followed by resumption at a dose lower than conventional posology. There were no fatal outcomes; however one patient had a permanent ileostomy. The mechanism underlying these toxicities is not well known. Clinicians should be aware of such toxicities.
Collapse
Affiliation(s)
- Nadim Mourad
- APHP, Oncodermatology Unit, Dermatology Department
| | | | - Julie Delyon
- APHP, Oncodermatology Unit, Dermatology Department
| | | | | | | | - Alice Ballon
- APHP, Oncodermatology Unit, Dermatology Department
| | - Cécile Pagès
- APHP, Oncodermatology Unit, Dermatology Department
| | | | - Céleste Lebbé
- APHP, Oncodermatology Unit, Dermatology Department.,Paris Diderot University, INSERM U976, Paris, France
| | | | | |
Collapse
|
15
|
Douki T. Oxidative Stress and Genotoxicity in Melanoma Induction: Impact on Repair Rather Than Formation of DNA Damage? Photochem Photobiol 2020; 96:962-972. [PMID: 32367509 DOI: 10.1111/php.13278] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 04/21/2020] [Indexed: 12/22/2022]
Abstract
Keratinocytes and melanocytes, two cutaneous cell types located within the epidermis, are the origin of most skin cancers, namely carcinomas and melanomas. These two types of tumors differ in many ways. First, carcinomas are almost 10 times more frequent than melanomas. In addition, the affected cellular pathways, the mutated genes and the metastatic properties of the tumors are not the same. This review addresses another specificity of melanomas: the role of photo-oxidative stress. UVA efficiently produces reactive oxygen species in melanocytes, which results in more frequent oxidatively generated DNA lesions than in other cell types. The question of the respective contribution of UVB-induced pyrimidine dimers and UVA-mediated oxidatively generated lesions to mutagenesis in melanoma remains open. Recent results based on next-generation sequencing techniques strongly suggest that the mutational signature associated with pyrimidine dimers is overwhelming in melanomas like in skin carcinomas. UVA-induced oxidative stress may yet be indirectly linked to the genotoxic pathways involved in melanoma through its ability to hamper DNA repair activities.
Collapse
Affiliation(s)
- Thierry Douki
- Université Grenoble Alpes, CEA, CNRS, IRIG, SyMMES, Grenoble, France
| |
Collapse
|
16
|
Metabolic Reprogramming in Metastatic Melanoma with Acquired Resistance to Targeted Therapies: Integrative Metabolomic and Proteomic Analysis. Cancers (Basel) 2020; 12:cancers12051323. [PMID: 32455924 PMCID: PMC7280989 DOI: 10.3390/cancers12051323] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 02/07/2023] Open
Abstract
Treatments of metastatic melanoma underwent an impressive development over the past few years, with the emergence of small molecule inhibitors targeting mutated proteins, such as BRAF, NRAS, or cKIT. However, since a significant proportion of patients acquire resistance to these therapies, new strategies are currently being considered to overcome this issue. For this purpose, melanoma cell lines with mutant BRAF, NRAS, or cKIT and with acquired resistances to BRAF, MEK, or cKIT inhibitors, respectively, were investigated using both 1H-NMR-based metabonomic and protein microarrays. The 1H-NMR profiles highlighted a similar go and return pattern in the metabolism of the BRAF, NRAS, and cKIT mutated cell lines. Indeed, melanoma cells exposed to mutation-specific inhibitors underwent metabolic disruptions following acute exposure but partially recovered their basal metabolism in long-term exposure, most likely acquiring resistance skills. The protein microarrays inquired about the potential cellular mechanisms used by the resistant cells to escape drug treatment, by showing decreased levels of proteins linked to the drug efficacy, especially in the downstream part of the MAPK signaling pathway. Integrating metabonomic and proteomic findings revealed some metabolic pathways (i.e., glutaminolysis, choline metabolism, glutathione production, glycolysis, oxidative phosphorylation) and key proteins (i.e., EPHA2, DUSP4, and HIF-1A) as potential targets to discard drug resistance.
Collapse
|
17
|
Tian Y, Guo W. A Review of the Molecular Pathways Involved in Resistance to BRAF Inhibitors in Patients with Advanced-Stage Melanoma. Med Sci Monit 2020; 26:e920957. [PMID: 32273491 PMCID: PMC7169438 DOI: 10.12659/msm.920957] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Melanoma is an aggressive malignancy of melanocytes and most commonly arises in the skin. In 2002, BRAF gene mutations were identified in melanoma, and this finding resulted in the development of several small-molecule molecular inhibitors that specifically targeted the BRAF V600E mutation. The development of targeted therapies for advanced-stage melanoma, including tyrosine kinase inhibitors (TKIs) of the BRAF (V600E) kinase, vemurafenib and dabrafenib, have been approved for the treatment of advanced melanoma leading to improved clinical outcomes. However, the development of BRAF inhibitor (BRAFi) resistance has significantly reduced the therapeutic efficacy after prolonged treatment. Recent studies have identified the molecular mechanisms for BRAFi resistance. This review aims to describe the impact of BRAFi resistance on the pathogenesis of melanoma, the current status of molecular pathways involved in BRAFi resistance, including intrinsic resistance, adaptive resistance, and acquired resistance. This review will discuss how an understanding of the mechanisms associated with BRAFi resistance may aid the identification of useful strategies for overcoming the resistance to BRAF-targeted therapy in patients with advanced-stage melanoma.
Collapse
Affiliation(s)
- Yangzi Tian
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
| | - Weinan Guo
- Department of Dermatology, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China (mainland)
| |
Collapse
|
18
|
Elder DE, Bastian BC, Cree IA, Massi D, Scolyer RA. The 2018 World Health Organization Classification of Cutaneous, Mucosal, and Uveal Melanoma: Detailed Analysis of 9 Distinct Subtypes Defined by Their Evolutionary Pathway. Arch Pathol Lab Med 2020; 144:500-522. [PMID: 32057276 DOI: 10.5858/arpa.2019-0561-ra] [Citation(s) in RCA: 224] [Impact Index Per Article: 56.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT.— There have been major advances in the understanding of melanoma since the last revision of the World Health Organization (WHO) classification in 2006. OBJECTIVE.— To discuss development of the 9 distinct types of melanoma and distinguishing them by their epidemiology, clinical and histologic morphology, and genomic characteristics. Each melanoma subtype is placed at the end of an evolutionary pathway that is rooted in its respective precursor, wherever appropriate and feasible, based on currently known data. Each precursor has a variable risk of progression culminating in its fully evolved, invasive melanoma. DATA SOURCES.— This review is based on the "Melanocytic Tumours" section of the 4th edition of the WHO Classification of Skin Tumours, published in 2018. CONCLUSIONS.— Melanomas were divided into those etiologically related to sun exposure and those that are not, as determined by their mutational signatures, anatomic site, and epidemiology. Melanomas on the sun-exposed skin were further divided by the histopathologic degree of cumulative solar damage (CSD) of the surrounding skin, into low and high CSD, on the basis of degree of associated solar elastosis. Low-CSD melanomas include superficial spreading melanomas and high-CSD melanomas incorporate lentigo maligna and desmoplastic melanomas. The "nonsolar" category includes acral melanomas, some melanomas in congenital nevi, melanomas in blue nevi, Spitz melanomas, mucosal melanomas, and uveal melanomas. The general term melanocytoma is proposed to encompass "intermediate" tumors that have an increased (though still low) probability of disease progression to melanoma.
Collapse
Affiliation(s)
- David E Elder
- From the Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia (Dr Elder); the Department of Dermatology, University of California San Francisco, San Francisco (Dr Bastian); International Agency for Research on Cancer, Lyon, France (Dr Cree); Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy (Dr Massi); and the Department of Pathology and Melanoma Institute Australia, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia (Dr Scolyer)
| | - Boris C Bastian
- From the Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia (Dr Elder); the Department of Dermatology, University of California San Francisco, San Francisco (Dr Bastian); International Agency for Research on Cancer, Lyon, France (Dr Cree); Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy (Dr Massi); and the Department of Pathology and Melanoma Institute Australia, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia (Dr Scolyer)
| | - Ian A Cree
- From the Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia (Dr Elder); the Department of Dermatology, University of California San Francisco, San Francisco (Dr Bastian); International Agency for Research on Cancer, Lyon, France (Dr Cree); Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy (Dr Massi); and the Department of Pathology and Melanoma Institute Australia, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia (Dr Scolyer)
| | - Daniela Massi
- From the Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia (Dr Elder); the Department of Dermatology, University of California San Francisco, San Francisco (Dr Bastian); International Agency for Research on Cancer, Lyon, France (Dr Cree); Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy (Dr Massi); and the Department of Pathology and Melanoma Institute Australia, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia (Dr Scolyer)
| | - Richard A Scolyer
- From the Department of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia (Dr Elder); the Department of Dermatology, University of California San Francisco, San Francisco (Dr Bastian); International Agency for Research on Cancer, Lyon, France (Dr Cree); Section of Anatomic Pathology, Department of Health Sciences, University of Florence, Florence, Italy (Dr Massi); and the Department of Pathology and Melanoma Institute Australia, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia (Dr Scolyer)
| |
Collapse
|
19
|
Boyle EM, Ashby C, Tytarenko RG, Deshpande S, Wang H, Wang Y, Rosenthal A, Sawyer J, Tian E, Flynt E, Hoering A, Johnson SK, Rutherford MW, Wardell CP, Bauer MA, Dumontet C, Facon T, Thanendrarajan S, Schinke CD, Zangari M, van Rhee F, Barlogie B, Cairns D, Jackson G, Thakurta A, Davies FE, Morgan GJ, Walker BA. BRAF and DIS3 Mutations Associate with Adverse Outcome in a Long-term Follow-up of Patients with Multiple Myeloma. Clin Cancer Res 2020; 26:2422-2432. [DOI: 10.1158/1078-0432.ccr-19-1507] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 10/11/2019] [Accepted: 01/22/2020] [Indexed: 11/16/2022]
|
20
|
Menzer C, Menzies AM, Carlino MS, Reijers I, Groen EJ, Eigentler T, de Groot JWB, van der Veldt AA, Johnson DB, Meiss F, Schlaak M, Schilling B, Westgeest HM, Gutzmer R, Pföhler C, Meier F, Zimmer L, Suijkerbuijk KP, Haalck T, Thoms KM, Herbschleb K, Leichsenring J, Menzer A, Kopp-Schneider A, Long GV, Kefford R, Enk A, Blank CU, Hassel JC. Targeted Therapy in Advanced Melanoma With Rare BRAF Mutations. J Clin Oncol 2019; 37:3142-3151. [PMID: 31580757 PMCID: PMC10448865 DOI: 10.1200/jco.19.00489] [Citation(s) in RCA: 70] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2019] [Indexed: 01/17/2023] Open
Abstract
PURPOSE BRAF/MEK inhibition is a standard of care for patients with BRAF V600E/K-mutated metastatic melanoma. For patients with less frequent BRAF mutations, however, efficacy data are limited. METHODS In the current study, 103 patients with metastatic melanoma with rare, activating non-V600E/K BRAF mutations that were treated with either a BRAF inhibitor (BRAFi), MEK inhibitor (MEKi), or the combination were included. BRAF mutation, patient and disease characteristics, response, and survival data were analyzed. RESULTS Fifty-eight patient tumors (56%) harbored a non-E/K V600 mutation, 38 (37%) a non-V600 mutation, and seven had both V600E and a rare BRAF mutation (7%). The most frequent mutations were V600R (43%; 44 of 103), L597P/Q/R/S (15%; 15 of 103), and K601E (11%; 11 of 103). Most patients had stage IV disease and 42% had elevated lactate dehydrogenase at BRAFi/MEKi initiation. Most patients received combined BRAFi/MEKi (58%) or BRAFi monotherapy (37%). Of the 58 patients with V600 mutations, overall response rate to BRAFi monotherapy and combination BRAFi/MEKi was 27% (six of 22) and 56% (20 of 36), respectively, whereas median progression-free survival (PFS) was 3.7 months and 8.0 months, respectively (P = .002). Of the 38 patients with non-V600 mutations, overall response rate was 0% (zero of 15) to BRAFi, 40% (two of five) to MEKi, and 28% (five of 18) to combination treatment, with a median PFS of 1.8 months versus 3.7 months versus 3.3 months, respectively. Multivariable analyses revealed superior survival (PFS and overall survival) with combination over monotherapy in rare V600 and non-V600 mutated melanoma. CONCLUSION Patients with rare BRAF mutations can respond to targeted therapy, however, efficacy seems to be lower compared with V600E mutated melanoma. Combination BRAFi/MEKi seems to be the best regimen for both V600 and non-V600 mutations. Yet interpretation should be done with care because of the heterogeneity of patients with small sample sizes for some of the reported mutations.
Collapse
Affiliation(s)
- Christian Menzer
- Heidelberg University Hospital, Heidelberg, Germany
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Alexander M. Menzies
- The University of Sydney, Sydney, NSW, Australia
- Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - Matteo S. Carlino
- The University of Sydney, Sydney, NSW, Australia
- Crown Princess Mary Cancer Centre Westmead, Sydney, NSW, Australia
| | - Irene Reijers
- Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | - Emma J. Groen
- Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | | | | | | | | | - Frank Meiss
- Medical Center–University of Freiburg and University of Freiburg, Freiburg, Germany
| | - Max Schlaak
- University Hospital Cologne, Cologne, Germany
- University Hospital, LMU Munich, Munich, Germany
| | | | | | | | | | | | - Lisa Zimmer
- University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | | | - Thomas Haalck
- University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Alexander Menzer
- University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | | | - Georgina V. Long
- The University of Sydney, Sydney, NSW, Australia
- Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - Richard Kefford
- The University of Sydney, Sydney, NSW, Australia
- Macquarie University, Sydney, NSW, Australia
| | | | - Christian U. Blank
- Netherlands Cancer Institute-Antoni van Leeuwenhoek, Amsterdam, the Netherlands
| | | |
Collapse
|
21
|
Melin A, Routier E, Tissot H, Rouleau E, Robert C. BRAF exon 11 mutant melanoma and sensitivity to BRAF/MEK inhibition: Two case reports. Eur J Cancer 2019; 121:109-112. [PMID: 31569065 DOI: 10.1016/j.ejca.2019.08.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/18/2019] [Accepted: 08/17/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Audrey Melin
- Department of Dermatology, Gustave Roussy, 114 Rue Edouard-Vaillant, 94800, Villejuif, France.
| | - Emilie Routier
- Department of Dermatology, Gustave Roussy, 114 Rue Edouard-Vaillant, 94800, Villejuif, France.
| | - Hubert Tissot
- Department of Nuclear Medicine, Gustave Roussy, 114 Rue Edouard-Vaillant, 94800, Villejuif, France.
| | - Etienne Rouleau
- Department of Medical Biology and Pathology, Gustave Roussy, 114 Rue Edouard-Vaillant, 94800, Villejuif, France.
| | - Caroline Robert
- Department of Dermatology, Gustave Roussy, 114 Rue Edouard-Vaillant, 94800, Villejuif, France; Paris-Sud University, 63 Rue Gabriel Péri, 94276, Le Kremlin-Bicêtre, France.
| |
Collapse
|
22
|
Metabolic flexibility in melanoma: A potential therapeutic target. Semin Cancer Biol 2019; 59:187-207. [PMID: 31362075 DOI: 10.1016/j.semcancer.2019.07.016] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2019] [Revised: 07/11/2019] [Accepted: 07/23/2019] [Indexed: 01/01/2023]
Abstract
Cutaneous melanoma (CM) represents one of the most metastasizing and drug resistant solid tumors. CM is characterized by a remarkable metabolic plasticity and an important connection between oncogenic activation and energetic metabolism. In fact, melanoma cells can use both cytosolic and mitochondrial compartments to produce adenosine triphosphate (ATP) during cancer progression. However, the CM energetic demand mainly depends on glycolysis, whose upregulation is strictly linked to constitutive activation of BRAF/MAPK pathway affected by BRAFV600E kinase mutant. Furthermore, the impressive metabolic plasticity of melanoma allows the development of resistance mechanisms to BRAF/MEK inhibitors (BRAFi/MEKi) and the adaptation to microenvironmental changes. The metabolic interaction between melanoma cells and tumor microenvironment affects the immune response and CM growth. In this review article, we describe the regulation of melanoma metabolic alterations and the metabolic interactions between cancer cells and microenvironment that influence melanoma progression and immune response. Finally, we summarize the hallmarks of melanoma therapies and we report BRAF/MEK pathway targeted therapy and mechanisms of metabolic resistance.
Collapse
|
23
|
Leichsenring J, Horak P, Kreutzfeldt S, Heining C, Christopoulos P, Volckmar A, Neumann O, Kirchner M, Ploeger C, Budczies J, Heilig CE, Hutter B, Fröhlich M, Uhrig S, Kazdal D, Allgäuer M, Harms A, Rempel E, Lehmann U, Thomas M, Pfarr N, Azoitei N, Bonzheim I, Marienfeld R, Möller P, Werner M, Fend F, Boerries M, Bubnoff N, Lassmann S, Longerich T, Bitzer M, Seufferlein T, Malek N, Weichert W, Schirmacher P, Penzel R, Endris V, Brors B, Klauschen F, Glimm H, Fröhling S, Stenzinger A. Variant classification in precision oncology. Int J Cancer 2019; 145:2996-3010. [DOI: 10.1002/ijc.32358] [Citation(s) in RCA: 49] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 04/08/2019] [Indexed: 02/06/2023]
Affiliation(s)
- Jonas Leichsenring
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Peter Horak
- National Center for Tumor Diseases (NCT) Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
| | - Simon Kreutzfeldt
- National Center for Tumor Diseases (NCT) Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
| | - Christoph Heining
- National Center for Tumor Diseases (NCT) Dresden Germany
- University Hospital Carl Gustav Carus Dresden Germany
| | - Petros Christopoulos
- Thoraxklinik Heidelberg Germany
- Translational Lung Cancer Research Heidelberg (TLCR‐H)German Center for Lung Research (DZL) Giessen Germany
| | - Anna‐Lena Volckmar
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Olaf Neumann
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Martina Kirchner
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Carolin Ploeger
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Jan Budczies
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | | | | | | | - Sebastian Uhrig
- German Cancer Research Center (DKFZ) Heidelberg Germany
- Faculty of BiosciencesHeidelberg University Heidelberg Germany
| | - Daniel Kazdal
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Michael Allgäuer
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Alexander Harms
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Eugen Rempel
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Ulrich Lehmann
- Institute of Pathology, Hannover Medical School Hanover Germany
| | - Michael Thomas
- Thoraxklinik Heidelberg Germany
- Translational Lung Cancer Research Heidelberg (TLCR‐H)German Center for Lung Research (DZL) Giessen Germany
| | - Nicole Pfarr
- Institute of Pathology, Technische Universität München Munich Germany
| | - Ninel Azoitei
- Clinic of Internal Medicine IUniversity Hospital Ulm Ulm Germany
| | - Irina Bonzheim
- Institute of Pathology, University Hospital Tübingen Tübingen Germany
| | | | - Peter Möller
- Institute of Pathology, University Hospital Ulm Ulm Germany
| | - Martin Werner
- Institute of Pathology, Medical Center, University of Freiburg Breisgau Germany
| | - Falko Fend
- Institute of Pathology, University Hospital Tübingen Tübingen Germany
| | - Melanie Boerries
- German Cancer Consortium (DKTK) Heidelberg Germany
- German Cancer Research Center (DKFZ) Heidelberg Germany
- Institute of Molecular Medicine and Cell ResearchUniversity of Freiburg Freiburg Germany
- MIRACUM Consortium of the Medical Informatics Initiative Freiburg Germany
| | - Nikolas Bubnoff
- German Cancer Consortium (DKTK) Heidelberg Germany
- German Cancer Research Center (DKFZ) Heidelberg Germany
- Department of Hematology, Oncology and Stem Cell Transplantation, Medical Center, Faculty of MedicineUniversity of Freiburg Freiburg Germany
- Department of Hematology and OncologyMedical Center, University of Schleswig‐Holstein Lübeck Germany
| | - Silke Lassmann
- Institute of Pathology, Medical Center, University of Freiburg Breisgau Germany
| | - Thomas Longerich
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
- Heidelberg‐Göttingen‐Hannover Medizininformatik (HiGHmed) Konsortium Heidelberg Germany
| | - Michael Bitzer
- Department of Internal Medicine IUniversity Hospital Tübingen Tübingen Germany
| | | | - Nisar Malek
- Department of Internal Medicine IUniversity Hospital Tübingen Tübingen Germany
| | - Wilko Weichert
- Institute of Pathology, Technische Universität München Munich Germany
| | - Peter Schirmacher
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
| | - Roland Penzel
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Volker Endris
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
| | - Benedikt Brors
- National Center for Tumor Diseases (NCT) Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
- German Cancer Research Center (DKFZ) Heidelberg Germany
| | | | - Hanno Glimm
- National Center for Tumor Diseases (NCT) Dresden Germany
| | - Stefan Fröhling
- National Center for Tumor Diseases (NCT) Heidelberg Heidelberg Germany
- German Cancer Consortium (DKTK) Heidelberg Germany
- DKFZ‐Heidelberg Center for Personalized Oncology (HIPO) Heidelberg Germany
| | - Albrecht Stenzinger
- Institute of Pathology, University Hospital Heidelberg Heidelberg Germany
- DKFZ‐Heidelberg Center for Personalized Oncology (HIPO) Heidelberg Germany
| |
Collapse
|
24
|
Chung JH, Dewal N, Sokol E, Mathew P, Whitehead R, Millis SZ, Frampton GM, Bratslavsky G, Pal SK, Lee RJ, Necchi A, Gregg JP, Lara P, Antonarakis ES, Miller VA, Ross JS, Ali SM, Agarwal N. Prospective Comprehensive Genomic Profiling of Primary and Metastatic Prostate Tumors. JCO Precis Oncol 2019; 3:PO.18.00283. [PMID: 31218271 PMCID: PMC6583915 DOI: 10.1200/po.18.00283] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2018] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Comprehensive genomic profiling (CGP) is increasingly used for routine clinical management of prostate cancer. To inform targeted treatment strategies, 3,476 clinically advanced prostate tumors were analyzed by CGP for genomic alterations (GAs) and signatures of genomic instability. METHODS Prostate cancer samples (1,660 primary site and 1,816 metastatic site tumors from unmatched patients) were prospectively analyzed by CGP (FoundationOne Assay; Foundation Medicine, Cambridge, MA) for GAs and genomic signatures (genome-wide loss of heterozygosity [gLOH], microsatellite instability [MSI] status, tumor mutational burden [TMB]). RESULTS Frequently altered genes were TP53 (44%), PTEN (32%), TMPRSS2-ERG (31%), and AR (23%). Potentially targetable GAs were frequently identified in DNA repair, phosphatidylinositol 3-kinase, and RAS/RAF/MEK pathways. DNA repair pathway GAs included homologous recombination repair (23%), Fanconi anemia (5%), CDK12 (6%), and mismatch repair (4%) GAs. BRCA1/2, ATR, and FANCA GAs were associated with high gLOH, whereas CDK12-altered tumors were infrequently gLOH high. Median TMB was low (2.6 mutations/Mb). A subset of cases (3%) had high TMB, of which 71% also had high MSI. Metastatic site tumors were enriched for the 11q13 amplicon (CCND1/FGF19/FGF4/FGF3) and GAs in AR, LYN, MYC, NCOR1, PIK3CB, and RB1 compared with primary tumors. CONCLUSION Routine clinical CGP in the real-world setting identified GAs that are investigational biomarkers for targeted therapies in 57% of cases. gLOH and MSI/TMB signatures could further inform selection of poly (ADP-ribose) polymerase inhibitors and immunotherapies, respectively. Correlation of DNA repair GAs with gLOH identified genes associated with homologous recombination repair deficiency. GAs enriched in metastatic site tumors suggest therapeutic strategies for metastatic prostate cancer. Lack of clinical outcome correlation was a limitation of this study.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Andrea Necchi
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Primo Lara
- University of California, Davis, Medical Center, Sacramento, CA
| | | | | | - Jeffrey S. Ross
- Foundation Medicine, Cambridge, MA
- Upstate Medical University, Syracuse, NY
| | | | | |
Collapse
|
25
|
Laikova KV, Oberemok VV, Krasnodubets AM, Gal'chinsky NV, Useinov RZ, Novikov IA, Temirova ZZ, Gorlov MV, Shved NA, Kumeiko VV, Makalish TP, Bessalova EY, Fomochkina II, Esin AS, Volkov ME, Kubyshkin AV. Advances in the Understanding of Skin Cancer: Ultraviolet Radiation, Mutations, and Antisense Oligonucleotides as Anticancer Drugs. Molecules 2019; 24:E1516. [PMID: 30999681 PMCID: PMC6514765 DOI: 10.3390/molecules24081516] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 04/13/2019] [Accepted: 04/15/2019] [Indexed: 12/15/2022] Open
Abstract
Skin cancer has always been and remains the leader among all tumors in terms of occurrence. One of the main factors responsible for skin cancer, natural and artificial UV radiation, causes the mutations that transform healthy cells into cancer cells. These mutations inactivate apoptosis, an event required to avoid the malignant transformation of healthy cells. Among these deadliest of cancers, melanoma and its 'younger sister', Merkel cell carcinoma, are the most lethal. The heavy toll of skin cancers stems from their rapid progression and the fact that they metastasize easily. Added to this is the difficulty in determining reliable margins when excising tumors and the lack of effective chemotherapy. Possibly the biggest problem posed by skin cancer is reliably detecting the extent to which cancer cells have spread throughout the body. The initial tumor is visible and can be removed, whereas metastases are invisible to the naked eye and much harder to eliminate. In our opinion, antisense oligonucleotides, which can be used in the form of targeted ointments, provide real hope as a treatment that will eliminate cancer cells near the tumor focus both before and after surgery.
Collapse
Affiliation(s)
- Kateryna V Laikova
- Medical Academy named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Lenin Boulevard 5/7, 295051 Simferopol, Crimea.
- Research Institute of Agriculture of Crimea, Kiyevskaya St. 150, 295493, Simferopol, Crimea.
| | - Volodymyr V Oberemok
- Taurida Academy, V.I. Vernadsky Crimean Federal University, Vernadsky Av. 4, 295007 Simferopol, Crimea.
- Nikita Botanical Gardens ⁻ National Scientific Centre RAS, Nikitsky spusk 52, vil. Nikita, 298648 Yalta, Crimea.
| | - Alisa M Krasnodubets
- Taurida Academy, V.I. Vernadsky Crimean Federal University, Vernadsky Av. 4, 295007 Simferopol, Crimea.
| | - Nikita V Gal'chinsky
- Taurida Academy, V.I. Vernadsky Crimean Federal University, Vernadsky Av. 4, 295007 Simferopol, Crimea.
| | - Refat Z Useinov
- Taurida Academy, V.I. Vernadsky Crimean Federal University, Vernadsky Av. 4, 295007 Simferopol, Crimea.
| | - Ilya A Novikov
- Taurida Academy, V.I. Vernadsky Crimean Federal University, Vernadsky Av. 4, 295007 Simferopol, Crimea.
| | - Zenure Z Temirova
- Medical Academy named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Lenin Boulevard 5/7, 295051 Simferopol, Crimea.
| | - Mikhail V Gorlov
- D. Mendeleev University of Chemical Technology of Russia, Miusskaya sq. 9, 125047 Moscow, Russia.
| | - Nikita A Shved
- Centre for Genomic and Regenerative Medicine, School of Biomedicine, Far Eastern Federal University, Sukhanova St. 8, 690090 Vladivostok, Russia.
- National Scientific Center of Marine Biology, Far Eastern Branch of Russian Academy of Sciences, Palchevsky St. 17, 690041 Vladivostok, Russia.
| | - Vadim V Kumeiko
- Centre for Genomic and Regenerative Medicine, School of Biomedicine, Far Eastern Federal University, Sukhanova St. 8, 690090 Vladivostok, Russia.
- National Scientific Center of Marine Biology, Far Eastern Branch of Russian Academy of Sciences, Palchevsky St. 17, 690041 Vladivostok, Russia.
| | - Tatiana P Makalish
- Medical Academy named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Lenin Boulevard 5/7, 295051 Simferopol, Crimea.
| | - Evgeniya Y Bessalova
- Medical Academy named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Lenin Boulevard 5/7, 295051 Simferopol, Crimea.
| | - Iryna I Fomochkina
- Medical Academy named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Lenin Boulevard 5/7, 295051 Simferopol, Crimea.
| | - Andrey S Esin
- D. Mendeleev University of Chemical Technology of Russia, Miusskaya sq. 9, 125047 Moscow, Russia.
| | - Mikhail E Volkov
- Ltd "NPF Syntol", Тimiryazevskaya St. 42, 127434 Moscow, Russia.
| | - Anatoly V Kubyshkin
- Medical Academy named after S.I. Georgievsky, V.I. Vernadsky Crimean Federal University, Lenin Boulevard 5/7, 295051 Simferopol, Crimea.
| |
Collapse
|
26
|
Nájera L, Alonso‐Juarranz M, Garrido M, Ballestín C, Moya L, Martínez‐Díaz M, Carrillo R, Juarranz A, Rojo F, Cuezva J, Rodríguez‐Peralto J. Prognostic implications of markers of the metabolic phenotype in human cutaneous melanoma. Br J Dermatol 2019; 181:114-127. [DOI: 10.1111/bjd.17513] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2018] [Indexed: 12/12/2022]
Affiliation(s)
- L. Nájera
- Servicio de Anatomía Patológica Hospital Universitario Puerta de Hierro Majadahonda, MadridSpain
| | | | - M. Garrido
- Instituto de Investigación Hospital 12 de Octubre Universidad Complutense de Madrid MadridSpain
| | - C. Ballestín
- IIS‐Fundación Jiménez Diaz C/Reyes Católicos 2 28049 MadridSpain
| | - L. Moya
- Servicio de Anatomía Patológica Hospital Universitario Ramón y Cajal MadridSpain
| | - M. Martínez‐Díaz
- Departamento de Biología Molecular Centro de Biología Molecular Severo Ochoa CSIC‐UAM MadridSpain
| | - R. Carrillo
- Servicio de Anatomía Patológica Hospital Universitario Ramón y Cajal MadridSpain
| | - A. Juarranz
- Departamento de Biología Facultad de Ciencias Universidad Autónoma de Madrid C/Darwin, 2 28049 MadridSpain
- Instituto Ramón y Cajal de Investigaciones Sanitarias (IRYCIS) MadridSpain
| | - F. Rojo
- IIS‐Fundación Jiménez Diaz C/Reyes Católicos 2 28049 MadridSpain
| | - J.M. Cuezva
- Instituto de Investigación Hospital 12 de Octubre Universidad Complutense de Madrid MadridSpain
- Departamento de Biología Molecular Centro de Biología Molecular Severo Ochoa CSIC‐UAM MadridSpain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER) ISCIII MadridSpain
| | - J.L. Rodríguez‐Peralto
- Instituto de Investigación Hospital 12 de Octubre Universidad Complutense de Madrid MadridSpain
- Centro de Investigación Biomédica en Red de Cáncer (CIBERONC) ISCIII Madrid Spain
| |
Collapse
|
27
|
Hartman ML, Sztiller-Sikorska M, Czyz M. Whole-exome sequencing reveals novel genetic variants associated with diverse phenotypes of melanoma cells. Mol Carcinog 2019; 58:588-602. [DOI: 10.1002/mc.22953] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Mariusz L. Hartman
- Department of Molecular Biology of Cancer; Medical University of Lodz; Lodz Poland
| | | | - Malgorzata Czyz
- Department of Molecular Biology of Cancer; Medical University of Lodz; Lodz Poland
| |
Collapse
|
28
|
Furlan I, Domljanovic I, Uhd J, Astakhova K. Improving the Design of Synthetic Oligonucleotide Probes by Fluorescence Melting Assay. Chembiochem 2018; 20:587-594. [DOI: 10.1002/cbic.201800511] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Indexed: 02/03/2023]
Affiliation(s)
- Ilaria Furlan
- Department of Physics, Chemistry and PharmacyUniversity of Southern Denmark Campusvej 55 5230 Odense M Denmark
| | - Ivana Domljanovic
- Department of ChemistryTechnical University of Denmark Kemitorvet 206–207 2800 Kgs. Lyngby Denmark
| | - Jesper Uhd
- Department of ChemistryTechnical University of Denmark Kemitorvet 206–207 2800 Kgs. Lyngby Denmark
| | - Kira Astakhova
- Department of ChemistryTechnical University of Denmark Kemitorvet 206–207 2800 Kgs. Lyngby Denmark
| |
Collapse
|
29
|
de Heer EC, Brouwers AH, Boellaard R, Sluiter WJ, Diercks GFH, Hospers GAP, de Vries EGE, Jalving M. Mapping heterogeneity in glucose uptake in metastatic melanoma using quantitative 18F-FDG PET/CT analysis. EJNMMI Res 2018; 8:101. [PMID: 30460579 PMCID: PMC6246760 DOI: 10.1186/s13550-018-0453-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 10/31/2018] [Indexed: 01/03/2023] Open
Abstract
Background Metastatic melanoma patients can have durable responses to systemic therapy and even long-term survival. However, a large subgroup of patients does not benefit. Tumour metabolic alterations may well be involved in the efficacy of both targeted and immunotherapy. Knowledge on in vivo tumour glucose uptake and its heterogeneity in metastatic melanoma may aid in upfront patient selection for novel (concomitant) metabolically targeted therapies. The aim of this retrospective study was to provide insight into quantitative 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) parameters and corresponding intra- and inter-patient heterogeneity in tumour 18F-FDG uptake among metastatic melanoma patients. Consecutive, newly diagnosed stage IV melanoma patients with a baseline 18F-FDG PET/CT scan performed between May 2014 and December 2015 and scheduled to start first-line systemic treatment were included. Volume of interests (VOIs) of all visible tumour lesions were delineated using a gradient-based contour method, and standardized uptake values (SUVs), metabolically active tumour volume (MATV) and total lesion glycolysis (TLG) were determined on a per-lesion and per-patient basis. Differences in quantitative PET parameters were explored between patient categories stratified by BRAFV600 and RAS mutational status, baseline serum lactate dehydrogenase (LDH) levels and tumour programmed death-ligand 1 (PD-L1) expression. Results In 64 patients, 1143 lesions ≥ 1 ml were delineated. Median number of lesions ≥ 1 ml was 6 (range 0–168), median maximum SUVpeak 9.5 (range 0–58), median total MATV 29 ml (range 0–2212) and median total TLG 209 (range 0–16,740). Per-patient analysis revealed considerable intra- and inter-patient heterogeneity. Maximum SUVs, MATV, number of lesions and TLG per patient did not differ when stratifying between BRAFV600 or RAS mutational status or PD-L1 expression status, but were higher in the patient group with elevated LDH levels (> 250 U/l) compared to the group with normal LDH levels (P < 0.001). A subset of patients with normal LDH levels also showed above median tumour 18F-FDG uptake. Conclusions Baseline tumour 18F-FDG uptake in stage IV melanoma is heterogeneous, independent of mutational status and cannot be fully explained by LDH levels. Further investigation of the prognostic and predictive value of quantitative 18F-FDG PET parameters is of interest. Electronic supplementary material The online version of this article (10.1186/s13550-018-0453-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Ellen C de Heer
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Adrienne H Brouwers
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Ronald Boellaard
- Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Wim J Sluiter
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Gilles F H Diercks
- Department of Pathology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Geke A P Hospers
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Elisabeth G E de Vries
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands
| | - Mathilde Jalving
- Department of Medical Oncology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, PO Box 30.001, 9700 RB, Groningen, The Netherlands.
| |
Collapse
|
30
|
Dankner M, Lajoie M, Moldoveanu D, Nguyen TT, Savage P, Rajkumar S, Huang X, Lvova M, Protopopov A, Vuzman D, Hogg D, Park M, Guiot MC, Petrecca K, Mihalcioiu C, Watson IR, Siegel PM, Rose AA. Dual MAPK Inhibition Is an Effective Therapeutic Strategy for a Subset of Class II BRAF Mutant Melanomas. Clin Cancer Res 2018; 24:6483-6494. [DOI: 10.1158/1078-0432.ccr-17-3384] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2017] [Revised: 03/28/2018] [Accepted: 06/06/2018] [Indexed: 11/16/2022]
|
31
|
Validity of Targeted Next-Generation Sequencing in Routine Care for Identifying Clinically Relevant Molecular Profiles in Non-Small-Cell Lung Cancer: Results of a 2-Year Experience on 1343 Samples. J Mol Diagn 2018; 20:550-564. [PMID: 29787863 DOI: 10.1016/j.jmoldx.2018.04.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 03/15/2018] [Accepted: 04/11/2018] [Indexed: 11/22/2022] Open
Abstract
Theranostic assays are based on single-gene testing, but the ability of next-generation sequencing (NGS) to interrogate numerous genetic alterations will progressively replace single-gene assays. Although NGS was evaluated to screen for theranostic mutations, its usefulness in clinical practice on large series of samples remains to be demonstrated. NGS performance was assessed following guidelines. TaqMan probes and NGS were compared for their ability to detect EGFR and KRAS mutations, and NGS mutation profiles were analyzed on a large series of non-small-cell lung cancers (n = 1343). The R2 correlation between expected and measured allelic ratio, using commercial samples, was >0.96. Mutation detection threshold was 2% for 10 ng of DNA input. κ Scores for TaqMan versus NGS were 0.99 (95% CI, 0.97-1.00) for EGFR and 0.98 (95% CI, 0.97-1.00) for KRAS after exclusion of rare EGFR (n = 40) and KRAS (n = 60) mutations. NGS identified 693 and 292 mutations in validated and potential oncogenic drivers, respectively. Significant associations were found between EGFR and PI3KCA or CTNNB1 and between KRAS and STK11. Potential oncogenic driver mutations or gene amplifications were more frequent in validated oncogenic driver nonmutated samples. This work is a proof of concept that targeted NGS is accessible in routine screening, including large screening, at reasonable cost. Clinical data should be collected and implemented in specific databases to make molecular data meaningful for direct patients' benefit.
Collapse
|
32
|
Leonardi GC, Falzone L, Salemi R, Zanghì A, Spandidos DA, McCubrey JA, Candido S, Libra M. Cutaneous melanoma: From pathogenesis to therapy (Review). Int J Oncol 2018; 52:1071-1080. [PMID: 29532857 PMCID: PMC5843392 DOI: 10.3892/ijo.2018.4287] [Citation(s) in RCA: 221] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 02/08/2018] [Indexed: 02/07/2023] Open
Abstract
In less than 10 years, melanoma treatment has been revolutionized with the approval of tyrosine kinase inhibitors and immune checkpoint inhibitors, which have been shown to have a significant impact on the prognosis of patients with melanoma. The early steps of this transformation have taken place in research laboratories. The mitogen‑activated protein kinase (MAPK) pathway, phosphoinositol‑3‑kinase (PI3K) pathway promote the development of melanoma through numerous genomic alterations on different components of these pathways. Moreover, melanoma cells deeply interact with the tumor microenvironment and the immune system. This knowledge has led to the identification of novel therapeutic targets and treatment strategies. In this review, the epidemiological features of cutaneous melanoma along with the biological mechanisms involved in its development and progression are summarized. The current state‑of‑the‑art of advanced stage melanoma treatment strategies and the currently available evidence of the use of predictive and prognostic biomarkers are also discussed.
Collapse
Affiliation(s)
- Giulia C. Leonardi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania
| | - Luca Falzone
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania
| | - Rossella Salemi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania
| | - Antonino Zanghì
- Department of Medical and Surgical Sciences and Advanced Technology 'G.F. Ingrassia', University of Catania, 95125 Catania, Italy
| | - Demetrios A. Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, 71003 Heraklion, Crete, Greece
| | - James A. McCubrey
- Department of Microbiology and Immunology, Brody School of Medicine at East Carolina University, Greenville, NC 27858, USA
| | - Saverio Candido
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania
- Research Center of Tumor Prevention, Diagnosis and Cure (CRS PreDiCT), University of Catania, 95123 Catania, Italy
| |
Collapse
|
33
|
Betancor-Fernández I, Timson DJ, Salido E, Pey AL. Natural (and Unnatural) Small Molecules as Pharmacological Chaperones and Inhibitors in Cancer. Handb Exp Pharmacol 2018; 245:155-190. [PMID: 28993836 DOI: 10.1007/164_2017_55] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Mutations causing single amino acid exchanges can dramatically affect protein stability and function, leading to disease. In this chapter, we will focus on several representative cases in which such mutations affect protein stability and function leading to cancer. Mutations in BRAF and p53 have been extensively characterized as paradigms of loss-of-function/gain-of-function mechanisms found in a remarkably large fraction of tumours. Loss of RB1 is strongly associated with cancer progression, although the molecular mechanisms by which missense mutations affect protein function and stability are not well known. Polymorphisms in NQO1 represent a remarkable example of the relationships between intracellular destabilization and inactivation due to dynamic alterations in protein ensembles leading to loss of function. We will review the function of these proteins and their dysfunction in cancer and then describe in some detail the effects of the most relevant cancer-associated single amino exchanges using a translational perspective, from the viewpoints of molecular genetics and pathology, protein biochemistry and biophysics, structural, and cell biology. This will allow us to introduce several representative examples of natural and synthetic small molecules applied and developed to overcome functional, stability, and regulatory alterations due to cancer-associated amino acid exchanges, which hold the promise for using them as potential pharmacological cancer therapies.
Collapse
Affiliation(s)
- Isabel Betancor-Fernández
- Centre for Biomedical Research on Rare Diseases (CIBERER), Hospital Universitario de Canarias, Tenerife, 38320, Spain
| | - David J Timson
- School of Pharmacy and Biomolecular Sciences, University of Brighton, Huxley Building, Lewes Road, Brighton, BN2 4GJ, UK
| | - Eduardo Salido
- Centre for Biomedical Research on Rare Diseases (CIBERER), Hospital Universitario de Canarias, Tenerife, 38320, Spain
| | - Angel L Pey
- Department of Physical Chemistry, University of Granada, Granada, 18071, Spain.
| |
Collapse
|
34
|
Affiliation(s)
- H Schaider
- Dermatology Research Centre, Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, QLD, Australia
| | - R A Sturm
- Dermatology Research Centre, Diamantina Institute, The University of Queensland, Translational Research Institute, Brisbane, QLD, Australia
| |
Collapse
|
35
|
Richtig G, Ehall B, Richtig E, Aigelsreiter A, Gutschner T, Pichler M. Function and Clinical Implications of Long Non-Coding RNAs in Melanoma. Int J Mol Sci 2017; 18:E715. [PMID: 28350340 PMCID: PMC5412301 DOI: 10.3390/ijms18040715] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 03/16/2017] [Accepted: 03/17/2017] [Indexed: 02/06/2023] Open
Abstract
Metastatic melanoma is the most deadly type of skin cancer. Despite the success of immunotherapy and targeted agents, the majority of patients experience disease recurrence upon treatment and die due to their disease. Long non-coding RNAs (lncRNAs) are a new subclass of non-protein coding RNAs involved in (epigenetic) regulation of cell growth, invasion, and other important cellular functions. Consequently, recent research activities focused on the discovery of these lncRNAs in a broad spectrum of human diseases, especially cancer. Additional efforts have been undertaken to dissect the underlying molecular mechanisms employed by lncRNAs. In this review, we will summarize the growing evidence of deregulated lncRNA expression in melanoma, which is linked to tumor growth and progression. Moreover, we will highlight specific molecular pathways and modes of action for some well-studied lncRNAs and discuss their potential clinical implications.
Collapse
Affiliation(s)
- Georg Richtig
- Institute of Experimental and Clinical Pharmacology, Medical University of Graz, Graz 8010, Austria.
- Department of Dermatology, Medical University of Graz, Graz 8036, Austria.
| | - Barbara Ehall
- Institute for Pathology, Medical University of Graz, Graz 8036, Austria.
- Division of Hematology, Department of Internal Medicine, Medical University of Graz, Graz 8036, Austria.
| | - Erika Richtig
- Department of Dermatology, Medical University of Graz, Graz 8036, Austria.
| | | | - Tony Gutschner
- Faculty of Medicine, Martin-Luther-University Halle-Wittenberg, Halle (Saale) 06120, Germany.
| | - Martin Pichler
- Division of Clinical Oncology, Department of Medicine, Medical University of Graz, Graz 8036, Austria.
| |
Collapse
|
36
|
Prediction of Response in Melanoma Therapy by Systemic Inflammatory Response - One Size Fits Not All. EBioMedicine 2017; 18:13-14. [PMID: 28366295 PMCID: PMC5405174 DOI: 10.1016/j.ebiom.2017.03.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 03/22/2017] [Indexed: 01/05/2023] Open
|