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Dorfer S, Ressler JM, Riebenbauer K, Kancz S, Purkhauser K, Bachmayr V, Cataisson C, Kirnbauer R, Petzelbauer P, Wiesmueller M, Egg M, Hoeller C, Handisurya A. BRAF Inhibition and UVB Light Synergistically Promote Mus musculus Papillomavirus 1-Induced Skin Tumorigenesis. Cancers (Basel) 2024; 16:3133. [PMID: 39335105 DOI: 10.3390/cancers16183133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2024] [Revised: 09/04/2024] [Accepted: 09/10/2024] [Indexed: 09/30/2024] Open
Abstract
The development of keratinocytic skin tumors, presumably attributable to paradoxical activation of the MAPK pathway, represents a relevant side effect of targeted therapies with BRAF inhibitors (BRAFis). The role of cutaneous papillomavirus infection in BRAFi-associated skin carcinogenesis, however, is still inconclusive. Employing the Mus musculus papillomavirus 1 (MmuPV1) skin infection model, the impact of BRAFis and UVB exposure on papillomavirus induced skin tumorigenesis was investigated in immunocompetent FVB/NCrl mice. Systemic BRAF inhibition in combination with UVB light induced skin tumors in 62% of the MmuPV1-infected animals. In contrast, significantly fewer tumors were observed in the absence of either BRAF inhibition, UVB irradiation or virus infection, as demonstrated by lesional outgrowth in 20%, 5% and 0% of the mice, respectively. Combinatory exposure to BRAFis and UVB favored productive viral infection, which was shown by high numbers of MmuPV1 genome copies and E1^E4 spliced transcripts and an abundance of E6/E7 oncogene mRNA and viral capsid proteins. BRAF inhibition, but not viral infection or UVB light, activated ERK1/2, whereas γH2AX expression, inducible by UVB light, remained unaltered by BRAFis. These results provide experimental evidence that BRAF inhibition and UVB irradiation synergistically promote MmuPV1-induced skin tumor development in vivo. This indicates an alternative pathway by which papillomavirus skin infection may contribute to BRAFi-associated skin tumorigenesis.
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Affiliation(s)
- Sonja Dorfer
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
| | - Julia Maria Ressler
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
| | | | - Stefanie Kancz
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
| | - Kim Purkhauser
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
| | - Victoria Bachmayr
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
| | - Christophe Cataisson
- Laboratory of Cancer Biology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Reinhard Kirnbauer
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
| | - Peter Petzelbauer
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
| | - Markus Wiesmueller
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
| | - Maximilian Egg
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
| | - Christoph Hoeller
- Department of Dermatology, Medical University of Vienna, 1090 Vienna, Austria
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2
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Park JK, Huang LC, Kossler AL. Erdheim-Chester disease and vemurafenib: a review of ophthalmic presentations and clinical outcomes. Orbit 2023; 42:233-244. [PMID: 35702885 DOI: 10.1080/01676830.2022.2087232] [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: 01/06/2022] [Accepted: 05/30/2022] [Indexed: 05/17/2023]
Abstract
PURPOSE To provide a comprehensive review of ocular and orbital manifestations of Erdheim-Chester Disease (ECD) and compare clinical outcomes with vemurafenib (INN) to historical treatments (HT). Primary outcomes are ophthalmic findings on presentation, changes in visual acuity, and mortality rate. Secondary outcomes include the progression of ocular findings, systemic involvements, and treatment modalities. METHODS All published literature from January 1983 to March 2021 was searched for ophthalmic manifestations of ECD. Clinical outcomes following HT were collected and compared with INN. RESULTS Forty-seven patients with ECD and ophthalmic presentations were identified. The mean age was 49.6 years (SD = 15.0). Proptosis (65.6%) and extraocular muscle restrictions (42.5%) were the most common presenting signs. Of 41 (87.2%) patients with orbital masses on radiologic examination, 90.2% were bilateral, and 53.7% were located in the intraconal space. Ophthalmic examination was significant for xanthelasma (27.2%), optic disc edema (34.0%), and subretinal changes (21.3%). Common treatments were systemic steroids (76.6%), interferon-α (17.0%), and cyclophosphamide (14.9%). INN was less commonly used (12.8%). The mean change in logMAR visual acuity declined with HT (29.9%) but improved with INN (79.1%) (p > 0.05). The proportion of eyes with complete vision loss increased after HT (p < 0.05). The overall mortality rate was 27.7% and notably higher in the HT group (29.3%) when compared to the INN group (16.7%) (p > 0.05). CONCLUSION ECD presents with many ophthalmic manifestations. Although the intraocular treatments remain controversial, INN should be highly considered in treating orbital ECD patients with BRAF-V600E mutations to prevent and reverse vision loss.
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Affiliation(s)
- Ji Kwan Park
- Oculofacial Plastic and Orbital Surgery, Indianapolis, Indiana, USA
| | - Laura C Huang
- Pediatric Ophthalmology, Seattle Children's Hospital, University of Washington, Seattle, Washington, USA
| | - Andrea L Kossler
- Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, California, USA
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3
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Tham M, Stark HJ, Jauch A, Harwood C, Pavez Lorie E, Boukamp P. Adverse Effects of Vemurafenib on Skin Integrity: Hyperkeratosis and Skin Cancer Initiation Due to Altered MEK/ERK-Signaling and MMP Activity. Front Oncol 2022; 12:827985. [PMID: 35174094 PMCID: PMC8842679 DOI: 10.3389/fonc.2022.827985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 01/03/2022] [Indexed: 11/24/2022] Open
Abstract
The BRAF inhibitor vemurafenib, approved for treating patients with BRAF V600E-mutant and unresectable or metastatic melanomas, rapidly induces cutaneous adverse events, including hyperkeratotic skin lesions and cutaneous squamous cell carcinomas (cSCC). To determine, how vemurafenib would provoke these adverse events, we utilized long-term in vitro skin equivalents (SEs) comprising epidermal keratinocytes and dermal fibroblasts in their physiological environment. We inserted keratinocytes with different genetic background [normal keratinocytes: NHEK, HaCaT (p53/mut), and HrasA5 (p53/mut+Hras/mut)] to analyze effects depending on the stage of carcinogenesis. We now show that vemurafenib activates MEK-ERK signaling in both, keratinocytes, and fibroblasts in vitro and in the in vivo-like SEs. As a consequence, vemurafenib does not provide a growth advantage but leads to a differentiation phenotype, causing accelerated differentiation and hyperkeratosis in the NHEK and normalized stratification and cornification in the transformed keratinocytes. Although all keratinocytes responded very similarly to vemurafenib in their expression profile, particularly with a significant induction of MMP1 and MMP3, only the HrasA5 cells revealed a vemurafenib-dependent pathophysiological shift to tumor progression, i.e., the initiation of invasive growth. This was shown by increased proteolytic activity allowing for penetration of the basement membrane and invasion into the disrupted underlying matrix. Blocking MMP activity, by the addition of ilomastat, prevented invasion with all corresponding degradative activities, thus substantiating that the RAS-RAF-MEK-ERK/MMP axis is the most important molecular basis for the rapid switch towards tumorigenic conversion of the HrasA5 keratinocytes upon vemurafenib treatment. Finally, cotreatment with vemurafenib and the MEK inhibitor cobimetinib prevented MEK-ERK hyperactivation and with that abolished both, the epidermal differentiation and the tumor invasion phenotype. This suggests that both cutaneous adverse events are under direct control of vemurafenib-dependent MEK-ERK hyperactivation and confirms the dependence on preexisting genetic alterations of the skin keratinocytes that determine the basis towards induction of tumorigenic progression.
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Affiliation(s)
- Marius Tham
- Department of Genetics of Skin Carcinogenesis, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hans-Jürgen Stark
- Department of Applied Tumor Biology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - Anna Jauch
- Institute of Human Genetics, University Heidelberg, Heidelberg, Germany
| | - Catherine Harwood
- Department of Dermatology, Royal London Hospital, Barts Health NHS Trust, London, United Kingdom.,Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | | | - Petra Boukamp
- Department of Genetics of Skin Carcinogenesis, German Cancer Research Center (DKFZ), Heidelberg, Germany.,IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
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4
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Yetsko K, Farrell JA, Blackburn NB, Whitmore L, Stammnitz MR, Whilde J, Eastman CB, Ramia DR, Thomas R, Krstic A, Linser P, Creer S, Carvalho G, Devlin MA, Nahvi N, Leandro AC, deMaar TW, Burkhalter B, Murchison EP, Schnitzler C, Duffy DJ. Molecular characterization of a marine turtle tumor epizootic, profiling external, internal and postsurgical regrowth tumors. Commun Biol 2021; 4:152. [PMID: 33526843 PMCID: PMC7851172 DOI: 10.1038/s42003-021-01656-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 12/31/2020] [Indexed: 01/30/2023] Open
Abstract
Sea turtle populations are under threat from an epizootic tumor disease (animal epidemic) known as fibropapillomatosis. Fibropapillomatosis continues to spread geographically, with prevalence of the disease also growing at many longer-affected sites globally. However, we do not yet understand the precise environmental, mutational and viral events driving fibropapillomatosis tumor formation and progression.Here we perform transcriptomic and immunohistochemical profiling of five fibropapillomatosis tumor types: external new, established and postsurgical regrowth tumors, and internal lung and kidney tumors. We reveal that internal tumors are molecularly distinct from the more common external tumors. However, they have a small number of conserved potentially therapeutically targetable molecular vulnerabilities in common, such as the MAPK, Wnt, TGFβ and TNF oncogenic signaling pathways. These conserved oncogenic drivers recapitulate remarkably well the core pan-cancer drivers responsible for human cancers. Fibropapillomatosis has been considered benign, but metastatic-related transcriptional signatures are strongly activated in kidney and established external tumors. Tumors in turtles with poor outcomes (died/euthanized) have genes associated with apoptosis and immune function suppressed, with these genes providing putative predictive biomarkers.Together, these results offer an improved understanding of fibropapillomatosis tumorigenesis and provide insights into the origins, inter-tumor relationships, and therapeutic treatment for this wildlife epizootic.
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Affiliation(s)
- Kelsey Yetsko
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
| | - Jessica A Farrell
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
- Department of Biology, University of Florida, Gainesville, FL, 32611, USA
| | - Nicholas B Blackburn
- Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX, USA
- South Texas Diabetes and Obesity Institute, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX, USA
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Liam Whitmore
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
- Department of Biological Sciences, School of Natural Sciences, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland
| | - Maximilian R Stammnitz
- Transmissible Cancer Group, Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Jenny Whilde
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
| | - Catherine B Eastman
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
| | - Devon Rollinson Ramia
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
| | - Rachel Thomas
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
| | - Aleksandar Krstic
- Systems Biology Ireland & Precision Oncology Ireland, School of Medicine, University College Dublin, Belfield, Dublin, 4, Ireland
| | - Paul Linser
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
| | - Simon Creer
- Molecular Ecology and Fisheries Genetics Laboratory, School of Biological Sciences, Bangor University, Bangor, Gwynedd, LL57 2UW, UK
| | - Gary Carvalho
- Molecular Ecology and Fisheries Genetics Laboratory, School of Biological Sciences, Bangor University, Bangor, Gwynedd, LL57 2UW, UK
| | | | - Nina Nahvi
- Sea Turtle Inc., South Padre Island, TX, USA
| | - Ana Cristina Leandro
- Department of Human Genetics, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX, USA
- South Texas Diabetes and Obesity Institute, School of Medicine, University of Texas Rio Grande Valley, Brownsville, TX, USA
| | | | - Brooke Burkhalter
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
| | - Elizabeth P Murchison
- Transmissible Cancer Group, Department of Veterinary Medicine, University of Cambridge, Cambridge, CB3 0ES, UK
| | - Christine Schnitzler
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA
- Department of Biology, University of Florida, Gainesville, FL, 32611, USA
| | - David J Duffy
- The Whitney Laboratory for Marine Bioscience and Sea Turtle Hospital, University of Florida, St. Augustine, FL, 32080, USA.
- Department of Biology, University of Florida, Gainesville, FL, 32611, USA.
- Department of Biological Sciences, School of Natural Sciences, Faculty of Science and Engineering, University of Limerick, Limerick, Ireland.
- Systems Biology Ireland & Precision Oncology Ireland, School of Medicine, University College Dublin, Belfield, Dublin, 4, Ireland.
- Molecular Ecology and Fisheries Genetics Laboratory, School of Biological Sciences, Bangor University, Bangor, Gwynedd, LL57 2UW, UK.
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5
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Deutsch A, Balagula Y, McLellan BN. Anticancer therapies associated with secondary cutaneous malignancies: A review of the literature. J Am Acad Dermatol 2020; 83:1425-1433. [DOI: 10.1016/j.jaad.2020.04.074] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/03/2020] [Accepted: 04/15/2020] [Indexed: 12/22/2022]
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The Protein Tyrosine Phosphatase H1 PTPH1 Supports Proliferation of Keratinocytes and is a Target of the Human Papillomavirus Type 8 E6 Oncogene. Cells 2019; 8:cells8030244. [PMID: 30875834 PMCID: PMC6468676 DOI: 10.3390/cells8030244] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 03/07/2019] [Accepted: 03/09/2019] [Indexed: 12/15/2022] Open
Abstract
Human papillomaviruses (HPV) replicate their DNA in the suprabasal layer of the infected mucosa or skin. In order to create a suitable environment for vegetative viral DNA replication HPV delay differentiation and sustain keratinocyte proliferation that can lead to hyperplasia. The mechanism underlying cell growth stimulation is not well characterized. Here, we show that the E6 oncoprotein of the βHPV type 8 (HPV8), which infects the cutaneous skin and is associated with skin cancer in Epidermodysplasia verruciformis patients and immunosuppressed organ transplant recipients, binds to the protein tyrosine phosphatase H1 (PTPH1), which resulted in increased protein expression and phosphatase activity of PTPH1. Suppression of PTPH1 in immortalized keratinocytes reduced cell proliferation as well as the level of epidermal growth factor receptor (EGFR). Furthermore, we report that HPV8E6 expressing keratinocytes have increased level of active, GTP-bound Ras. This effect was independent of PTPH1. Therefore, HPV8E6-mediated targeting of PTPH1 might result in higher level of EGFR and enhanced keratinocyte proliferation. The HPV8E6-mediated stimulation of Ras may be an additional step to induce cell growth. Our results provide novel insights into the mechanism how βHPVE6 proteins support proliferation of infected keratinocytes, thus creating an environment with increased risk of development of skin cancer particularly upon UV-induced DNA mutations.
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7
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Mastomys Species as Model Systems for Infectious Diseases. Viruses 2019; 11:v11020182. [PMID: 30795569 PMCID: PMC6409723 DOI: 10.3390/v11020182] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 02/13/2019] [Accepted: 02/20/2019] [Indexed: 12/17/2022] Open
Abstract
Replacements of animal models by advanced in vitro systems in biomedical research, despite exceptions, are currently still not satisfactory in reproducing the whole complexity of pathophysiological mechanisms that finally lead to disease. Therefore, preclinical models are additionally required to reflect analogous in vivo situations as found in humans. Despite proven limitations of both approaches, only a combined experimental arrangement guarantees generalizability of results and their transfer to the clinics. Although the laboratory mouse still stands as a paradigm for many scientific discoveries and breakthroughs, it is mandatory to broaden our view by also using nontraditional animal models. The present review will first reflect the value of experimental systems in life science and subsequently describes the preclinical rodent model Mastomys coucha that-although still not well known in the scientific community-has a long history in research of parasites, bacteria, papillomaviruses and cancer. Using Mastomys, we could recently show for the first time that cutaneous papillomaviruses-in conjunction with UV as an environmental risk factor-induce squamous cell carcinomas of the skin via a "hit-and-run" mechanism. Moreover, Mastomys coucha was also used as a proof-of-principle model for the successful vaccination against non-melanoma skin cancer even under immunosuppressive conditions.
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8
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Purdie KJ, Proby CM, Rizvi H, Griffin H, Doorbar J, Sommerlad M, Feltkamp MC, der Meijden EV, Inman GJ, South AP, Leigh IM, Harwood CA. The Role of Human Papillomaviruses and Polyomaviruses in BRAF-Inhibitor Induced Cutaneous Squamous Cell Carcinoma and Benign Squamoproliferative Lesions. Front Microbiol 2018; 9:1806. [PMID: 30154763 PMCID: PMC6102365 DOI: 10.3389/fmicb.2018.01806] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 07/18/2018] [Indexed: 12/19/2022] Open
Abstract
Background: Human papillomavirus (HPV) has long been proposed as a cofactor in the pathogenesis of cutaneous squamous cell carcinoma (cSCC). More recently, the striking clinico-pathological features of cSCCs that complicate treatment of metastatic melanoma with inhibitors targeting BRAF mutations (BRAFi) has prompted speculation concerning a pathogenic role for oncogenic viruses. Here, we investigate HPV and human polyomaviruses (HPyV) and correlate with clinical, histologic, and genetic features in BRAFi-associated cSCC. Materials and Methods: Patients receiving BRAFi treatment were recruited at Barts Health NHS Trust. HPV DNA was detected in microdissected frozen samples using reverse line probe technology and degenerate and nested PCR. HPV immunohistochemistry was performed in a subset of samples. Quantitative PCR was performed to determine the presence and viral load of HPyVs with affinity for the skin (HPyV6, HPyV7, HPyV9, MCPyV, and TSPyV). These data were correlated with previous genetic mutational analysis of H, K and NRAS, NOTCH1/2, TP53, CDKN2A, CARD11, CREBBP, TGFBR1/2. Chromosomal aberrations were profiled using single nucleotide polymorphism (SNP) arrays. Results: Forty-five skin lesions from seven patients treated with single agent vemurafenib in 2012–2013 were analyzed: 12 cSCC, 19 viral warts (VW), 2 actinic keratosis (AK), 5 verrucous keratosis/other squamoproliferative (VK/SP) lesions, one melanocytic lesion and 6 normal skin samples. Significant histologic features of viral infection were seen in 10/12 (83%) cSCC. HPV DNA was detected in 18/19 (95%) VW/SP, 9/12 (75%) cSCC, 4/5 (80%) SP, and 3/6 (50%) normal skin samples and in 1/12 cases assessed by immunohistochemistry. HPyV was co-detected in 22/30 (73%) of samples, usually at low viral load, with MCPyV and HPyV7 the most common. SNP arrays confirmed low levels of chromosomal abnormality and there was no significant correlation between HPV or HPyV detection and individual gene mutations or overall mutational burden. Conclusion: Despite supportive clinicopathologic evidence, the role for HPV and HPyV infection in the pathogenesis of BRAFi-induced squamoproliferative lesions remains uncertain. Synergistic oncogenic mechanisms are plausible although speculative. Nonetheless, with the prospect of a significant increase in the adjuvant use of these drugs, further research is justified and may provide insight into the pathogenesis of other BRAFi-associated malignancies.
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Affiliation(s)
- Karin J Purdie
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Charlotte M Proby
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Hasan Rizvi
- Department of Pathology, Barts Health NHS Trust, London, United Kingdom
| | - Heather Griffin
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - John Doorbar
- Division of Virology, Department of Pathology, University of Cambridge, Cambridge, United Kingdom
| | - Mary Sommerlad
- Department of Dermatology, Barts Health NHS Trust, London, United Kingdom
| | - Mariet C Feltkamp
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - Els Van der Meijden
- Department of Medical Microbiology, Leiden University Medical Center, Leiden, Netherlands
| | - Gareth J Inman
- Division of Cancer Research, School of Medicine, University of Dundee, Dundee, United Kingdom
| | - Andrew P South
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, PA, United States
| | - Irene M Leigh
- Institute of Dentistry, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Catherine A Harwood
- Centre for Cell Biology and Cutaneous Research, Blizard Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom.,Department of Dermatology, Barts Health NHS Trust, London, United Kingdom
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Hasche D, Vinzón SE, Rösl F. Cutaneous Papillomaviruses and Non-melanoma Skin Cancer: Causal Agents or Innocent Bystanders? Front Microbiol 2018; 9:874. [PMID: 29770129 PMCID: PMC5942179 DOI: 10.3389/fmicb.2018.00874] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Accepted: 04/16/2018] [Indexed: 12/12/2022] Open
Abstract
There is still controversy in the scientific field about whether certain types of cutaneous human papillomaviruses (HPVs) are causally involved in the development of non-melanoma skin cancer (NMSC). Deciphering the etiological role of cutaneous HPVs requires - besides tissue culture systems - appropriate preclinical models to match the obtained results with clinical data from affected patients. Clear scientific evidence about the etiology and underlying mechanisms involved in NMSC development is fundamental to provide reasonable arguments for public health institutions to classify at least certain cutaneous HPVs as group 1 carcinogens. This in turn would have implications on fundraising institutions and health care decision makers to force - similarly as for anogenital cancer - the implementation of a broad vaccination program against "high-risk" cutaneous HPVs to prevent NMSC as the most frequent cancer worldwide. Precise knowledge of the multi-step progression from normal cells to cancer is a prerequisite to understand the functional and clinical impact of cofactors that affect the individual outcome and the personalized treatment of a disease. This overview summarizes not only recent arguments that favor the acceptance of a viral etiology in NMSC development but also reflects aspects of causality in medicine, the use of empirically meaningful model systems and strategies for prevention.
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Affiliation(s)
- Daniel Hasche
- Division of Viral Transformation Mechanisms, Research Program "Infection, Inflammation and Cancer", German Cancer Research Center, Heidelberg, Germany
| | - Sabrina E Vinzón
- Laboratory of Molecular and Cellular Therapy, Fundación Instituto Leloir, IIBBA-CONICET, Buenos Aires, Argentina
| | - Frank Rösl
- Division of Viral Transformation Mechanisms, Research Program "Infection, Inflammation and Cancer", German Cancer Research Center, Heidelberg, Germany
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10
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Wu JH, Cohen DN, Rady PL, Tyring SK. BRAF inhibitor-associated cutaneous squamous cell carcinoma: new mechanistic insight, emerging evidence for viral involvement and perspectives on clinical management. Br J Dermatol 2017; 177:914-923. [PMID: 28129674 DOI: 10.1111/bjd.15348] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 12/18/2022]
Abstract
Mutations in the BRAF proto-oncogene occur in the majority of cutaneous melanomas. The commonly detected valine (V) to glutamate (E) mutation (V600E) is known to drive melanomagenesis and has thus been the target of two highly selective chemotherapeutic agents: vemurafenib and dabrafenib. While BRAF inhibitor therapy has revolutionized the treatment of metastatic melanoma, unanticipated cutaneous toxicities, including the development of cutaneous squamous cell carcinomas (cSCCs), are frequently reported and hinder therapeutic durability. However, the mechanisms by which BRAF inhibitors induce cutaneous neoplasms are poorly understood, thus posing a challenge for specific therapies. In this review, we summarize the clinical and molecular profiles of BRAF inhibitor-associated cSCCs, with a focus on factors that may contribute to disease pathogenesis. In particular, we discuss the emerging evidence pointing towards viral involvement in BRAF inhibitor-induced cutaneous neoplasms and offer new perspectives on future therapeutic interventions. Continued clinical and mechanistic studies along this line will not only allow for better understanding of the pathogenic progression of BRAF inhibitor-induced cSCCs, but will also lead to development of new therapeutic and preventative options for patients receiving targeted cancer therapy.
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Affiliation(s)
- J H Wu
- Baylor College of Medicine, Houston, TX, U.S.A.,Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, U.S.A
| | - D N Cohen
- Department of Pathology and Immunology, Baylor College of Medicine, Houston, TX, U.S.A
| | - P L Rady
- Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, U.S.A
| | - S K Tyring
- Department of Dermatology, University of Texas Health Science Center at Houston, Houston, TX, U.S.A
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11
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Dai J, Kunder CA, Chu EY, Chan EF, Egan CL, Novoa RA. Development of RET mutant cutaneous angiosarcoma during BRAF inhibitor therapy. J Cutan Pathol 2017; 44:1053-1056. [PMID: 28796396 DOI: 10.1111/cup.13024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 07/28/2017] [Accepted: 08/06/2017] [Indexed: 12/12/2022]
Abstract
Treatment with BRAF inhibitors may lead to paradoxical mitogen-activated protein kinase (MAPK) pathway activation and accelerated tumorigenesis in cells with preexisting oncogenic hits. This phenomenon manifests clinically in the development of squamous cell carcinomas (SCCs) and keratoacanthomas (KAs) in patients treated with BRAF inhibitors. Cases of extracutaneous malignancies associated with BRAF inhibitors have also been reported. We present a case of a patient who developed a cutaneous angiosarcoma 6 months after initiation of vemurafenib therapy. Next-generation sequencing (NGS) revealed a mutation in RET, which lies upstream of the MAPK pathway. This case highlights that treatment with BRAF inhibitors may promote the accelerated growth of secondary malignancies. Physician awareness of the spectrum of secondary malignancies associated with BRAF inhibitor treatment will support their early detection and treatment.
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Affiliation(s)
- Julia Dai
- Department of Dermatology, Stanford University Medical Center, Stanford, California
| | - Christian A Kunder
- Department of Pathology, Stanford University Medical Center, Stanford, California
| | - Emily Y Chu
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Edward F Chan
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Christine L Egan
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Roberto A Novoa
- Department of Dermatology, Stanford University Medical Center, Stanford, California.,Department of Pathology, Stanford University Medical Center, Stanford, California
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Ogita A, Ansai SI, Misago N, Anan T, Fukumoto T, Saeki H. Clinicopathological study of crateriform verruca: Crateriform epithelial lesions histopathologically distinct from keratoacanthoma. J Dermatol 2016; 43:1154-1159. [DOI: 10.1111/1346-8138.13331] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Accepted: 01/13/2016] [Indexed: 01/26/2023]
Affiliation(s)
- Azusa Ogita
- Division of Dermatology; Nippon Medical School Musashi Kosugi Hospital; Kawasaki Japan
| | - Shin-ichi Ansai
- Division of Dermatology; Nippon Medical School Musashi Kosugi Hospital; Kawasaki Japan
| | | | - Takashi Anan
- Sapporo Dermatopathology Institute; Sapporo Japan
| | | | - Hidehisa Saeki
- Department of Dermatology; Nippon Medical School; Tokyo Japan
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13
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Beckervordersandforth J, Pujari S, Rennspiess D, Speel EJM, Winnepenninckx V, Diaz C, Weyers W, Haugg AM, Kurz AK, zur Hausen A. Frequent detection of human polyomavirus 6 in keratoacanthomas. Diagn Pathol 2016; 11:58. [PMID: 27388771 PMCID: PMC4936261 DOI: 10.1186/s13000-016-0509-z] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 06/29/2016] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND The recent discovery of the Merkel cell polyomavirus and its consistent association with Merkel cell carcinoma has drawn attention to the numerous recently discovered polyomaviruses and their possible involvement in the etiopathogenesis of non-melanoma skin cancer (NMSC). Data on the recently discovered human polyomavirus 6 (HPyV6) and its role in NMSC are sparse and in part controversial. METHODS In the present study we tested a large number (n = 299) of NMSC specimens for the presence of human polyomavirus 6 (HPyV6) by DNA PCR and HPyV6 fluorescence in situ hybridization (FISH). In detail, 59 keratoacanthomas (KA), 109 basal cell carcinomas (BCC), 86 squamous cell carcinomas (SCC) and 45 trichoblastomas (TB) were tested for the presence of HPyV6. RESULTS HPyV6 DNA PCR and subsequent sequence analysis revealed that 25 KAs (42.3 %), 23 BCCs (21.1 %), 8 SCCs (9.3 %) and 10 TBs (22.2 %) were HPyV6 positive. The presence of HPyV6 DNA was visualized and validated on the single cell level within the histomorphological context by HPyV6 fluorescence in situ hybridization. CONCLUSIONS The high frequency of HPyV6 DNA in 42.3 % of KA possibly points to a role for HPyV6 in the etiopathogenesis of KAs. Although the detection rate of HPyV6 DNA in BCCs and TBs is within the previously reported detection range in normal skin, it does not exclude a possible role for HPyV6 in the carcinogenesis in a significant subset of these skin tumors.
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Affiliation(s)
- Jan Beckervordersandforth
- />Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Sreedhar Pujari
- />Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Dorit Rennspiess
- />Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Ernst Jan M. Speel
- />Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Véronique Winnepenninckx
- />Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | - Carlos Diaz
- />Center for Dermatopathology, Freiburg, Germany
| | | | - Anke Maria Haugg
- />Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
| | | | - Axel zur Hausen
- />Department of Pathology, GROW-School for Oncology & Developmental Biology, Maastricht University Medical Center, P. Debyelaan 25, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands
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14
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Falchook GS, Rady P, Konopinski JC, Busaidy N, Hess K, Hymes S, Nguyen HP, Prieto VG, Bustinza-Linares E, Lin Q, Parkhurst KL, Hong DS, Sherman S, Tyring SK, Kurzrock R. Merkel cell polyomavirus and human papilloma virus in proliferative skin lesions arising in patients treated with BRAF inhibitors. Arch Dermatol Res 2016; 308:357-65. [DOI: 10.1007/s00403-016-1650-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 03/20/2016] [Accepted: 04/14/2016] [Indexed: 01/07/2023]
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15
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da Silva-Diz V, Simón-Extremera P, Bernat-Peguera A, de Sostoa J, Urpí M, Penín RM, Sidelnikova DP, Bermejo O, Viñals JM, Rodolosse A, González-Suárez E, Moruno AG, Pujana MÁ, Esteller M, Villanueva A, Viñals F, Muñoz P. Cancer Stem-like Cells Act via Distinct Signaling Pathways in Promoting Late Stages of Malignant Progression. Cancer Res 2015; 76:1245-59. [DOI: 10.1158/0008-5472.can-15-1631] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 12/04/2015] [Indexed: 11/16/2022]
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16
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Clynick B, Tabone T, Fuller K, Erber W, Meehan K, Millward M, Wood BA, Harvey NT. Mutational Analysis of BRAF Inhibitor-Associated Squamoproliferative Lesions. J Mol Diagn 2015; 17:644-51. [PMID: 26319365 DOI: 10.1016/j.jmoldx.2015.05.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 05/19/2015] [Accepted: 05/22/2015] [Indexed: 01/07/2023] Open
Abstract
In recent years, there has been increasing use of BRAF-inhibiting drugs for the treatment of various malignancies, including melanoma. However, these agents are associated with the development of other nonmelanoma skin lesions, in particular squamoproliferative lesions such as keratoacanthomas (KAs), squamous cell carcinomas, and BRAF inhibitor-associated verrucous keratoses. The molecular pathogenesis of these lesions is of interest, not only for therapeutic reasons, but also for the insight it might provide into the development of similar lesions in a sporadic setting. We used next-generation sequencing to compare the mutational profiles of lesions after treatment with a BRAF inhibitor, with similar lesions arising sporadically. HRAS mutations were common among the BRAF inhibitor-induced lesions, being identified in 56%, compared with 14% of lesions in the sporadic group (P = 0.002). Thus, despite similar histomorphological appearances, the underlying molecular mechanisms may be different. In addition, within the BRAF inhibitor-associated group, the lesions designated as KAs and BRAF inhibitor-associated verrucous keratoses had a similar mutational profile (mutations in PIK3CA, APC, and HRAS), which was distinct to that seen in squamous cell carcinomas (FGFR3, CDKN2A, and STK11). We have previously noted histological overlap between KAs and BRAF inhibitor-associated verrucous keratoses, and this finding supports the notion that they may represent morphological or temporal variants of a single lesion type.
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Affiliation(s)
- Britt Clynick
- Translational Cancer Pathology Laboratory, School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Tania Tabone
- Translational Cancer Pathology Laboratory, School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Kathryn Fuller
- Translational Cancer Pathology Laboratory, School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Wendy Erber
- Translational Cancer Pathology Laboratory, School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Katie Meehan
- Translational Cancer Pathology Laboratory, School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia
| | - Michael Millward
- Department of Medical Oncology, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia; School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
| | - Benjamin A Wood
- Translational Cancer Pathology Laboratory, School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia; Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia
| | - Nathan T Harvey
- Translational Cancer Pathology Laboratory, School of Pathology and Laboratory Medicine, The University of Western Australia, Crawley, Western Australia, Australia; Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, Western Australia, Australia.
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17
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Cohen DN, Lawson SK, Shaver AC, Du L, Nguyen HP, He Q, Johnson DB, Lumbang WA, Moody BR, Prescott JL, Chandra PK, Boyd AS, Zwerner JP, Robbins JB, Tyring SK, Rady PL, Chappell JD, Shyr Y, Infante JR, Sosman JA. Contribution of Beta-HPV Infection and UV Damage to Rapid-Onset Cutaneous Squamous Cell Carcinoma during BRAF-Inhibition Therapy. Clin Cancer Res 2015; 21:2624-34. [PMID: 25724524 PMCID: PMC4452444 DOI: 10.1158/1078-0432.ccr-14-2667] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 02/06/2015] [Indexed: 12/21/2022]
Abstract
PURPOSE BRAF-inhibition (BRAFi) therapy for advanced melanoma carries a high rate of secondary cutaneous squamous cell carcinoma (cSCC) and risk of other cancers. UV radiation and α-genus human papillomavirus (HPV) are highly associated with SCC, but a novel role for β-genus HPV is suspected in BRAFi-cSCC. Cutaneous β-HPV may act in concert with host and environmental factors in BRAFi-cSCC. EXPERIMENTAL DESIGN Primary BRAFi-cSCC tissue DNA isolated from patients receiving vemurafenib or dabrafenib from two cancer centers was analyzed for the presence of cutaneous oncogenic viruses and host genetic mutations. Diagnostic specimens underwent consensus dermatopathology review. Clinical parameters for UV exposure and disease course were statistically analyzed in conjunction with histopathology. RESULTS Twenty-nine patients contributed 69 BRAFi-cSCC lesions. BRAFi-cSCC had wart-like features (BRAFi-cSCC-WF) in 22% of specimens. During vemurafenib therapy, BRAFi-cSCC-WF arose 11.6 weeks more rapidly than conventional cSCC when controlled for gender and UV exposure (P value = 0.03). Among all BRAFi-cSCC, β-genus HPV-17, HPV-38, HPV-111 were most frequently isolated, and novel β-HPV genotypes were discovered (CTR, CRT-11, CRT-22). Sequencing revealed 63% of evaluated BRAFi-cSCCs harbored RAS mutations with PIK3CA, CKIT, ALK, and EGFR mutations also detected. CONCLUSIONS We examined clinical, histopathologic, viral, and genetic parameters in BRAFi-cSCC demonstrating rapid onset; wart-like histomorphology; β-HPV-17, HPV-38, and HPV-111 infection; UV damage; and novel ALK and CKIT mutations. Discovered β-HPV genotypes expand the spectrum of tumor-associated viruses. These findings enhance our understanding of factors cooperating with BRAF inhibition that accelerate keratinocyte oncogenesis as well as broaden the knowledge base of multifactorial mediators of cancer in general.
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Affiliation(s)
- Daniel N Cohen
- Departments of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee.
| | - Steven K Lawson
- Departments of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Aaron C Shaver
- Departments of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Liping Du
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | | | - Qin He
- University of Texas, Department of Dermatology, Houston, Texas
| | - Douglas B Johnson
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | - Wilfred A Lumbang
- Department of Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | | | | | - Alan S Boyd
- Departments of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee. Department of Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee. Pathology Consultants of America, Columbia, Tennessee
| | - Jeffrey P Zwerner
- Departments of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee. Department of Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jason B Robbins
- Departments of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee. Department of Medicine, Division of Dermatology, Vanderbilt University Medical Center, Nashville, Tennessee. Pathology Associates of St. Thomas, Nashville, Tennessee
| | | | - Peter L Rady
- University of Texas, Department of Dermatology, Houston, Texas
| | - James D Chappell
- Departments of Pathology, Microbiology and Immunology, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Yu Shyr
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center, Nashville, Tennessee
| | | | - Jeffrey A Sosman
- Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center and Vanderbilt Ingram Cancer Center, Nashville, Tennessee
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18
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Vigarios E, Lamant L, Delord JP, Fricain JC, Chevreau C, Barrés B, Gomez-Roca C, Boulanger M, Sibaud V. Oral squamous cell carcinoma and hyperkeratotic lesions with BRAF inhibitors. Br J Dermatol 2015; 172:1680-1682. [PMID: 25495246 DOI: 10.1111/bjd.13610] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- E Vigarios
- Oral Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 av Irène Joliot-Curie, 31059, Toulouse CEDEX 9, France.,UFR Odontologie, 3 Chemin des Maraîchers, 31062, Toulouse CEDEX 9, France
| | - L Lamant
- Pathology Department, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 av Irène Joliot-Curie, 31059, Toulouse CEDEX 9, France
| | - J P Delord
- Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 av Irène Joliot-Curie, 31059, Toulouse CEDEX 9, France
| | - J C Fricain
- Oral Medicine Department, Pôle Odontologie et Santé Buccale, Hôpital Pellegrin, Place Amélie-Raba-Léon, 33076, Bordeaux CEDEX, France.,UFR Odontologie Bordeaux, 16-20 Cours de la Marne, 33076, Bordeaux CEDEX, France
| | - C Chevreau
- Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 av Irène Joliot-Curie, 31059, Toulouse CEDEX 9, France
| | - B Barrés
- Pathology Department, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 av Irène Joliot-Curie, 31059, Toulouse CEDEX 9, France
| | - C Gomez-Roca
- Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 av Irène Joliot-Curie, 31059, Toulouse CEDEX 9, France
| | - M Boulanger
- Oral Oncology Department, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 av Irène Joliot-Curie, 31059, Toulouse CEDEX 9, France.,UFR Odontologie, 3 Chemin des Maraîchers, 31062, Toulouse CEDEX 9, France
| | - V Sibaud
- Dermatology Department, Institut Claudius Regaud, Institut Universitaire du Cancer, Toulouse Oncopole, 1 av Irène Joliot-Curie, 31059, Toulouse CEDEX 9, France
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19
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Clynick B, Tabone T, Heel K, Erber W, Wood BA, Millward M, Harvey NT. Testing for human papillomavirus in BRAF inhibitor-associated verrucous keratoses. J Cutan Pathol 2014; 42:73-5. [PMID: 25487366 DOI: 10.1111/cup.12403] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 10/13/2014] [Accepted: 10/25/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Britt Clynick
- School of Pathology and Laboratory Medicine, The University of Western Australia, Perth, Australia
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20
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Schrama D, Groesser L, Ugurel S, Hafner C, Pastrana DV, Buck CB, Cerroni L, Theiler A, Becker JC. Presence of human polyomavirus 6 in mutation-specific BRAF inhibitor-induced epithelial proliferations. JAMA Dermatol 2014; 150:1180-6. [PMID: 24943872 PMCID: PMC8369517 DOI: 10.1001/jamadermatol.2014.1116] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IMPORTANCE A frequent adverse effect of mutation-specific BRAF inhibitor therapy is the induction of epithelial proliferations including cutaneous squamous cell carcinomas. To date, the only factor identified contributing to their development is the activation of the mitogen-activated signal transduction cascade by mutations in the RAS genes. However, these mutations explain only 60% of the tumors; hence, it is important to identify what is causing the remaining tumors. OBJECTIVE To test for the presence of human papillomaviruses (HPVs) and the recently identified human polyomaviruses (HPyVs), Merkel cell polyomavirus (MCPyV), and trichodysplasia spinulosa-associated polyomavirus (TSPyV), as well as HPyV-6, HPyV-7, HPyV-9, and HPyV-10, in epithelial proliferations occurring after BRAF inhibitor therapy to determine whether these oncogenic viruses may contribute to BRAF inhibitor-induced skin tumors. DESIGN, SETTING, AND PARTICIPANTS Retrospective study at a university hospital in Austria of epithelial proliferations that developed in patients with melanoma after initiation of treatment with the BRAF inhibitor vemurafenib. Samples were analyzed for (1) presence of the most frequently observed RAS mutations by SNaPshot technology, (2) detection of the viruses by real-time polymerase chain reaction, and (3) presence of capsid proteins of the most abundantly detected virus by immunohistochemical analysis. MAIN OUTCOMES AND MEASURES RAS mutational status, as well as HPV and HPyV presence, in BRAF inhibitor-induced epithelial proliferations. RESULTS Eighteen biopsy samples from 6 patients were retrieved from our hospital's archive. We identified RAS mutations in 10 (62%) of the 16 samples with clear results. DNA of HPyV-9, HPyV-10, and TSPyV were virtually absent in the samples. MCPyV DNA was present in 13 of 18 samples, and HPV, HPyV-6, and HPyV-7 DNA were present in all samples. In general, the amount of DNA encoding the latter viruses was rather low, with the exception of HPyV-6 in several samples of 1 individual patient. Notably, the relevance of the presence of HPyV-6 in the epithelial proliferation was underlined by immunohistochemical detection of the core protein VP1 of HPyV-6. CONCLUSIONS AND RELEVANCE The presence of both high HPyV-6 DNA load and VP1 protein suggests that polyomaviruses may contribute to the epithelial proliferations observed in patients receiving BRAF inhibitor therapy, albeit the relative impact as compared with that of RAS mutations appears circumstantial.
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Affiliation(s)
- David Schrama
- Department of Dermatology, Medical University of Graz, Graz, Austria2Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - Leopold Groesser
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Selma Ugurel
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - Christian Hafner
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Diana V Pastrana
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, Maryland
| | - Christopher B Buck
- Laboratory of Cellular Oncology, National Cancer Institute, Bethesda, Maryland
| | - Lorenzo Cerroni
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Anna Theiler
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - Jürgen C Becker
- Department of Dermatology, Medical University of Graz, Graz, Austria
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Frouin E, Guillot B, Larrieux M, Tempier A, Boulle N, Foulongne V, Girard C, Costes V, Solassol J. Cutaneous epithelial tumors induced by vemurafenib involve the MAPK and Pi3KCA pathways but not HPV nor HPyV viral infection. PLoS One 2014; 9:e110478. [PMID: 25360634 PMCID: PMC4215900 DOI: 10.1371/journal.pone.0110478] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 09/16/2014] [Indexed: 12/12/2022] Open
Abstract
The inhibitors of mutant BRAF that are used to treat metastatic melanoma induce squamoproliferative lesions. We conducted a prospective histopathological and molecular study on 27 skin lesions from 12 patients treated with vemurafenib. Mutation hot spots in HRAS, NRAS, KRAS, BRAF, and Pi3KCA were screened. HPV and HPyV infection status were also determined. The lesions consisted of 19 verrucal papillomas, 1 keratoacanthoma and 7 squamous cell carcinomas. No mutations were found within BRAF and NRAS. KRAS, HRAS, and Pi3KCA oncogenic mutations were found in 10 (83.3%), 7 (58.3%), and 4 (33.3%) patients respectively; however, these mutations were not consistent within all tumors of a given patient. Pi3KCA mutation was always associated with a mutation in HRAS. Finally, no correlation was found between the mutated gene or type of mutation and the type of cutaneous tumor or clinical response to vemurafenib. P16 protein level was not indicative of HPV infection. HPV was detected in only two lesions. Two cases had MCPyV, and one had HPyV7. In conclusion, neither HPV nor HPyV seem to be involved in the development of squamoproliferative lesions induced by verumafenib. By contrast, HRAS and KRAS play a predominant role in the physiopathology of these tumors.
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Affiliation(s)
- Eric Frouin
- Department of Biopathology, CHU Montpellier, Montpellier, France; University of Montpellier I, Montpellier, France
| | - Bernard Guillot
- University of Montpellier I, Montpellier, France; Department of Dermatology, CHU Montpellier, Montpellier, France; U1058, INSERM, University of Montpellier I, Montpellier, France
| | - Marion Larrieux
- Department of Biopathology, CHU Montpellier, Montpellier, France
| | - Ariane Tempier
- Department of Biopathology, CHU Montpellier, Montpellier, France
| | - Nathalie Boulle
- Department of Biopathology, CHU Montpellier, Montpellier, France; University of Montpellier I, Montpellier, France
| | - Vincent Foulongne
- University of Montpellier I, Montpellier, France; U1058, INSERM, University of Montpellier I, Montpellier, France; Department of Virology, CHU Montpellier, Montpellier, France
| | - Céline Girard
- University of Montpellier I, Montpellier, France; Department of Dermatology, CHU Montpellier, Montpellier, France; U1058, INSERM, University of Montpellier I, Montpellier, France
| | - Valérie Costes
- Department of Biopathology, CHU Montpellier, Montpellier, France; University of Montpellier I, Montpellier, France; U1058, INSERM, University of Montpellier I, Montpellier, France
| | - Jérome Solassol
- Department of Biopathology, CHU Montpellier, Montpellier, France; University of Montpellier I, Montpellier, France; Department of Clinical Oncoproteomics, Montpellier Cancer Institute (ICM), Montpellier, France
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22
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Hassel JC, Groesser L, Herschberger E, Weichert W, Hafner C. RAS mutations in benign epithelial tumors associated with BRAF inhibitor treatment of melanoma. J Invest Dermatol 2014; 135:636-639. [PMID: 25118623 DOI: 10.1038/jid.2014.360] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Jessica C Hassel
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany.
| | - Leopold Groesser
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Eva Herschberger
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
| | - Wilko Weichert
- Institute for Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Hafner
- Department of Dermatology, University Hospital Regensburg, Regensburg, Germany
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23
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Holderfield M, Deuker MM, McCormick F, McMahon M. Targeting RAF kinases for cancer therapy: BRAF-mutated melanoma and beyond. Nat Rev Cancer 2014; 14:455-67. [PMID: 24957944 PMCID: PMC4250230 DOI: 10.1038/nrc3760] [Citation(s) in RCA: 588] [Impact Index Per Article: 58.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The identification of mutationally activated BRAF in many cancers altered our conception of the part played by the RAF family of protein kinases in oncogenesis. In this Review, we describe the development of BRAF inhibitors and the results that have emerged from their analysis in both the laboratory and the clinic. We discuss the spectrum of RAF mutations in human cancer and the complex interplay between the tissue of origin and the response to RAF inhibition. Finally, we enumerate mechanisms of resistance to BRAF inhibition that have been characterized and postulate how strategies of RAF pathway inhibition may be extended in scope to benefit not only the thousands of patients who are diagnosed annually with BRAF-mutated metastatic melanoma but also the larger patient population with malignancies harbouring mutationally activated RAF genes that are ineffectively treated with the current generation of BRAF kinase inhibitors.
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Affiliation(s)
| | | | - Frank McCormick
- Corresponding Authors: Frank McCormick & Martin McMahon, Diller Family Cancer Research Bldg., 1450 Third Street, University of California, San Francisco, CA 94158, USA, &
| | - Martin McMahon
- Corresponding Authors: Frank McCormick & Martin McMahon, Diller Family Cancer Research Bldg., 1450 Third Street, University of California, San Francisco, CA 94158, USA, &
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