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Gibbs DC, Thomas NE, Kanetsky PA, Luo L, Busam KJ, Cust AE, Anton-Culver H, Gallagher RP, Zanetti R, Rosso S, Sacchetto L, Edmiston SN, Conway K, Ollila DW, Begg CB, Berwick M, Ward SV, Orlow I. Association of functional, inherited vitamin D-binding protein variants with melanoma-specific death. JNCI Cancer Spectr 2023; 7:pkad051. [PMID: 37494457 PMCID: PMC10496570 DOI: 10.1093/jncics/pkad051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Revised: 06/22/2023] [Accepted: 07/17/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND It is unclear whether genetic variants affecting vitamin D metabolism are associated with melanoma prognosis. Two functional missense variants in the vitamin D-binding protein gene (GC), rs7041 and rs4588, determine 3 common haplotypes, Gc1s, Gc1f, and Gc2, of which Gc1f may be associated with decreased all-cause death among melanoma patients based on results of a prior study, but the association of Gc1f with melanoma-specific death is unclear. METHODS We investigated the association of the Gc1s, Gc1f, and Gc2 haplotypes with melanoma-specific and all-cause death among 4490 individuals with incident, invasive primary melanoma in 2 population-based studies using multivariable Cox-proportional hazards regression. RESULTS In the pooled analysis of both datasets, the patients with the Gc1f haplotype had a 37% lower risk of melanoma-specific death than the patients without Gc1f (hazard ratio [HR] = 0.63, 95% confidence interval [CI] = 0.47 to 0.83, P = .001), with adjustments for age, sex, study center, first- or higher-order primary melanoma, tumor site, pigmentary phenotypes, and Breslow thickness. Associations were similar in both studies. In pooled analyses stratified by Breslow thickness, the corresponding melanoma-specific death HRs for those patients with the Gc1f haplotype compared with those without Gc1f were 0.89 (95% CI = 0.63 to 1.27) among participants with tumor Breslow thickness equal to or less than 2.0 mm and 0.40 (95% CI = 0.25 to 0.63) among participants with tumor Breslow thickness greater than 2.0 mm (Pinteraction = .003). CONCLUSIONS Our findings suggest that individuals with the GC haplotype Gc1f may have a lower risk of dying from melanoma-specifically from thicker, higher-risk melanoma-than individuals without this Gc1f haplotype.
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Affiliation(s)
| | - Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, USA
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Klaus J Busam
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anne E Cust
- Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia
- The Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, NSW, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Richard P Gallagher
- Cancer Control Research, British Columbia Cancer and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - Roberto Zanetti
- Center for Cancer Prevention, Piedmont Cancer Registry, Torino, Italy
- Fondo Elena Moroni for Oncology, Torino, Italy
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Stefano Rosso
- Center for Cancer Prevention, Piedmont Cancer Registry, Torino, Italy
- Fondo Elena Moroni for Oncology, Torino, Italy
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Lidia Sacchetto
- Center for Cancer Prevention, Piedmont Cancer Registry, Torino, Italy
- Fondo Elena Moroni for Oncology, Torino, Italy
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Sharon N Edmiston
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Kathleen Conway
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Epidemiology, Gillings Global School of Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - David W Ollila
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
- Department of Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Sarah V Ward
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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2
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Ward SV, Autuori I, Luo L, LaPilla E, Yoo S, Sharma A, Busam KJ, Olilla DW, Dwyer T, Anton-Culver H, Zanetti R, Sacchetto L, Cust AE, Gallagher RP, Kanetsky PA, Rosso S, Begg CB, Berwick M, Thomas NE, Orlow I. Sex-Specific Associations of MDM2 and MDM4 Variants with Risk of Multiple Primary Melanomas and Melanoma Survival in Non-Hispanic Whites. Cancers (Basel) 2023; 15:2707. [PMID: 37345045 PMCID: PMC10216616 DOI: 10.3390/cancers15102707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/04/2023] [Accepted: 05/08/2023] [Indexed: 06/23/2023] Open
Abstract
MDM2-SNP309 (rs2279744), a common genetic modifier of cancer incidence in Li-Fraumeni syndrome, modifies risk, age of onset, or prognosis in a variety of cancers. Melanoma incidence and outcomes vary by sex, and although SNP309 exerts an effect on the estrogen receptor, no consensus exists on its effect on melanoma. MDM2 and MDM4 restrain p53-mediated tumor suppression, independently or together. We investigated SNP309, an a priori MDM4-rs4245739, and two coinherited variants, in a population-based cohort of 3663 primary incident melanomas. Per-allele and per-haplotype (MDM2_SNP309-SNP285; MDM4_rs4245739-rs1563828) odds ratios (OR) for multiple-melanoma were estimated with logistic regression models. Hazard ratios (HR) for melanoma death were estimated with Cox proportional hazards models. In analyses adjusted for covariates, females carrying MDM4-rs4245739*C were more likely to develop multiple melanomas (ORper-allele = 1.25, 95% CI 1.03-1.51, and Ptrend = 0.03), while MDM2-rs2279744*G was inversely associated with melanoma-death (HRper-allele = 0.63, 95% CI 0.42-0.95, and Ptrend = 0.03). We identified 16 coinherited expression quantitative loci that control the expression of MDM2, MDM4, and other genes in the skin, brain, and lungs. Our results suggest that MDM4/MDM2 variants are associated with the development of subsequent primaries and with the death of melanoma in a sex-dependent manner. Further investigations of the complex MDM2/MDM4 motif, and its contribution to the tumor microenvironment and observed associations, are warranted.
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Affiliation(s)
- Sarah V. Ward
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
- School of Population and Global Health, The University of Western Australia, Perth, WA 6009, Australia
| | - Isidora Autuori
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Li Luo
- Department of Internal Medicine, The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87106, USA
| | - Emily LaPilla
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Sarah Yoo
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Ajay Sharma
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Klaus J. Busam
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - David W. Olilla
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Terence Dwyer
- Clinical Sciences Theme, Heart Group, Murdoch Children’s Research Institute, Melbourne, VIC 3052, Australia
- Nuffield Department of Women’s & Reproductive Health, University of Oxford, Oxford OX3 9DU, UK
- Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Carlton, VIC 3010, Australia
- Oxford Martin School, University of Oxford, Oxford OX1 3BD, UK
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS 7000, Australia
| | - Hoda Anton-Culver
- Department of Medicine, University of California, Irvine, CA 92617, USA
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, 10126 Turin, Italy
| | - Lidia Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, 10126 Turin, Italy
| | - Anne E. Cust
- The Daffodil Centre, The University of Sydney, A Joint Venture with Cancer Council NSW, Sydney, NSW 2006, Australia
- Melanoma Institute Australia, The University of Sydney, Wollstonecraft, NSW 2065, Australia
| | - Richard P. Gallagher
- BC Cancer Research Institute, Vancouver, BC V5Z 1L3, Canada
- Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC V5Z 4E8, Canada
| | - Peter A. Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL 33612, USA
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, 10126 Turin, Italy
| | - Colin B. Begg
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Marianne Berwick
- Department of Internal Medicine, The University of New Mexico Comprehensive Cancer Center, Albuquerque, NM 87106, USA
| | - Nancy E. Thomas
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC 27514, USA
- Department of Dermatology, University of North Carolina, Chapel Hill, NC 27514, USA
| | - Irene Orlow
- Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
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3
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Lezcano C, Berwick M, Luo L, Barnhill R, Duncan LM, Gerami P, Lowe L, Messina JL, Scolyer RA, Wood B, Yeh I, Zembowicz A, Busam KJ. Interobserver agreement in the histopathological classification of desmoplastic melanomas. Pathology 2023; 55:223-226. [PMID: 36653238 PMCID: PMC9974895 DOI: 10.1016/j.pathol.2022.12.347] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 12/08/2022] [Accepted: 12/13/2022] [Indexed: 01/03/2023]
Abstract
Desmoplastic melanoma is a subtype of melanoma characterised by amelanotic fusiform melanocytes dispersed in a collagenous stroma. Cell-poor and fibrous stroma-rich 'pure' variants have been distinguished from 'mixed' variants with areas of higher cell density and/or less desmoplastic stroma. This distinction is relevant because patients whose tumours display a pure phenotype have a lower risk for regional lymph node metastasis and distant recurrence. However, little is known about interobserver agreement among pathologists in the subclassification of desmoplastic melanoma. To address this issue, we conducted a study in which eleven dermatopathologists independently evaluated whole slide scanned images of excisions from 30 desmoplastic melanomas. The participating pathologists were asked to classify the tumours as pure or mixed. They were also asked to record the presence or absence of neurotropism and angiotropism. We found substantial interobserver agreement between the 11 dermatopathologists in the classification of tumours as pure versus mixed desmoplastic melanoma (kappa=0.64; p<0.0001). There was fair agreement between the 11 dermatopathologists in the evaluation of presence versus absence of neurotropism (kappa=0.26; p<0.0001), and slight agreement in the assessment of angiotropism (kappa=0.13; p<0.0001). The level of concordance in the subclassification of desmoplastic melanomas is encouraging for the acceptance of this prognostic parameter in the real-world practice of melanoma pathology.
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Affiliation(s)
- Cecilia Lezcano
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer, New York, NY, USA.
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Raymond Barnhill
- Department of Translational Research, Institut Curie, Université de Paris UFR de Médecine, Paris, France
| | - Lyn M Duncan
- Pathology Service, Dermatopathology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Lori Lowe
- Departments of Pathology and Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Jane L Messina
- Department of Cutaneous Oncology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia; Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
| | - Benjamin Wood
- Department of Anatomical Pathology, PathWest Laboratory Medicine, Perth, WA, Australia
| | - Iwei Yeh
- Departments of Dermatology and Pathology, University of California San Francisco, San Francisco, CA, USA
| | - Artur Zembowicz
- Dermatopathology Consultations LLC, Lahey Clinic and Tufts Medical School, Boston, MA, USA
| | - Klaus J Busam
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer, New York, NY, USA
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4
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Kostrzewa CE, Luo L, Arora A, Seshan VE, Ernstoff MS, Edmiston SN, Conway K, Gorlov I, Busam K, Orlow I, Hernando-Monge E, Thomas NE, Berwick M, Begg CB, Shen R. Pathway Alterations in Stage II/III Primary Melanoma. JCO Precis Oncol 2023; 7:e2200439. [PMID: 36926987 PMCID: PMC10309586 DOI: 10.1200/po.22.00439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 12/12/2022] [Accepted: 01/26/2023] [Indexed: 03/18/2023] Open
Abstract
PURPOSE Genomic classification of melanoma has thus far focused on the mutational status of BRAF, NRAS, and NF1. The clinical utility of this classification remains limited, and the landscape of alterations in other oncogenic signaling pathways is underexplored. METHODS Using primary samples from the InterMEL study, a retrospective cohort of cases with specimens collected from an international consortium with participating institutions throughout the United States and Australia, with oversampling of cases who ultimately died of melanoma, we examined mutual exclusivity and co-occurrence of genomic alterations in 495 stage II/III primary melanomas across 11 cancer pathways. Somatic mutation and copy number alterations were analyzed from next-generation sequencing using a clinical sequencing panel. RESULTS Mutations in the RTK-RAS pathway were observed in 81% of cases. Other frequently occurring pathways were TP53 (31%), Cell Cycle (30%), and PI3K (18%). These frequencies are generally lower than was observed in The Cancer Genome Atlas, where the specimens analyzed were predominantly obtained from metastases. Overall, 81% of the cases had at least one targetable mutation. The RTK-RAS pathway was the only pathway that demonstrated strong and statistically significant mutual exclusivity. However, this strong mutual exclusivity signal was evident only for the three common genes in the pathway (BRAF, NRAS, and NF1). Analysis of co-occurrence of different pathways exhibited no positive significant trends. However, interestingly, a high frequency of cases with none of these pathways represented was observed, 8.4% of cases versus 4.0% expected (P < .001). A higher frequency of RTK-RAS singletons (with no other pathway alteration) was observed compared with The Cancer Genome Atlas. Clonality analyses suggest strongly that both the cell cycle and RTK-RAS pathways represent early events in melanogenesis. CONCLUSION Our results confirm the dominance of mutations in the RTK-RAS pathway. The presence of many mutations in several well-known, actionable pathways suggests potential avenues for targeted therapy in these early-stage cases.
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Affiliation(s)
- Caroline E. Kostrzewa
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Li Luo
- Department of Internal Medicine and the UNM Comprehensive Cancer Center, Albuquerque, NM
| | - Arshi Arora
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Venkatraman E. Seshan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Sharon N. Edmiston
- Department of Dermatology and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Kathleen Conway
- Department of Dermatology and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC
| | - Ivan Gorlov
- Epidemiology and Population Science, Baylor Medical Center, Houston, TX
| | - Klaus Busam
- Department of Pathology and Laboratory Science, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Nancy E. Thomas
- Department of Dermatology and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Marianne Berwick
- Department of Internal Medicine and the UNM Comprehensive Cancer Center, Albuquerque, NM
| | - Colin B. Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Ronglai Shen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY
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5
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Neale RE, Lucas RM, Byrne SN, Hollestein L, Rhodes LE, Yazar S, Young AR, Berwick M, Ireland RA, Olsen CM. The effects of exposure to solar radiation on human health. Photochem Photobiol Sci 2023:10.1007/s43630-023-00375-8. [PMID: 36856971 PMCID: PMC9976694 DOI: 10.1007/s43630-023-00375-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 03/02/2023]
Abstract
This assessment by the Environmental Effects Assessment Panel (EEAP) of the Montreal Protocol under the United Nations Environment Programme (UNEP) evaluates the effects of ultraviolet (UV) radiation on human health within the context of the Montreal Protocol and its Amendments. We assess work published since our last comprehensive assessment in 2018. Over the last four years gains have been made in knowledge of the links between sun exposure and health outcomes, mechanisms, and estimates of disease burden, including economic impacts. Of particular note, there is new information about the way in which exposure to UV radiation modulates the immune system, causing both harms and benefits for health. The burden of skin cancer remains high, with many lives lost to melanoma and many more people treated for keratinocyte cancer, but it has been estimated that the Montreal Protocol will prevent 11 million cases of melanoma and 432 million cases of keratinocyte cancer that would otherwise have occurred in the United States in people born between 1890 and 2100. While the incidence of skin cancer continues to rise, rates have stabilised in younger populations in some countries. Mortality has also plateaued, partly due to the use of systemic therapies for advanced disease. However, these therapies are very expensive, contributing to the extremely high economic burden of skin cancer, and emphasising the importance and comparative cost-effectiveness of prevention. Photodermatoses, inflammatory skin conditions induced by exposure to UV radiation, can have a marked detrimental impact on the quality of life of sufferers. More information is emerging about their potential link with commonly used drugs, particularly anti-hypertensives. The eyes are also harmed by over-exposure to UV radiation. The incidence of cataract and pterygium is continuing to rise, and there is now evidence of a link between intraocular melanoma and sun exposure. It has been estimated that the Montreal Protocol will prevent 63 million cases of cataract that would otherwise have occurred in the United States in people born between 1890 and 2100. Despite the clearly established harms, exposure to UV radiation also has benefits for human health. While the best recognised benefit is production of vitamin D, beneficial effects mediated by factors other than vitamin D are emerging. For both sun exposure and vitamin D, there is increasingly convincing evidence of a positive role in diseases related to immune function, including both autoimmune diseases and infection. With its influence on the intensity of UV radiation and global warming, the Montreal Protocol has, and will have, both direct and indirect effects on human health, potentially changing the balance of the risks and benefits of spending time outdoors.
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Affiliation(s)
- R. E. Neale
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD Australia ,School of Public Health, University of Queensland, Brisbane, QLD Australia
| | - R. M. Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT Australia
| | - S. N. Byrne
- School of Medical Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - L. Hollestein
- Erasmus MC Cancer Institute, Rotterdam, The Netherlands ,Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - L. E. Rhodes
- Dermatology Research Centre, School of Biological Sciences, University of Manchester, Salford Royal Hospital, Northern Care Alliance NHS Trust, Manchester, UK
| | - S. Yazar
- Garvan Medical Research Institute, Sydney, NSW Australia
| | | | - M. Berwick
- University of New Mexico Comprehensive Cancer Center, Albuquerque, USA
| | - R. A. Ireland
- School of Medical Science, Faculty of Medicine and Health, University of Sydney, Sydney, NSW Australia
| | - C. M. Olsen
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD Australia ,Frazer Institute, University of Queensland, Brisbane, QLD Australia
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6
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Gorlov IP, Conway K, Edmiston SN, Parrish EA, Hao H, Amos CI, Tsavachidis S, Gorlova OY, Begg C, Hernando E, Cheng C, Shen R, Orlow I, Luo L, Ernstoff MS, Kuan PF, Ollila DW, Tsai YS, Berwick M, Thomas NE. Methylation of nonessential genes in cutaneous melanoma - Rule Out hypothesis. Melanoma Res 2023; 33:163-172. [PMID: 36805567 PMCID: PMC10148896 DOI: 10.1097/cmr.0000000000000881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Differential methylation plays an important role in melanoma development and is associated with survival, progression and response to treatment. However, the mechanisms by which methylation promotes melanoma development are poorly understood. The traditional explanation of selective advantage provided by differential methylation postulates that hypermethylation of regulatory 5'-cytosine-phosphate-guanine-3' dinucleotides (CpGs) downregulates the expression of tumor suppressor genes and therefore promotes tumorigenesis. We believe that other (not necessarily alternative) explanations of the selective advantages of methylation are also possible. Here, we hypothesize that melanoma cells use methylation to shut down transcription of nonessential genes - those not required for cell survival and proliferation. Suppression of nonessential genes allows tumor cells to be more efficient in terms of energy and resource usage, providing them with a selective advantage over the tumor cells that transcribe and subsequently translate genes they do not need. We named the hypothesis the Rule Out (RO) hypothesis. The RO hypothesis predicts higher methylation of CpGs located in regulatory regions (CpG islands) of nonessential genes. It also predicts the higher methylation of regulatory CpGs linked to nonessential genes in melanomas compared to nevi and lower expression of nonessential genes in malignant (derived from melanoma) versus normal (derived from nonaffected skin) melanocytes. The analyses conducted using in-house and publicly available data found that all predictions derived from the RO hypothesis hold, providing observational support for the hypothesis.
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Affiliation(s)
- Ivan P Gorlov
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Kathleen Conway
- Department of Dermatology, University of North Carolina
- Department of Epidemiology
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Sharon N Edmiston
- Department of Dermatology, University of North Carolina
- Department of Epidemiology
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Eloise A Parrish
- Department of Applied Mathematics and Statistics, State University of New York, Stony Brook
| | - Honglin Hao
- Department of Dermatology, University of North Carolina
| | | | | | - Olga Y Gorlova
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Colin Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York
| | - Eva Hernando
- Department of Pathology, New York University School of Medicine, New York
| | - Chao Cheng
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Ronglai Shen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York
| | - Li Luo
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Maxico
| | - Marc S Ernstoff
- Roswell Park Comprehensive Cancer Center, Elm and Carlton, Buffalo
| | - Pei Fen Kuan
- Department of Applied Mathematics and Statistics, State University of New York, Stony Brook and
| | - David W Ollila
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Yihsuan S Tsai
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Maxico
| | - Nancy E Thomas
- Department of Dermatology, University of North Carolina
- Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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7
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Orlow I, Sadeghi KD, Edmiston SN, Kenney JM, Lezcano C, Wilmott JS, Cust AE, Scolyer RA, Mann GJ, Lee TK, Burke H, Jakrot V, Shang P, Ferguson PM, Boyce TW, Ko JS, Ngo P, Funchain P, Rees JR, O'Connell K, Hao H, Parrish E, Conway K, Googe PB, Ollila DW, Moschos SJ, Hernando E, Hanniford D, Argibay D, Amos CI, Lee JE, Osman I, Luo L, Kuan PF, Aurora A, Gould Rothberg BE, Bosenberg MW, Gerstenblith MR, Thompson C, Bogner PN, Gorlov IP, Holmen SL, Brunsgaard EK, Saenger YM, Shen R, Seshan V, Nagore E, Ernstoff MS, Busam KJ, Begg CB, Thomas NE, Berwick M. InterMEL: An international biorepository and clinical database to uncover predictors of survival in early-stage melanoma. PLoS One 2023; 18:e0269324. [PMID: 37011054 PMCID: PMC10069769 DOI: 10.1371/journal.pone.0269324] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 03/14/2023] [Indexed: 04/05/2023] Open
Abstract
INTRODUCTION We are conducting a multicenter study to identify classifiers predictive of disease-specific survival in patients with primary melanomas. Here we delineate the unique aspects, challenges, and best practices for optimizing a study of generally small-sized pigmented tumor samples including primary melanomas of at least 1.05mm from AJTCC TNM stage IIA-IIID patients. We also evaluated tissue-derived predictors of extracted nucleic acids' quality and success in downstream testing. This ongoing study will target 1,000 melanomas within the international InterMEL consortium. METHODS Following a pre-established protocol, participating centers ship formalin-fixed paraffin embedded (FFPE) tissue sections to Memorial Sloan Kettering Cancer Center for the centralized handling, dermatopathology review and histology-guided coextraction of RNA and DNA. Samples are distributed for evaluation of somatic mutations using next gen sequencing (NGS) with the MSK-IMPACTTM assay, methylation-profiling (Infinium MethylationEPIC arrays), and miRNA expression (Nanostring nCounter Human v3 miRNA Expression Assay). RESULTS Sufficient material was obtained for screening of miRNA expression in 683/685 (99%) eligible melanomas, methylation in 467 (68%), and somatic mutations in 560 (82%). In 446/685 (65%) cases, aliquots of RNA/DNA were sufficient for testing with all three platforms. Among samples evaluated by the time of this analysis, the mean NGS coverage was 249x, 59 (18.6%) samples had coverage below 100x, and 41/414 (10%) failed methylation QC due to low intensity probes or insufficient Meta-Mixed Interquartile (BMIQ)- and single sample (ss)- Noob normalizations. Six of 683 RNAs (1%) failed Nanostring QC due to the low proportion of probes above the minimum threshold. Age of the FFPE tissue blocks (p<0.001) and time elapsed from sectioning to co-extraction (p = 0.002) were associated with methylation screening failures. Melanin reduced the ability to amplify fragments of 200bp or greater (absent/lightly pigmented vs heavily pigmented, p<0.003). Conversely, heavily pigmented tumors rendered greater amounts of RNA (p<0.001), and of RNA above 200 nucleotides (p<0.001). CONCLUSION Our experience with many archival tissues demonstrates that with careful management of tissue processing and quality control it is possible to conduct multi-omic studies in a complex multi-institutional setting for investigations involving minute quantities of FFPE tumors, as in studies of early-stage melanoma. The study describes, for the first time, the optimal strategy for obtaining archival and limited tumor tissue, the characteristics of the nucleic acids co-extracted from a unique cell lysate, and success rate in downstream applications. In addition, our findings provide an estimate of the anticipated attrition that will guide other large multicenter research and consortia.
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Affiliation(s)
- Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Keimya D Sadeghi
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Sharon N Edmiston
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Jessica M Kenney
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Cecilia Lezcano
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - James S Wilmott
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Anne E Cust
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- The Daffodil Centre, University of Sydney, a joint venture with Cancer Council New South Wales, Australia
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - Graham J Mann
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Centre for Cancer Research, Westmead Institute for Medical Research, The University of Sydney, Westmead, New South Wales, Australia
- John Curtin School of Medical Research, Australian National University, Canberra, Australia
| | - Tim K Lee
- British Columbia Cancer Research Center, Vancouver, British Columbia, Canada
| | - Hazel Burke
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Valerie Jakrot
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Ping Shang
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Peter M Ferguson
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and New South Wales Health Pathology, Sydney, New South Wales, Australia
| | - Tawny W Boyce
- Department of Internal Medicine, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, United States of America
| | - Jennifer S Ko
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Peter Ngo
- Department of Hospital Medicine, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Pauline Funchain
- Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Judy R Rees
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire, United States of America
| | - Kelli O'Connell
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Honglin Hao
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Eloise Parrish
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Kathleen Conway
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Paul B Googe
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - David W Ollila
- Department of Surgery, Division of Surgical Oncology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Stergios J Moschos
- Department of Medicine, Division of Medical Oncology, The University of North Carolina Lineberger Comprehensive Cancer Center, Chapel Hill, North Carolina, United States of America
| | - Eva Hernando
- Department of Pathology, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Douglas Hanniford
- Department of Pathology, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Diana Argibay
- Department of Pathology, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Christopher I Amos
- Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Jeffrey E Lee
- Department of Surgical Oncology, University of Texas, MD Anderson Cancer Center, Houston, Texas, United States of America
| | - Iman Osman
- Department of Urology, New York University Grossman School of Medicine, New York, NY, United States of America
- Department of Medicine, New York University Grossman School of Medicine, New York, NY, United States of America
- Department of Dermatology, New York University Grossman School of Medicine, New York, NY, United States of America
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, United States of America
| | - Pei-Fen Kuan
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, New York, United States of America
| | - Arshi Aurora
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Bonnie E Gould Rothberg
- Smilow Cancer Hospital, Yale-New Haven Health System, New Haven, Connecticut, United States of America
| | - Marcus W Bosenberg
- Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Dermatology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Pathology, Yale School of Medicine, New Haven, Connecticut, United States of America
- Department of Immunobiology, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Meg R Gerstenblith
- Department of Dermatology, University Hospitals Cleveland Medical Center/Case Western Reserve University School of Medicine, Cleveland, Ohio, United States of America
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Cheryl Thompson
- Department of Nutrition, Case Western Reserve University, Cleveland, Ohio, United States of America
- Department of Public Health Sciences, Penn State University College of Medicine, Hershey, Pennsylvania, United States of America
| | - Paul N Bogner
- Department of Dermatology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
- Department of Pathology, Roswell Park Comprehensive Cancer Center, Buffalo, New York, United States of America
| | - Ivan P Gorlov
- Department of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Sheri L Holmen
- Department of Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah, United States of America
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah, United States of America
- Department of Surgery, University of Utah Health Sciences Center, Salt Lake City, Utah, United States of America
| | - Elise K Brunsgaard
- Huntsman Cancer Institute, University of Utah Health Sciences Center, Salt Lake City, Utah, United States of America
| | - Yvonne M Saenger
- Department of Medicine, Division of Hematology/Oncology, Columbia University Irving Medical Center, New York, New York, United States of America
- Albert Einstein Cancer Center, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Ronglai Shen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Venkatraman Seshan
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Marc S Ernstoff
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, ImmunoOncology Branch, Developmental Therapeutics Program, Rockville, Maryland, United States of America
| | - Klaus J Busam
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Nancy E Thomas
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico, United States of America
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8
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Luo L, Shen R, Arora A, Orlow I, Busam KJ, Lezcano C, Lee TK, Hernando E, Gorlov I, Amos C, Ernstoff MS, Seshan VE, Cust AE, Wilmott J, Scolyer R, Mann G, Nagore E, Funchain P, Ko J, Ngo P, Edmiston SN, Conway K, Googe PB, Ollila D, Lee JE, Fang S, Rees JR, Thompson CL, Gerstenblith M, Bosenberg M, Gould Rothberg B, Osman I, Saenger Y, Reynolds AZ, Schwartz M, Boyce T, Holmen S, Brunsgaard E, Bogner P, Kuan PF, Wiggins C, Thomas N, Begg CB, Berwick M. Landscape of mutations in early stage primary cutaneous melanoma: An InterMEL study. Pigment Cell Melanoma Res 2022; 35:605-612. [PMID: 35876628 PMCID: PMC9640183 DOI: 10.1111/pcmr.13058] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 07/15/2022] [Accepted: 07/22/2022] [Indexed: 01/09/2023]
Abstract
It is unclear why some melanomas aggressively metastasize while others remain indolent. Available studies employing multi-omic profiling of melanomas are based on large primary or metastatic tumors. We examine the genomic landscape of early-stage melanomas diagnosed prior to the modern era of immunological treatments. Untreated cases with Stage II/III cutaneous melanoma were identified from institutions throughout the United States, Australia and Spain. FFPE tumor sections were profiled for mutation, methylation and microRNAs. Preliminary results from mutation profiling and clinical pathologic correlates show the distribution of four driver mutation sub-types: 31% BRAF; 18% NRAS; 21% NF1; 26% Triple Wild Type. BRAF mutant tumors had younger age at diagnosis, more associated nevi, more tumor infiltrating lymphocytes, and fewer thick tumors although at generally more advanced stage. NF1 mutant tumors were frequent on the head/neck in older patients with severe solar elastosis, thicker tumors but in earlier stages. Triple Wild Type tumors were predominantly male, frequently on the leg, with more perineural invasion. Mutations in TERT, TP53, CDKN2A and ARID2 were observed often, with TP53 mutations occurring particularly frequently in the NF1 sub-type. The InterMEL study will provide the most extensive multi-omic profiling of early-stage melanoma to date. Initial results demonstrate a nuanced understanding of the mutational and clinicopathological landscape of these early-stage tumors.
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9
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Kolla AM, Berwick M, Polsky D. Differentiating Between Lead-Time Bias and True Survival Benefits When Discussing Racial and Ethnic Disparities in Melanoma. JAMA Dermatol 2022; 158:701. [PMID: 35442387 DOI: 10.1001/jamadermatol.2022.0330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Avani M Kolla
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York
| | - Marianne Berwick
- Comprehensive Cancer Center, University of New Mexico, Albuquerque
| | - David Polsky
- Ronald O. Perelman Department of Dermatology, NYU Grossman School of Medicine, New York, New York.,Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, New York
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10
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Moubarak RS, Koetz-Ploch L, Mullokandov G, Gaziel A, de Pablos-Aragoneses A, Argibay D, Kleffman K, Sokolova E, Berwick M, Thomas NE, Osman I, Brown BD, Hernando E. In Vivo miRNA Decoy Screen Reveals miR-124a as a Suppressor of Melanoma Metastasis. Front Oncol 2022; 12:852952. [PMID: 35480113 PMCID: PMC9036958 DOI: 10.3389/fonc.2022.852952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 02/24/2022] [Indexed: 11/30/2022] Open
Abstract
Melanoma is a highly prevalent cancer with an increasing incidence worldwide and high metastatic potential. Brain metastasis is a major complication of the disease, as more than 50% of metastatic melanoma patients eventually develop intracranial disease. MicroRNAs (miRNAs) have been found to play an important role in the tumorigenicity of different cancers and have potential as markers of disease outcome. Identification of relevant miRNAs has generally stemmed from miRNA profiling studies of cells or tissues, but these approaches may have missed miRNAs with relevant functions that are expressed in subfractions of cancer cells. We performed an unbiased in vivo screen to identify miRNAs with potential functions as metastasis suppressors using a lentiviral library of miRNA decoys. Notably, we found that a significant fraction of melanomas that metastasized to the brain carried a decoy for miR-124a, a miRNA that is highly expressed in the brain/neurons. Additional loss- and gain-of-function in vivo validation studies confirmed miR-124a as a suppressor of melanoma metastasis and particularly of brain metastasis. miR-124a overexpression did not inhibit tumor growth in vivo, underscoring that miR-124a specifically controls processes required for melanoma metastatic growth, such as seeding and growth post-extravasation. Finally, we provide proof of principle of this miRNA as a promising therapeutic agent by showing its ability to impair metastatic growth of melanoma cells seeded in distal organs. Our efforts shed light on miR-124a as an antimetastatic agent, which could be leveraged therapeutically to impair metastatic growth and improve patient survival.
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Affiliation(s)
- Rana S. Moubarak
- Department of Pathology, New York University (NYU) School of Medicine, New York, NY, United States
- Interdisciplinary Melanoma Cooperative Group (IMCG), New York University (NYU) Cancer Institute, New York, NY, United States
- Laura and Isaac Perlmutter Cancer Center, New York University (NYU) Langone Health, New York, NY, United States
| | - Lisa Koetz-Ploch
- Department of Pathology, New York University (NYU) School of Medicine, New York, NY, United States
- Interdisciplinary Melanoma Cooperative Group (IMCG), New York University (NYU) Cancer Institute, New York, NY, United States
| | - Gavriel Mullokandov
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Avital Gaziel
- Department of Pathology, New York University (NYU) School of Medicine, New York, NY, United States
- Interdisciplinary Melanoma Cooperative Group (IMCG), New York University (NYU) Cancer Institute, New York, NY, United States
| | - Ana de Pablos-Aragoneses
- Department of Pathology, New York University (NYU) School of Medicine, New York, NY, United States
- Interdisciplinary Melanoma Cooperative Group (IMCG), New York University (NYU) Cancer Institute, New York, NY, United States
| | - Diana Argibay
- Department of Pathology, New York University (NYU) School of Medicine, New York, NY, United States
- Interdisciplinary Melanoma Cooperative Group (IMCG), New York University (NYU) Cancer Institute, New York, NY, United States
| | - Kevin Kleffman
- Department of Pathology, New York University (NYU) School of Medicine, New York, NY, United States
- Interdisciplinary Melanoma Cooperative Group (IMCG), New York University (NYU) Cancer Institute, New York, NY, United States
| | - Elena Sokolova
- Department of Pathology, New York University (NYU) School of Medicine, New York, NY, United States
- Interdisciplinary Melanoma Cooperative Group (IMCG), New York University (NYU) Cancer Institute, New York, NY, United States
| | - Marianne Berwick
- Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States
| | - Nancy E. Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, United States
| | - Iman Osman
- Interdisciplinary Melanoma Cooperative Group (IMCG), New York University (NYU) Cancer Institute, New York, NY, United States
- Laura and Isaac Perlmutter Cancer Center, New York University (NYU) Langone Health, New York, NY, United States
- Ronald O. Perelman Department of Dermatology, New York University (NYU) School of Medicine, New York, NY, United States
| | - Brian D. Brown
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Eva Hernando
- Department of Pathology, New York University (NYU) School of Medicine, New York, NY, United States
- Interdisciplinary Melanoma Cooperative Group (IMCG), New York University (NYU) Cancer Institute, New York, NY, United States
- Laura and Isaac Perlmutter Cancer Center, New York University (NYU) Langone Health, New York, NY, United States
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11
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Riley K, Sussman A, Schofield E, Guest D, Dailey YT, Schwartz MR, Buller DB, Hunley K, Kaphingst K, Berwick M, Hay JL. Effect of Superstitious Beliefs and Risk Intuitions on Genetic Test Decisions. Med Decis Making 2022; 42:398-403. [PMID: 34455851 PMCID: PMC8882703 DOI: 10.1177/0272989x211029272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Moving beyond numeric representations of risk perceptions, we examine cognitive causation, or superstitious thinking, and negative affect in risk as predictors of MC1R (i.e., moderate v. high risk) skin cancer genetic testing and responses to this testing. METHODS Participants (N = 496) completed baseline assessments using validated measures of cognitive causation (beliefs that thinking about cancer risk increases cancer likelihood) and negative affect in risk (negative feelings generated during risk perception) and subsequently received a test offer. Participants could access a website to learn about and request genetic testing. Those who tested (n = 167) completed assessments of cognitive and affective reactions 2 wk after testing, including the Impact of Events-Revised Intrusive thoughts subscale. RESULTS Those with higher negative affect in risk were less likely to return a saliva sample for testing (odds ratio = 0.98, 95% confidence interval = 0.96-0.99). Those with higher cognitive causation reported more fear (b = 0.28-0.31; P's < 0.05). Higher negative affect in risk was associated with more emotion-laden test responses, particularly in those receiving higher-risk as compared with average-risk results. CONCLUSION Negative affect in risk did not hamper test information seeking, although it did inhibit the uptake of genetic testing. Those with higher cognitive causation showed more fear regarding their test result, as indicated by higher distress in those who received average-risk results and lower believability in those who received higher-risk results.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kim Kaphingst
- University of Utah, Huntsman Cancer Center, Salt Lake City, UT, USA
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12
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Barnes PW, Robson TM, Neale PJ, Williamson CE, Zepp RG, Madronich S, Wilson SR, Andrady AL, Heikkilä AM, Bernhard GH, Bais AF, Neale RE, Bornman JF, Jansen MAK, Klekociuk AR, Martinez-Abaigar J, Robinson SA, Wang QW, Banaszak AT, Häder DP, Hylander S, Rose KC, Wängberg SÅ, Foereid B, Hou WC, Ossola R, Paul ND, Ukpebor JE, Andersen MPS, Longstreth J, Schikowski T, Solomon KR, Sulzberger B, Bruckman LS, Pandey KK, White CC, Zhu L, Zhu M, Aucamp PJ, Liley JB, McKenzie RL, Berwick M, Byrne SN, Hollestein LM, Lucas RM, Olsen CM, Rhodes LE, Yazar S, Young AR. Environmental effects of stratospheric ozone depletion, UV radiation, and interactions with climate change: UNEP Environmental Effects Assessment Panel, Update 2021. Photochem Photobiol Sci 2022; 21:275-301. [PMID: 35191005 PMCID: PMC8860140 DOI: 10.1007/s43630-022-00176-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 01/14/2022] [Indexed: 12/07/2022]
Abstract
The Environmental Effects Assessment Panel of the Montreal Protocol under the United Nations Environment Programme evaluates effects on the environment and human health that arise from changes in the stratospheric ozone layer and concomitant variations in ultraviolet (UV) radiation at the Earth’s surface. The current update is based on scientific advances that have accumulated since our last assessment (Photochem and Photobiol Sci 20(1):1–67, 2021). We also discuss how climate change affects stratospheric ozone depletion and ultraviolet radiation, and how stratospheric ozone depletion affects climate change. The resulting interlinking effects of stratospheric ozone depletion, UV radiation, and climate change are assessed in terms of air quality, carbon sinks, ecosystems, human health, and natural and synthetic materials. We further highlight potential impacts on the biosphere from extreme climate events that are occurring with increasing frequency as a consequence of climate change. These and other interactive effects are examined with respect to the benefits that the Montreal Protocol and its Amendments are providing to life on Earth by controlling the production of various substances that contribute to both stratospheric ozone depletion and climate change.
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Affiliation(s)
- P W Barnes
- Biological Sciences and Environment Program, Loyola University New Orleans, New Orleans, USA
| | - T M Robson
- Organismal and Evolutionary Biology (OEB), Viikki Plant Science Centre (ViPS), University of Helsinki, Helsinki, Finland
| | - P J Neale
- Smithsonian Environmental Research Center, Edgewater, USA
| | | | - R G Zepp
- ORD/CEMM, US Environmental Protection Agency, Athens, GA, USA
| | - S Madronich
- Atmospheric Chemistry Observations and Modeling Laboratory, National Center for Atmospheric Research, Boulder, USA
| | - S R Wilson
- School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - A L Andrady
- Chemical and Biomolecular Engineering, North Carolina State University, Apex, USA
| | - A M Heikkilä
- Finnish Meteorological Institute, Helsinki, Finland
| | | | - A F Bais
- Laboratory of Atmospheric Physics, Department of Physics, Aristotle University, Thessaloniki, Greece
| | - R E Neale
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - J F Bornman
- Food Futures Institute, Murdoch University, Perth, Australia.
| | | | - A R Klekociuk
- Antarctic Climate Program, Australian Antarctic Division, Kingston, Australia
| | - J Martinez-Abaigar
- Faculty of Science and Technology, University of La Rioja, La Rioja, Logroño, Spain
| | - S A Robinson
- Securing Antarctica's Environmental Future, Global Challenges Program and School of Earth, Atmospheric and Life Sciences, University of Wollongong, Wollongong, Australia
| | - Q-W Wang
- Institute of Applied Ecology, Chinese Academy of Sciences (CAS), Shenyang, China
| | - A T Banaszak
- Unidad Académica De Sistemas Arrecifales, Universidad Nacional Autónoma De México, Puerto Morelos, Mexico
| | - D-P Häder
- Department of Biology, Friedrich-Alexander University, Möhrendorf, Germany
| | - S Hylander
- Centre for Ecology and Evolution in Microbial Model Systems-EEMiS, Linnaeus University, Kalmar, Sweden.
| | - K C Rose
- Biological Sciences, Rensselaer Polytechnic Institute, Troy, USA
| | - S-Å Wängberg
- Marine Sciences, University of Gothenburg, Gothenburg, Sweden
| | - B Foereid
- Environment and Natural Resources, Norwegian Institute of Bioeconomy Research, Ås, Norway
| | - W-C Hou
- Environmental Engineering, National Cheng Kung University, Tainan, Taiwan
| | - R Ossola
- Environmental System Science (D-USYS), ETH Zürich, Zürich, Switzerland
| | - N D Paul
- Lancaster Environment Centre, Lancaster University, Lancaster, UK
| | - J E Ukpebor
- Chemistry Department, Faculty of Physical Sciences, University of Benin, Benin City, Nigeria
| | - M P S Andersen
- Department of Chemistry and Biochemistry, California State University, Northridge, USA
- Department of Chemistry, University of Copenhagen, Copenhagen, Denmark
| | - J Longstreth
- The Institute for Global Risk Research, LLC, Bethesda, USA
| | - T Schikowski
- Research Group of Environmental Epidemiology, Leibniz Institute of Environmental Medicine, Düsseldorf, Germany
| | - K R Solomon
- Centre for Toxicology, School of Environmental Sciences, University of Guelph, Guelph, Canada
| | - B Sulzberger
- Academic Guest, Swiss Federal Institute of Aquatic Science and Technology, 8600, Dübendorf, Switzerland
| | - L S Bruckman
- Materials Science and Engineering, Case Western Reserve University, Cleveland, USA
| | - K K Pandey
- Wood Processing Division, Institute of Wood Science and Technology, Bangalore, India
| | - C C White
- Polymer Science and Materials Chemistry (PSMC), Exponent, Bethesda, USA
| | - L Zhu
- College of Materials Science and Engineering, Donghua University, Shanghai, China
| | - M Zhu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, Donghua University, Shanghai, China
| | - P J Aucamp
- Ptersa Environmental Consultants, Pretoria, South Africa
| | - J B Liley
- National Institute of Water and Atmospheric Research, Alexandra, New Zealand
| | - R L McKenzie
- National Institute of Water and Atmospheric Research, Alexandra, New Zealand
| | - M Berwick
- Internal Medicine, University of New Mexico, Albuquerque, USA
| | - S N Byrne
- Applied Medical Science, University of Sydney, Sydney, Australia
| | - L M Hollestein
- Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - R M Lucas
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - C M Olsen
- Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - L E Rhodes
- Photobiology Unit, Dermatology Research Centre, School of Biological Sciences, Faculty of Biology Medicine and Health, University of Manchester, Manchester, UK
| | - S Yazar
- Garvan Institute of Medical Research, Sydney, Australia
| | - A R Young
- St John's Institute of Dermatology, King's College London (KCL), London, UK
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Khan E, Kaphingst KA, Meyer White K, Sussman A, Guest D, Schofield E, Dailey YT, Robers E, Schwartz MR, Li Y, Buller D, Hunley K, Berwick M, Hay JL. Comprehension of skin cancer genetic risk feedback in primary care patients. J Community Genet 2022; 13:113-119. [PMID: 34797550 PMCID: PMC8799794 DOI: 10.1007/s12687-021-00566-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022] Open
Abstract
Few studies have examined comprehension and miscomprehension of genetic risk feedback for moderate-risk genes in the general population. We examined the prevalence and nature of accurate and inaccurate genetic risk feedback comprehension among those who received genetic testing for melanocortin-1-receptor (MC1R) gene variants that confer moderate melanoma risk. Participants (N = 145 Albuquerque, NM) were tested as part of a randomized controlled trial. Two weeks after receiving MC1R genetic risk feedback, participants answered open-ended questions regarding their reactions to the MC1R feedback report. Participants' comprehension of their feedback (average-risk or higher-risk for melanoma) was evaluated through qualitative analysis of open-ended responses. Most participants demonstrated comprehension of their feedback results (i.e., 63% of average-risk participants [ARPs]; 51% of higher-risk participants [HRPs]). Miscomprehension was evident in fewer participants (i.e., 16% of ARPs, 11% of HRPs). A few ARPs misunderstood the purpose of testing, whereas a few HRPs reported confusion about the meaning of their risk feedback. Some participants' responses to the open-ended questions were too ambiguous to ascertain comprehension or miscomprehension (i.e., 21% of ARPs, 38% of HRPs). Taken together, these findings suggest that genetic testing feedback for MC1R risk variants is largely comprehensible to general population participants. This study adds to the work examining comprehension and usage of common, moderate risk genetic information in public health contexts. However, to maximize the utility of genetic risk information in the general population, further research is needed to investigate and address areas where common genetic risk feedback misunderstandings occur.
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Affiliation(s)
- Erva Khan
- Department of Psychiatry and Behavioral Sciences, Mount Sinai Beth Israel, 281 1st Avenue, New York, NY, 10003, USA.
| | - Kimberly A Kaphingst
- Huntsman Cancer Institute and Department of Communication, University of Utah, Salt Lake City, UT, USA
| | - Kirsten Meyer White
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Andrew Sussman
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Dolores Guest
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yvonne T Dailey
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Erika Robers
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Matthew R Schwartz
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Keith Hunley
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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14
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Davari DR, Orlow I, Kanetsky PA, Luo L, Edmiston SN, Conway K, Parrish EA, Hao H, Busam KJ, Sharma A, Kricker A, Cust AE, Anton-Culver H, Gruber SB, Gallagher RP, Zanetti R, Rosso S, Sacchetto L, Dwyer T, Ollila DW, Begg CB, Berwick M, Thomas NE. Disease-Associated Risk Variants in ANRIL Are Associated with Tumor-Infiltrating Lymphocyte Presence in Primary Melanomas in the Population-Based GEM Study. Cancer Epidemiol Biomarkers Prev 2021; 30:2309-2316. [PMID: 34607836 PMCID: PMC8643342 DOI: 10.1158/1055-9965.epi-21-0686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 08/19/2021] [Accepted: 09/23/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Genome-wide association studies have reported that genetic variation at ANRIL (CDKN2B-AS1) is associated with risk of several chronic diseases including coronary artery disease, coronary artery calcification, myocardial infarction, and type 2 diabetes mellitus. ANRIL is located at the CDKN2A/B locus, which encodes multiple melanoma tumor suppressors. We investigated the association of these variants with melanoma prognostic characteristics. METHODS The Genes, Environment, and Melanoma Study enrolled 3,285 European origin participants with incident invasive primary melanoma. For each of ten disease-associated SNPs at or near ANRIL, we used linear and logistic regression modeling to estimate, respectively, the per allele mean changes in log of Breslow thickness and ORs for presence of ulceration and tumor-infiltrating lymphocytes (TIL). We also assessed effect modification by tumor NRAS/BRAF mutational status. RESULTS Rs518394, rs10965215, and rs564398 passed false discovery and were each associated (P ≤ 0.005) with TILs, although only rs564398 was independently associated (P = 0.0005) with TILs. Stratified by NRAS/BRAF mutational status, rs564398*A was significantly positively associated with TILs among NRAS/BRAF mutant, but not wild-type, cases. We did not find SNP associations with Breslow thickness or ulceration. CONCLUSIONS ANRIL rs564398 was associated with TIL presence in primary melanomas, and this association may be limited to NRAS/BRAF-mutant cases. IMPACT Pathways related to ANRIL variants warrant exploration in relationship to TILs in melanoma, especially given the impact of TILs on immunotherapy and survival.
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Affiliation(s)
- Danielle R. Davari
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Peter A. Kanetsky
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Sharon N. Edmiston
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Kathleen Conway
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Eloise A. Parrish
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Honglin Hao
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Klaus J. Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ajay Sharma
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anne Kricker
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anne E. Cust
- Daffodil Centre, The University of Sydney, a joint venture with Cancer Council NSW, Sydney, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, Irvine, California
| | | | - Richard P. Gallagher
- BC Cancer and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Lidia Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Terence Dwyer
- Murdoch Children's Research Institute, Melbourne, Australia
- The Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, United Kingdom
- Department of Pediatrics, University of Melbourne, Melbourne, Australia
- Oxford Martin School, University of Oxford, Oxford, United Kingdom
| | - David W. Ollila
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Department of Surgery, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Colin B. Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Nancy E. Thomas
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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15
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Banerjee SC, Sussman A, Schofield E, Guest DD, Dailey YS, Schwartz MR, Buller DB, Hunley K, Kaphingst K, Berwick M, Hay JL. "Let's Talk about Skin Cancer": Examining Association between Family Communication about Skin Cancer, Perceived Risk, and Sun Protection Behaviors. J Health Commun 2021; 26:576-585. [PMID: 34612176 PMCID: PMC8513818 DOI: 10.1080/10810730.2021.1966686] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Family communication about skin cancer risk may motivate protective behaviors. However, it is unclear how widespread such communication might be. In this study, we describe prevalence and patterns (across environmental, personal, and behavioral factors) of family communication about skin cancer across N = 600 diverse (79% female, 48% Hispanic, 44% non-Hispanic White) primary care patients from Albuquerque, New Mexico, a geographical location with year-round sun exposure. Over half reported discussing general cancer (77%) and skin cancer risks (66%) with their families. The most frequent target of skin cancer risk communication included doctors (54%), followed by friends/coworkers (49%), spouse/partner (43%), other family members (38%), sisters (36%), mothers (36%), daughters (33%), sons (32%), father (24%), and brothers (22%). On average, participants reported having talked to three family members about skin cancer risks. The most frequently discussed content of skin cancer risk communication was the use of sun protection (89%), followed by the personal risk of skin cancer (68%), who had skin cancer in the family (60%), family risk of skin cancer (59%), time of sun exposure (57%), and skin cancer screening (57%). A family or personal history of cancer, higher perceived risk, higher health literacy, being non-Hispanic, having higher education or income, and proactive sun protective behavior were associated with greater family communication about general cancer and skin cancer risks. These study findings have implications for interventions that encourage discussions about skin cancer risk, sun protection, and skin cancer screening that lead to adoption of sun-safe behaviors.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Kim Kaphingst
- University of Utah, Huntsman Cancer Center, Salt Lake City, UT, USA
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16
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Yardman-Frank JM, Bronner B, Rosso S, From L, Busam K, Groben P, Tucker P, Cust A, Armstrong B, Kricker A, Marrett L, Anton-Culver H, Gruber S, Gallagher R, Zanetti R, Sacchetto L, Dwyer T, Venn A, Orlow I, Kanetsky P, Luo L, Thomas N, Begg C, Berwick M. Comparison of community pathologists with expert dermatopathologists evaluating Breslow thickness and histopathologic subtype in a large international population-based study of melanoma. JAAD Int 2021; 4:25-27. [PMID: 34409386 PMCID: PMC8362323 DOI: 10.1016/j.jdin.2021.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
| | - Baillie Bronner
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | | | | | - Klaus Busam
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Pam Groben
- University of North Carolina, Chapel Hill, North Carolina
| | | | - Anne Cust
- Sydney University, New South Wales, Australia
| | | | | | | | | | | | - Rick Gallagher
- British Columbia Cancer Research Center, Vancouver, Canada
| | | | | | | | | | - Irene Orlow
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Li Luo
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Nancy Thomas
- University of North Carolina, Chapel Hill, North Carolina
| | - Colin Begg
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marianne Berwick
- University of New Mexico School of Medicine, Albuquerque, New Mexico
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Osmani S, Chao Z, Barnhill R, Berwick M. Not every age is created equal: risk factors for melanoma differ by age. Int J Dermatol 2021; 61:e74-e76. [PMID: 33934340 DOI: 10.1111/ijd.15621] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/31/2021] [Accepted: 04/01/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Sabah Osmani
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Zefr Chao
- University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Raymond Barnhill
- Department of Translational Research, Institut Curie, Paris, France
| | - Marianne Berwick
- University of New Mexico Department of Internal Medicine, Albuquerque, NM, USA
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18
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Gibbs D, Thomas N, Orlow I, Kanetsky P, Luo L, Cust A, Begg C, Berwick M, Ward S. 526 Functional, inherited vitamin D-binding protein variants associated with mortality among melanoma patients. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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19
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Davari D, Orlow I, Kanetsky P, Luo L, Busam K, Cust A, Begg C, Berwick M, Thomas N. 523 ANRIL inherited variants associated with primary melanoma TIL grade. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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20
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Yardman-Frank JM, Glassheim E, Kricker A, Armstrong BK, Marrett LD, Luo L, Cust AE, Busam KJ, Orlow I, Gallagher RP, Gruber SB, Anton-Culver H, Rosso S, Zanetti R, Sacchetto L, Kanetsky PA, Dwyer T, Venn A, Lee-Taylor J, Begg CB, Thomas NE, Berwick M. Differences in Melanoma Between Canada and New South Wales, Australia: A Population-Based Genes, Environment, and Melanoma (GEM) Study. JID Innov 2021; 1:100002. [PMID: 33768212 PMCID: PMC7990302 DOI: 10.1016/j.xjidi.2021.100002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/22/2020] [Accepted: 12/07/2020] [Indexed: 11/21/2022] Open
Abstract
In an effort to understand the difference between melanomas diagnosed in Australia (New South Wales) and Canada, where the incidence in New South Wales is almost three times greater than in Canada, and mortality is twice as high although survival is slightly more favorable, we had one pathologist review 1,271 melanomas from British Columbia and Ontario, Canada, to compare these to melanomas in New South Wales, Australia. We hypothesized that histopathologic characteristics might provide insight into divergent pathways to melanoma development. We found a number of differences in risk factors and tumor characteristics between the two geographic areas. There were higher mole counts and darker phenotypes in the Canadian patients, while the Australian patients had greater solar elastosis, more lentigo maligna melanomas, and more tumor infiltrating lymphocytes. We hypothesize that the differences observed may illustrate different etiologies – the cumulative exposure pathway among Australian patients and the nevus pathway among Canadian patients. This is one of the largest studies investigating the divergent pathway hypothesis and is particularly robust due to the evaluation of all lesions by one dermatopathologist.
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Affiliation(s)
| | - Elyssa Glassheim
- University of New Mexico School of Medicine, Albuquerque, New Mexico, USA
| | - Anne Kricker
- Sydney School of Public Health Melanoma Institute Australia, University of Sydney, Sydney, Australia
- Melanoma Institute Australia, University of Sydney, Sydney, Australia
| | - Bruce K. Armstrong
- Sydney School of Public Health, University of Sydney, Sydney, Australia
- Sax Institute, Sydney, New South Wales, Australia
| | - Loraine D. Marrett
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, Ontario, Canada
| | - Li Luo
- Division of Epidemiology, Biostatistics and Preventive Medicine, Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
| | - Anne E. Cust
- Sydney School of Public Health Melanoma Institute Australia, University of Sydney, Sydney, Australia
- Melanoma Institute Australia, University of Sydney, Sydney, Australia
| | - Klaus J. Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | | | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, California, USA
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Lidia Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Peter A. Kanetsky
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Terence Dwyer
- The George Institute, University of Oxford, Oxford, United Kingdom
| | - Alison Venn
- Menzies Research Institute, University of Tasmania, Hobart, Australia
| | - Julia Lee-Taylor
- Atmospheric Chemistry Division, National Center for Atmospheric Research, Boulder, Colorado, USA
| | - Colin B. Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Nancy E. Thomas
- Department of Dermatology, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA for the GEM Study Group
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA for the GEM Study Group
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico, USA
- Department of Dermatology, University of New Mexico, Albuquerque, New Mexico, USA
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21
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Kaphingst KA, Khan E, White KM, Sussman A, Guest D, Schofield E, Dailey YT, Robers E, Schwartz MR, Li Y, Buller D, Hunley K, Berwick M, Hay JL. Effects of health literacy skills, educational attainment, and level of melanoma risk on responses to personalized genomic testing. Patient Educ Couns 2021; 104:12-19. [PMID: 32773237 PMCID: PMC7749822 DOI: 10.1016/j.pec.2020.07.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 05/27/2020] [Accepted: 07/21/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Few studies have examined how health literacy impacts responses to genetic information. METHODS We examined this issue among 145 English or Spanish-speaking adult primary care patients enrolled in a trial that offered testing for MC1R gene variants that confer moderately increased melanoma risk. We investigated whether health literacy skills, educational attainment, or melanoma risk were related to short-term cognitive and affective responses to genetic test results. RESULTS On average, participants found the test results to be highly believable and clear, with low levels of negative emotional responses and moderate levels of positive responses. In adjusted models, health literacy skills were significantly inversely associated with confusion (OR = 0.75, 95 % CI = 0.58, 0.96); those with higher education thought significantly less about their test results (β = -0.66), were less hopeful (β = -0.89), and had lower distress (β = -1.15). We also observed a significant interaction (p < .001) between health literacy and melanoma risk in affecting the frequency of thoughts about test results. CONCLUSION The findings indicate that health literacy skills may affect to what extent individuals elaborate cognitively on genetic information. PRACTICE IMPLICATIONS Patients with lower health literacy skills or education may need support in understanding genetic test results.
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Affiliation(s)
- Kimberly A Kaphingst
- Huntsman Cancer Institute and Department of Communication, University of Utah, Salt Lake City, UT, USA.
| | - Erva Khan
- Memorial Sloan Kettering Cancer Center, New York, USA
| | - Kirsten Meyer White
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Andrew Sussman
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Dolores Guest
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | | | - Yvonne T Dailey
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Erika Robers
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Matthew R Schwartz
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Yuelin Li
- Memorial Sloan Kettering Cancer Center, New York, USA
| | | | - Keith Hunley
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, USA
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22
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Berwick M. Abstract IA12: Preventing melanoma progression through a genomic approach. Cancer Res 2020. [DOI: 10.1158/1538-7445.mel2019-ia12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The InterMEL Program Project has been designed to fill a gap in our knowledge about the biology and clinical course of Stage II and Stage III melanoma. This program, Integration of Clinical and Molecular Biomarkers for Melanoma Survival, is work from a consortium of 12 institutions, using primary melanomas, and differs from the TCGA, which was 80% metastatic melanoma. We are attempting to use genomics (next-gen sequencing, methylation analyses, miRNA, and expression analyses) to form an integrated signature for survival among those diagnosed with Stages II and III melanoma. Such a signature could assist clinicians in determining whether to treat the patient, prior to metastases, with newer therapies or to less aggressively follow those patients unlikely to die of their disease. To do this, we are evaluating 1,000 tumors—500 from those who died from melanoma within 5 years, and 500 from those who lived more than 5 years without progression. Expert pathologists review each lesion for eligibility and classification of clinical characteristics. These tumors have not been treated with immunotherapy or targeted therapies. Full clinical information is available for each tumor, including age, sex, race/ethnicity, anatomic site, histologic subtype, AJCC8 stage, sentinel lymph node status, Breslow thickness, ulceration, mitotic index, TILs, regression, satellites, tumor purity, date of progression (if progressed), vital status, follow-up time to death or last contact. To date, we have clinical and pathologic data on more than 500 of the 1,000 tumors and genomic data on more than 100 of these. We find better survival among those with higher mutation burden, poorer survival among those with a CIMP methylation phenotype, and a number of miRNAs associated with survival.
Citation Format: Marianne Berwick, InterMEL. Preventing melanoma progression through a genomic approach [abstract]. In: Proceedings of the AACR Special Conference on Melanoma: From Biology to Target; 2019 Jan 15-18; Houston, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(19 Suppl):Abstract nr IA12.
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23
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Yardman-Frank JM, Ramey S, Ravichandran N, Osmani S, Ko R, Berwick M, Durkin JR. The effect of providing one-on-one training on skin cancer prevention at community-based free skin cancer screenings: A survey study. J Am Acad Dermatol 2020; 85:784-786. [PMID: 32890587 DOI: 10.1016/j.jaad.2020.08.105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 08/26/2020] [Accepted: 08/27/2020] [Indexed: 11/24/2022]
Affiliation(s)
| | - Shannen Ramey
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | | | - Sabah Osmani
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Randy Ko
- University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico School of Medicine, Albuquerque, New Mexico
| | - John R Durkin
- Department of Dermatology, University of New Mexico School of Medicine, Albuquerque, New Mexico.
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Grossman D, Okwundu N, Bartlett EK, Marchetti MA, Othus M, Coit DG, Hartman RI, Leachman SA, Berry EG, Korde L, Lee SJ, Bar-Eli M, Berwick M, Bowles T, Buchbinder EI, Burton EM, Chu EY, Curiel-Lewandrowski C, Curtis JA, Daud A, Deacon DC, Ferris LK, Gershenwald JE, Grossmann KF, Hu-Lieskovan S, Hyngstrom J, Jeter JM, Judson-Torres RL, Kendra KL, Kim CC, Kirkwood JM, Lawson DH, Leming PD, Long GV, Marghoob AA, Mehnert JM, Ming ME, Nelson KC, Polsky D, Scolyer RA, Smith EA, Sondak VK, Stark MS, Stein JA, Thompson JA, Thompson JF, Venna SS, Wei ML, Swetter SM. Prognostic Gene Expression Profiling in Cutaneous Melanoma: Identifying the Knowledge Gaps and Assessing the Clinical Benefit. JAMA Dermatol 2020; 156:1004-1011. [PMID: 32725204 PMCID: PMC8275355 DOI: 10.1001/jamadermatol.2020.1729] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Importance Use of prognostic gene expression profile (GEP) testing in cutaneous melanoma (CM) is rising despite a lack of endorsement as standard of care. Objective To develop guidelines within the national Melanoma Prevention Working Group (MPWG) on integration of GEP testing into the management of patients with CM, including (1) review of published data using GEP tests, (2) definition of acceptable performance criteria, (3) current recommendations for use of GEP testing in clinical practice, and (4) considerations for future studies. Evidence Review The MPWG members and other international melanoma specialists participated in 2 online surveys and then convened a summit meeting. Published data and meeting abstracts from 2015 to 2019 were reviewed. Findings The MPWG members are optimistic about the future use of prognostic GEP testing to improve risk stratification and enhance clinical decision-making but acknowledge that current utility is limited by test performance in patients with stage I disease. Published studies of GEP testing have not evaluated results in the context of all relevant clinicopathologic factors or as predictors of regional nodal metastasis to replace sentinel lymph node biopsy (SLNB). The performance of GEP tests has generally been reported for small groups of patients representing particular tumor stages or in aggregate form, such that stage-specific performance cannot be ascertained, and without survival outcomes compared with data from the American Joint Committee on Cancer 8th edition melanoma staging system international database. There are significant challenges to performing clinical trials incorporating GEP testing with SLNB and adjuvant therapy. The MPWG members favor conducting retrospective studies that evaluate multiple GEP testing platforms on fully annotated archived samples before embarking on costly prospective studies and recommend avoiding routine use of GEP testing to direct patient management until prospective studies support their clinical utility. Conclusions and Relevance More evidence is needed to support using GEP testing to inform recommendations regarding SLNB, intensity of follow-up or imaging surveillance, and postoperative adjuvant therapy. The MPWG recommends further research to assess the validity and clinical applicability of existing and emerging GEP tests. Decisions on performing GEP testing and patient management based on these results should only be made in the context of discussion of testing limitations with the patient or within a multidisciplinary group.
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Affiliation(s)
- Douglas Grossman
- Huntsman Cancer Institute, Salt Lake City, Utah
- Department of Dermatology, University of Utah, Salt Lake City
- Department of Oncological Sciences, University of Utah, Salt Lake City
| | | | - Edmund K Bartlett
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael A Marchetti
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Megan Othus
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Daniel G Coit
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rebecca I Hartman
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Sancy A Leachman
- Department of Dermatology and Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Elizabeth G Berry
- Department of Dermatology and Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Larissa Korde
- Division of Cancer Treatment and Diagnosis, National Cancer Institute, Bethesda, Maryland
| | - Sandra J Lee
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- Department of Data Sciences, Harvard Medical School, Boston, Massachusetts
| | - Menashe Bar-Eli
- Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston
| | - Marianne Berwick
- Departments of Dermatology and Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque
| | - Tawnya Bowles
- Department of Surgery, Division of Surgical Oncology, University of Utah, Salt Lake City
| | - Elizabeth I Buchbinder
- Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts
- Department of Internal Medicine, Harvard Medical School, Boston, Massachusetts
| | - Elizabeth M Burton
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Emily Y Chu
- Department of Dermatology, Perelman School of Medicine University of Pennsylvania, Philadelphia
| | | | - Julia A Curtis
- Department of Dermatology, University of Utah, Salt Lake City
| | - Adil Daud
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
- Department of Hematology/Oncology, University of California, San Francisco
| | - Dekker C Deacon
- Department of Dermatology, University of Utah, Salt Lake City
| | - Laura K Ferris
- Department of Dermatology and University of Pittsburgh Clinical and Translational Science Institute, Pittsburgh, Pennsylvania
| | - Jeffrey E Gershenwald
- Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston
| | - Kenneth F Grossmann
- Huntsman Cancer Institute, Salt Lake City, Utah
- Department of Medicine, Division of Oncology, University of Utah, Salt Lake City
| | - Siwen Hu-Lieskovan
- Huntsman Cancer Institute, Salt Lake City, Utah
- Department of Medicine, Division of Oncology, University of Utah, Salt Lake City
| | - John Hyngstrom
- Huntsman Cancer Institute, Salt Lake City, Utah
- Department of Surgery, Division of Surgical Oncology, University of Utah, Salt Lake City
| | - Joanne M Jeter
- Department of Internal Medicine and The Ohio State University Comprehensive Cancer Center, Columbus
| | - Robert L Judson-Torres
- Huntsman Cancer Institute, Salt Lake City, Utah
- Department of Dermatology, University of Utah, Salt Lake City
| | - Kari L Kendra
- Department of Internal Medicine and The Ohio State University Comprehensive Cancer Center, Columbus
| | - Caroline C Kim
- Department of Dermatology, Tufts Medical Center, Boston, Massachusetts
- Partners Healthcare, Newton Wellesley Dermatology Associates, Wellesley, Massachusetts
| | - John M Kirkwood
- Department of Internal Medicine and UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David H Lawson
- Department of Hematology and Medical Oncology, Emory University School of Medicine, Winship Cancer Institute of Emory University, Atlanta, Georgia
| | | | - Georgina V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Medical Oncology, Royal North Shore Hospital, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Ashfaq A Marghoob
- Dermatology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Janice M Mehnert
- Department of Medical Oncology, Robert Wood Johnson University Hospital, New Brunswick, New Jersey
- Rutgers Cancer Institute of New Jersey, New Brunswick
| | - Michael E Ming
- Department of Dermatology, Perelman School of Medicine University of Pennsylvania, Philadelphia
| | - Kelly C Nelson
- Department of Dermatology, The University of Texas MD Anderson Cancer Center, Houston
| | - David Polsky
- Department of Dermatology, Ronald O. Perelman Department of Dermatology, Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York University School of Medicine, New York, New York
| | - Richard A Scolyer
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Charles Perkins Centre, The University of Sydney, Sydney, Australia
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, New South Wales, Australia
| | - Eric A Smith
- Department of Pathology, University of Utah, Salt Lake City
| | - Vernon K Sondak
- Department of Cutaneous Oncology, Moffitt Cancer Center & Research Institute, Tampa, Florida
- Department of Oncologic Sciences, University of South Florida Morsani College of Medicine, Tampa
| | - Mitchell S Stark
- The University of Queensland Diamantina Institute, The University of Queensland, Dermatology Research Centre, Brisbane, Australia
| | - Jennifer A Stein
- Department of Dermatology, Ronald O. Perelman Department of Dermatology, Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York University School of Medicine, New York, New York
| | - John A Thompson
- Fred Hutchinson Cancer Research Center, Seattle, Washington
- Department of Oncology, University of Washington, Seattle
- Seattle Cancer Care Alliance, Seattle, Washington
| | - John F Thompson
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Department of Melanoma and Surgical Oncology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Suraj S Venna
- Inova Schar Cancer Institute, Department of Medicine, Virginia Commonwealth University, Fairfax
| | - Maria L Wei
- Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco
- Department of Dermatology, University of California, San Francisco
- Dermatology Service, Veterans Affairs Medical Center, San Francisco, California
| | - Susan M Swetter
- Stanford University Medical Center and Cancer Institute, Stanford, California
- Dermatology Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, California
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25
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Wood RP, Heyworth JS, McCarthy NS, Mauguen A, Berwick M, Thomas NE, Millward MJ, Anton-Culver H, Cust AE, Dwyer T, Gallagher RP, Gruber SB, Kanetsky PA, Orlow I, Rosso S, Moses EK, Begg CB, Ward SV. Association of Known Melanoma Risk Factors with Primary Melanoma of the Scalp and Neck. Cancer Epidemiol Biomarkers Prev 2020; 29:2203-2210. [PMID: 32856602 DOI: 10.1158/1055-9965.epi-20-0595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 07/02/2020] [Accepted: 08/14/2020] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Scalp and neck (SN) melanoma confers a worse prognosis than melanoma of other sites but little is known about its determinants. We aimed to identify associations between SN melanoma and known risk genes, phenotypic traits, and sun exposure patterns. METHODS Participants were cases from the Western Australian Melanoma Health Study (n = 1,200) and the Genes, Environment, and Melanoma Study (n = 3,280). Associations between risk factors and SN melanoma, compared with truncal and arm/leg melanoma, were investigated using binomial logistic regression. Facial melanoma was also compared with the trunk and extremities, to evaluate whether associations were subregion specific, or reflective of the whole head/neck region. RESULTS Compared with other sites, increased odds of SN and facial melanoma were observed in older individuals [SN: OR = 1.28, 95% confidence interval (CI) = 0.92-1.80, P trend = 0.016; Face: OR = 4.57, 95% CI = 3.34-6.35, P trend < 0.001] and those carrying IRF4-rs12203592*T (SN: OR = 1.35, 95% CI = 1.12-1.63, P trend = 0.002; Face: OR = 1.29, 95% CI = 1.10-1.50, P trend = 0.001). Decreased odds were observed for females (SN: OR = 0.49, 95% CI = 0.37-0.64, P < 0.001; Face: OR = 0.66, 95% CI = 0.53-0.82, P < 0.001) and the presence of nevi (SN: OR = 0.66, 95% CI = 0.49-0.89, P = 0.006; Face: OR = 0.65, 95% CI = 0.52-0.83, P < 0.001). CONCLUSIONS Differences observed between SN melanoma and other sites were also observed for facial melanoma. Factors previously associated with the broader head and neck region, notably older age, may be driven by the facial subregion. A novel finding was the association of IRF4-rs12203592 with both SN and facial melanoma. IMPACT Understanding the epidemiology of site-specific melanoma will enable tailored strategies for risk factor reduction and site-specific screening campaigns.
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Affiliation(s)
- Renee P Wood
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jane S Heyworth
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Nina S McCarthy
- School of Biomedical Sciences, The University of Western Australia, Perth, Western Australia, Australia
| | - Audrey Mauguen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Nancy E Thomas
- Department of Dermatology, School of Medicine and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina
| | - Michael J Millward
- Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Hoda Anton-Culver
- Department of Medicine, University of California, Irvine, California
| | - Anne E Cust
- Sydney School of Public Health and The Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - Terence Dwyer
- George Institute for Global Health Research, University of Oxford, Oxford, United Kingdom
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Richard P Gallagher
- British Columbia Cancer Research Centre and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Stephen B Gruber
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, California
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Eric K Moses
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sarah V Ward
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia.
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
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26
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Gorlov IP, Amos CI, Tsavachidis S, Begg C, Hernando E, Cheng C, Shen R, Orlow I, Luo L, Ernstoff MS, Parker J, Thomas NE, Gorlova OY, Berwick M. Human genes differ by their UV sensitivity estimated through analysis of UV-induced silent mutations in melanoma. Hum Mutat 2020; 41:1751-1760. [PMID: 32643855 DOI: 10.1002/humu.24078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 06/19/2020] [Accepted: 07/02/2020] [Indexed: 11/09/2022]
Abstract
We hypothesized that human genes differ by their sensitivity to ultraviolet (UV) exposure. We used somatic mutations detected by genome-wide screens in melanoma and reported in the Catalog Of Somatic Mutations In Cancer. As a measure of UV sensitivity, we used the number of silent mutations generated by C>T transitions in pyrimidine dimers of a given transcript divided by the number of potential sites for this type of mutations in the transcript. We found that human genes varied by UV sensitivity by two orders of magnitude. We noted that the melanoma-associated tumor suppressor gene CDKN2A was among the top five most UV-sensitive genes in the human genome. Melanoma driver genes have a higher UV-sensitivity compared with other genes in the human genome. The difference was more prominent for tumor suppressors compared with oncogene. The results of this study suggest that differential sensitivity of human transcripts to UV light may explain melanoma specificity of some driver genes. Practical significance of the study relates to the fact that differences in UV sensitivity among human genes need to be taken into consideration whereas predicting melanoma-associated genes by the number of somatic mutations detected in a given gene.
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Affiliation(s)
- Ivan P Gorlov
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | | | | | - Colin Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Eva Hernando
- Department of Pathology, New York University School of Medicine, New York, New York
| | - Chao Cheng
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ronglai Shen
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Li Luo
- Department of Internal Medicine and Dermatology, University of New Mexico, Albuquerque, New Mexico
| | - Marc S Ernstoff
- Department of Medical Oncology, Roswell Park Comprehensive Cancer Center, Elm, and Carlton, Buffalo, New York
| | - Joel Parker
- Department of Genetics, Lineberger Comprehensive Cancer Center, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina
| | - Olga Y Gorlova
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
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27
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Ward SV, Gibbs DC, Orlow I, Thomas NE, Kanetsky PA, Luo L, Cust AE, Anton-Culver H, Gruber SB, Gallagher RP, Rosso S, Zanetti R, Dwyer T, Begg CB, Berwick M. Association of IRF4 single-nucleotide polymorphism rs12203592 with melanoma-specific survival. Br J Dermatol 2020; 183:163-165. [PMID: 31958143 PMCID: PMC7334062 DOI: 10.1111/bjd.18881] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- S. V. Ward
- Centre for Genetic Origins of Health and Disease, School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia,Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - D. C. Gibbs
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - I. Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - N. E. Thomas
- Department of Dermatology, School of Medicine and Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - P. A. Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - L. Luo
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - A. E. Cust
- Sydney School of Public Health and The Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia
| | - H. Anton-Culver
- Department of Medicine, University of California, Irvine, California, USA
| | - S. B. Gruber
- Department of Medical Oncology, City of Hope National Medical Center, Duarte, CA, USA
| | - R. P. Gallagher
- British Columbia Cancer Research Centre and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | - S. Rosso
- Piedmont Cancer Registry, Turin, Italy
| | | | - T. Dwyer
- George Institute for Global Health Research, University of Oxford, Oxford, UK,Murdoch Children’s Research Institute, Melbourne, VIC, Australia
| | - C. B. Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - M. Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
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28
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Cust AE, Badcock C, Smith J, Thomas NE, Haydu LE, Armstrong BK, Law MH, Thompson JF, Kanetsky PA, Begg CB, Shi Y, Kricker A, Orlow I, Sharma A, Yoo S, Leong SF, Berwick M, Ollila DW, Lo S. A risk prediction model for the development of subsequent primary melanoma in a population-based cohort. Br J Dermatol 2020; 182:1148-1157. [PMID: 31520533 PMCID: PMC7069770 DOI: 10.1111/bjd.18524] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2019] [Indexed: 01/06/2023]
Abstract
BACKGROUND Guidelines for follow-up of patients with melanoma are based on limited evidence. OBJECTIVES To guide skin surveillance, we developed a risk prediction model for subsequent primary melanomas, using demographic, phenotypical, histopathological, sun exposure and genomic risk factors. METHODS Using Cox regression frailty models, we analysed data for 2613 primary melanomas from 1266 patients recruited to the population-based Genes, Environment and Melanoma study in New South Wales, Australia, with a median of 14 years' follow-up via the cancer registry. Discrimination and calibration were assessed. RESULTS The median time to diagnosis of a subsequent primary melanoma decreased with each new primary melanoma. The final model included 12 risk factors. Harrell's C-statistic was 0·73 [95% confidence interval (CI) 0·68-0·77], 0·65 (95% CI 0·62-0·68) and 0·65 (95% CI 0·61-0·69) for predicting second, third and fourth primary melanomas, respectively. The risk of a subsequent primary melanoma was 4·75 times higher (95% CI 3·87-5·82) for the highest vs. the lowest quintile of the risk score. The mean absolute risk of a subsequent primary melanoma within 5 years was 8·0 ± SD 4.1% after the first primary melanoma, and 46·8 ± 15·0% after the second, but varied substantially by risk score. CONCLUSIONS The risk of developing a subsequent primary melanoma varies considerably between individuals and is particularly high for those with two or more primary melanomas. The risk prediction model and its associated nomograms enable estimation of the absolute risk of subsequent primary melanoma, on the basis of on an individual's risk factors, and can be used to tailor surveillance intensity, communicate risk and provide patient education. What's already known about this topic? Current guidelines for the frequency and length of follow-up to detect new primary melanomas in patients with one or more previous primary melanomas are based on limited evidence. People with one or more primary melanomas have, on average, a higher risk of developing another primary invasive melanoma, compared with the general population, but an accurate way of estimating individual risk is needed. What does this study add? We provide a comprehensive risk prediction model for subsequent primary melanomas, using data from 1266 participants with melanoma (2613 primary melanomas), over a median 14 years' follow-up. The model includes 12 risk factors comprising demographic, phenotypical, histopathological and genomic factors, and sun exposure. It enables estimation of the absolute risk of subsequent primary melanomas, and can be used to tailor surveillance intensity, communicate individual risk and provide patient education.
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Affiliation(s)
- A E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - C Badcock
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - J Smith
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - N E Thomas
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC, U.S.A
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, U.S.A
| | - L E Haydu
- University of Texas MD Anderson Cancer Center, Houston, TX, U.S.A
| | - B K Armstrong
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - M H Law
- Statistical Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - J F Thompson
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - P A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, U.S.A
| | - C B Begg
- Department of Dermatology, University of North Carolina, Chapel Hill, NC, U.S.A
| | - Y Shi
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, NM, U.S.A
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA, U.S.A
| | - A Kricker
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - I Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, U.S.A
| | - A Sharma
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, U.S.A
| | - S Yoo
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, U.S.A
| | - S F Leong
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY, U.S.A
| | - M Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, NM, U.S.A
| | - D W Ollila
- Lineberger Comprehensive Cancer Center, Chapel Hill, NC, U.S.A
- Department of Surgery, University of North Carolina, Chapel Hill, NC, U.S.A
| | - S Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
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29
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Hay JL, Zielaskowski K, Meyer White K, Kaphingst K, Robers E, Guest D, Sussman A, Talamantes Y, Schwartz M, Rodríguez VM, Li Y, Schofield E, Bigney J, Hunley K, Buller D, Berwick M. Interest and Uptake of MC1R Testing for Melanoma Risk in a Diverse Primary Care Population: A Randomized Clinical Trial. JAMA Dermatol 2019; 154:684-693. [PMID: 29801061 DOI: 10.1001/jamadermatol.2018.0592] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Importance Germline variants in the MC1R gene are common and confer moderate melanoma risk in those with varied skin types. Approaches to precision skin cancer prevention that include genetic information may promote risk awareness and risk reduction in the general population, including Hispanics. Objective To examine prevalence of interest in and uptake of MC1R testing in the general population and examine patterns across demographic and skin cancer risk factors. Design, Setting, and Participants A randomized clinical trial examined interest in and uptake of MC1R testing among patients at University of New Mexico General Internal Medicine clinics. Study participants were randomized to either a usual-care condition (National Cancer Institute skin cancer pamphlet for diverse skin types) or an MC1R test offer. Participants were registered clinic patients (≥6 months) and English or Spanish fluent. Of the 600 participants recruited to the overall trial, the present study included those 499 participants randomized to the MC1R test offer. Interventions Participants were presented with the option to log onto the study website to read 3 educational modules presenting the rationale, benefits, and drawbacks of MC1R testing. Main Outcomes and Measures Main outcomes include website log on (yes vs no), saliva test kit request (yes vs no), and saliva test kit return for MC1R testing (yes vs no). Demographic and skin cancer risk factors were examined as potential predictors of test interest and uptake. Results Of the 499 participants (220 [44%] non-Hispanic white, 242 [48%] Hispanic, 396 [79%] female; mean [SD] age, 54 [14.3] years), 232 (46%) elected to learn about MC1R testing by logging onto the website; 204 (88%) of those who logged on decided to request testing; and 167 (82%) of those who requested testing returned the kit. The strongest predictors of website log on were race/ethnicity and education (non-Hispanic whites were more likely to log on [odds ratio for Hispanics vs non-Hispanic whites, 0.5; 95% CI, 0.3-0.7], as were more highly educated individuals [odds ratio for more than high school vs high school or less, 2.7; 95% CI, 1.7-4.3]). The strongest predictor of ordering the test was sunburn history (odds ratio, 5.4; 95% CI, 2.3-12.9 vs no sunburn history). Conclusions and Relevance There were moderately high levels of MC1R test interest and uptake in this diverse sample. Addressing potential barriers to testing may be warranted as genomic information becomes integrated into general population approaches to the precision prevention of skin cancer. Trial Registration ClinicalTrials.gov identifier: NCT03130569.
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Affiliation(s)
- Jennifer L Hay
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kate Zielaskowski
- Clinical Research Finance, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Kirsten Meyer White
- Division of Epidemiology, Department of Internal Medicine, University of New Mexico, Albuquerque
| | - Kimberly Kaphingst
- Department of Communication, University of Utah, Salt Lake City.,Huntsman Cancer Institute, University of Utah, Salt Lake City
| | - Erika Robers
- New Mexico Translation and Transcription, Albuquerque
| | - Dolores Guest
- CRTC Population Sciences Academic Unit, University of New Mexico, Albuquerque
| | - Andrew Sussman
- Department of Family and Community Medicine, University of New Mexico, Albuquerque
| | - Yvonne Talamantes
- CRTC Population Sciences Academic Unit, University of New Mexico, Albuquerque
| | - Matthew Schwartz
- CRTC Population Sciences Academic Unit, University of New Mexico, Albuquerque
| | | | - Yuelin Li
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Elizabeth Schofield
- Department of Psychiatry and Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Jessica Bigney
- Department of General Internal Medicine, University of New Mexico, Albuquerque
| | - Keith Hunley
- Department of Anthropology, University of New Mexico, Albuquerque
| | | | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque.,Department of Dermatology, University of New Mexico, Albuquerque
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White KAM, Dailey YT, Guest DD, Zielaskowski K, Robers E, Sussman A, Hunley K, Hughes CR, Schwartz MR, Kaphingst KA, Buller DB, Hay JL, Berwick M. MC1R Variation in a New Mexico Population. Cancer Epidemiol Biomarkers Prev 2019; 28:1853-1856. [PMID: 31488411 DOI: 10.1158/1055-9965.epi-19-0378] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/10/2019] [Accepted: 08/30/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The Melanocortin 1 Receptor (MC1R) contributes to pigmentation, an important risk factor for developing melanoma. Evaluating SNPs in MC1R and association with race/ethnicity, skin type, and perceived cancer risk in a New Mexico (NM) population will elucidate the role of MC1R in a multicultural population. METHODS We genotyped MC1R in 191 NMs attending a primary care clinic in Albuquerque. We obtained individuals' self-identified race/ethnicity, skin type, and perceived cancer risk. We defined genetic risk as carriage of any one or more of the nine most common SNPs in MC1R. RESULTS We found that one MC1R SNP, R163Q (rs885479), was identified in 47.6% of self-identified Hispanics and 12.9% of non-Hispanic whites (NHW), making Hispanics at higher "genetic risk" (as defined by carrying one of the MC1R common variants). When we deleted R163Q from analyses, Hispanics were no longer at higher genetic risk (33.3%) compared with NHW (48.3%), consistent with melanoma rates, tanning ability, and lower perceived risk. Hispanics had a perceived risk significantly lower than NHW and a nonsignificant better tanning ability than NHW. CONCLUSIONS The R163Q variant in MC1R may not be a risk factor for melanoma among NM Hispanics. This suggestion points to the need to carefully interpret genetic risk factors among specific populations. IMPACT Genetic risk cannot be extrapolated from Northern European populations directly to non-European populations.
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Affiliation(s)
- Kirsten A M White
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Yvonne T Dailey
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico
| | - Dolores D Guest
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Kate Zielaskowski
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Erika Robers
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Andrew Sussman
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | - Keith Hunley
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico
| | | | - Matthew R Schwartz
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
| | | | | | - Jennifer L Hay
- Department of Psychiatry & Behavioral Sciences, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque, New Mexico. .,Comprehensive Cancer Center, University of New Mexico, Albuquerque, New Mexico
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Hay JL, Meyer White K, Sussman A, Kaphingst K, Guest D, Schofield E, Dailey YT, Robers E, Schwartz MR, Zielaskowski K, Li Y, Buller D, Hunley K, Berwick M. Psychosocial and Cultural Determinants of Interest and Uptake of Skin Cancer Genetic Testing in Diverse Primary Care. Public Health Genomics 2019; 22:58-68. [PMID: 31437847 DOI: 10.1159/000501985] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 07/07/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Translational research in genomics has limited reach and requires efforts to broaden access and utility in diverse populations. Skin cancer is common and rates are rising, including among Hispanics. Germline variants in the melanocortin-1 receptor (MC1R) gene are common in the population and confer moderate risk for melanoma and basal cell cancers across skin types. Feedback about MC1R risk status may promote skin cancer risk awareness and risk reduction. AIMS We examined the level of interest in pursuing MC1R testing, and patterns of interest across skin cancer perceived threat and control attitudes, cultural beliefs (family influence on health, health system distrust, cancer fatalism, skin cancer misconceptions), and health literacy. METHODS We used a study website to inform primary care patients in Albuquerque, NM about the benefits and drawbacks of MC1R testing. Website logon, request of a saliva test kit, and return of the test kit (yes vs. no) were primary assessments of study interest and uptake. RESULTS Of 499 participants provided with a test offer, 33% requested and returned the test. Lower family influence on participants' health was an important factor both overall and within ethnicity subgroups, and may indicate that primary care patients interested in skin cancer genetic testing see themselves as proactive health seekers, independent from family encouragement. Lower self-efficacy for skin cancer prevention was also an important characteristic of those who tested. CONCLUSION As evidence for common genetic markers for skin cancer accumulates, these findings suggest characteristics of those most likely to pursue genetic testing for skin cancer risk.
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Affiliation(s)
- Jennifer L Hay
- Memorial Sloan Kettering Cancer Center, New York, New York, USA,
| | | | | | - Kim Kaphingst
- Huntsman Cancer Center, University of Utah, Salt Lake City, Utah, USA
| | - Dolores Guest
- University of New Mexico, Albuquerque, New Mexico, USA
| | | | | | - Erika Robers
- University of New Mexico, Albuquerque, New Mexico, USA
| | | | | | - Yuelin Li
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | - Keith Hunley
- University of New Mexico, Albuquerque, New Mexico, USA
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Schwartz MR, Luo L, Berwick M. Abstract 3419: Sex, mutations, and mortality in early stage melanoma. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-3419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Our goal is to investigate the relationship between sex, tumor mutation burden (TMB) and survival in untreated primary melanoma tumors, using data collected in an ongoing large P01 study on the Integration of Clinical and Molecular Biomarkers for Melanoma Survival (InterMEL). Here we present preliminary findings on sex, survival, and somatic TMB from 60 Stage II and Stage III primary melanoma tumors, none of which have received immunotherapy using the MSK IMPACT™ next generation sequencing assay. Our preliminary analysis includes 30 patients who died within 5 years (median survival of 31 months) and 30 patients who lived for more than 5 years since diagnosis (median follow-up of 86 months). We found the expected relationship between TMB and better survival in a univariate Cox regression analysis (HR=0.43, 95% CI=0.19 to 0.97, P=0.04), but no evidence of association between TMB and sex (Wilcoxon rank-sum test P=0.7) or any relationship between sex and survival (logrank test P=0.42).
Our study is the first to investigate the relationship between sex, tumor mutational burden, and mortality in an early stage primary cohort that has not received immunotherapy. In our small sample, we observed the expected protective effect of TMB on survival, but no evidence of gender differences in TMB or survival. This is surprising given the robust, consistent, and well-documented female survival advantage (Roh et al., 2015; de Vries et al., 2008), and merits further investigation. Our results are an important first step to increasing our understanding of the relationship between mutational burden, survival, and biological sex.
References
Roh, M.R., Eliades, P., Gupta, S., Grant-Kels, J.M., and Tsao, H. (2015). Cutaneous melanoma in women. Int. J. Womens Dermatol. 1, 21–25.
de Vries, E., Nijsten, T.E.C., Visser, O., Bastiaannet, E., van Hattem, S., Janssen-Heijnen, M.L., and Coebergh, J.-W.W. (2008). Superior survival of females among 10
538 Dutch melanoma patients is independent of Breslow thickness, histologic type and tumor site. Ann. Oncol. 19, 583–589.
Citation Format: Matthew R. Schwartz, Li Luo, Marianne Berwick. Sex, mutations, and mortality in early stage melanoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3419.
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Affiliation(s)
| | - Li Luo
- University of New Mexico, Albuquerque, NM
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Abstract
PURPOSE OF REVIEW The goal of this review has been to elucidate the sex differences in cancer incidence and mortality in cutaneous melanoma. We have evaluated biological and behavioral research to determine where the critical questions exist. RECENT FINDINGS The most recent findings, through 2015, are exploratory in nature but seem to indicate that the differences are more likely due to biological variations rather than behavioral. While behavioral studies do show that women are more likely than men to seek health care and practice healthy behaviors, these differences are not sufficiently strong to explain the variation in incidence and mortality in cutaneous melanoma. Evolved differences in the immune systems of females and the role of sex steroid hormones in immunomodulation are two promising avenues for research. Studies in mice demonstrate that the newer immunotherapies are more effective in females and sex steroid hormones, such as estrogen receptor beta are inversely associated with tumor aggressiveness while testosterone increases it. SUMMARY Our analysis indicates that biological factors need to be investigated more thoroughly to understand the variation in incidence and mortality in cutaneous melanoma. Such understanding could lead to reducing incidence and mortality for both males and females (male incidence is 27.4 per 100,000; female 16.8 per 100,000; male mortality is 3.9 per 100,000; female mortality 1.6 per 100,000). It is most likely that behavioral differences between the sexes cannot account for the preponderance of male mortality. In addition to the important role of genetic factors, it is critical to evaluate further additional biological factors and their interactions with genetics and behavior.
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Affiliation(s)
| | - Li Luo
- University of New Mexico Comprehensive Cancer Center, Department of Internal Medicine
| | - Marianne Berwick
- University of New Mexico Comprehensive Cancer Center, Department of Internal Medicine and Department of Dermatology
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Miles JA, Orlow I, Kanetsky PA, Luo L, Cust AE, Armstrong BK, Kricker A, Anton-Culver H, Gruber SB, Gallagher RP, Zanetti R, Rosso S, Sacchetto L, Dwyer T, Gibbs DC, Busam KJ, Mavinkurve V, Ollila DW, Begg CB, Berwick M, Thomas NE. Relationship of Chromosome Arm 10q Variants to Occurrence of Multiple Primary Melanoma in the Population-Based Genes, Environment, and Melanoma (GEM) Study. J Invest Dermatol 2019; 139:1410-1412. [PMID: 30571972 PMCID: PMC6535117 DOI: 10.1016/j.jid.2018.11.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2018] [Accepted: 11/28/2018] [Indexed: 11/26/2022]
Affiliation(s)
- Jonathan A Miles
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Anne E Cust
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Melanoma Institute Australia, The University of Sydney, North Sydney, Australia
| | - Bruce K Armstrong
- School of Public and Global Health, The University of Western Australia, Perth, Australia
| | - Anne Kricker
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, California, USA
| | - Stephen B Gruber
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - Richard P Gallagher
- British Columbia Cancer and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Lidia Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy; Politecnico di Torino, Turin, Italy
| | - Terence Dwyer
- George Institute for Global Health, Nuffield Department of Obstetrics and Gynecology, University of Oxford, Oxford, UK
| | - David C Gibbs
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Vikram Mavinkurve
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - David W Ollila
- Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York, USA
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.
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Pellegrini C, Botta F, Massi D, Martorelli C, Facchetti F, Gandini S, Maisonneuve P, Avril MF, Demenais F, Bressac-de Paillerets B, Hoiom V, Cust AE, Anton-Culver H, Gruber SB, Gallagher RP, Marrett L, Zanetti R, Dwyer T, Thomas NE, Begg CB, Berwick M, Puig S, Potrony M, Nagore E, Ghiorzo P, Menin C, Manganoni AM, Rodolfo M, Brugnara S, Passoni E, Sekulovic LK, Baldini F, Guida G, Stratigos A, Ozdemir F, Ayala F, Fernandez-de-Misa R, Quaglino P, Ribas G, Romanini A, Migliano E, Stanganelli I, Kanetsky PA, Pizzichetta MA, García-Borrón JC, Nan H, Landi MT, Little J, Newton-Bishop J, Sera F, Fargnoli MC, Raimondi S. MC1R variants in childhood and adolescent melanoma: a retrospective pooled analysis of a multicentre cohort. Lancet Child Adolesc Health 2019; 3:332-342. [PMID: 30872112 PMCID: PMC6942319 DOI: 10.1016/s2352-4642(19)30005-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 12/10/2018] [Accepted: 12/21/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND Germline variants in the melanocortin 1 receptor gene (MC1R) might increase the risk of childhood and adolescent melanoma, but a clear conclusion is challenging because of the low number of studies and cases. We assessed the association of MC1R variants with childhood and adolescent melanoma in a large study comparing the prevalence of MC1R variants in child or adolescent patients with melanoma to that in adult patients with melanoma and in healthy adult controls. METHODS In this retrospective pooled analysis, we used the M-SKIP Project, the Italian Melanoma Intergroup, and other European groups (with participants from Australia, Canada, France, Greece, Italy, the Netherlands, Serbia, Spain, Sweden, Turkey, and the USA) to assemble an international multicentre cohort. We gathered phenotypic and genetic data from children or adolescents diagnosed with sporadic single-primary cutaneous melanoma at age 20 years or younger, adult patients with sporadic single-primary cutaneous melanoma diagnosed at age 35 years or older, and healthy adult individuals as controls. We calculated odds ratios (ORs) for childhood and adolescent melanoma associated with MC1R variants by multivariable logistic regression. Subgroup analysis was done for children aged 18 or younger and 14 years or younger. FINDINGS We analysed data from 233 young patients, 932 adult patients, and 932 healthy adult controls. Children and adolescents had higher odds of carrying MC1R r variants than did adult patients (OR 1·54, 95% CI 1·02-2·33), including when analysis was restricted to patients aged 18 years or younger (1·80, 1·06-3·07). All investigated variants, except Arg160Trp, tended, to varying degrees, to have higher frequencies in young patients than in adult patients, with significantly higher frequencies found for Val60Leu (OR 1·60, 95% CI 1·05-2·44; p=0·04) and Asp294His (2·15, 1·05-4·40; p=0·04). Compared with those of healthy controls, young patients with melanoma had significantly higher frequencies of any MC1R variants. INTERPRETATION Our pooled analysis of MC1R genetic data of young patients with melanoma showed that MC1R r variants were more prevalent in childhood and adolescent melanoma than in adult melanoma, especially in patients aged 18 years or younger. Our findings support the role of MC1R in childhood and adolescent melanoma susceptibility, with a potential clinical relevance for developing early melanoma detection and preventive strategies. FUNDING SPD-Pilot/Project-Award-2015; AIRC-MFAG-11831.
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Affiliation(s)
- Cristina Pellegrini
- Department of Dermatology and Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Francesca Botta
- Division of Epidemiology and Biostatistics, European Institute of Oncology IRCCS, Milan, Italy; Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Milan, Italy
| | - Daniela Massi
- Division of Pathological Anatomy, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Claudia Martorelli
- Department of Dermatology and Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Fabio Facchetti
- Pathology Section, Department of Molecular and Translational Medicine, Spedali Civili di Brescia, University of Brescia, Brescia, Italy
| | - Sara Gandini
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, European Institute of Oncology IRCCS, Milan, Italy
| | - Marie-Françoise Avril
- APHP, Dermatology Department, Hôpital Cochin and Paris Descartes University, Paris, France
| | - Florence Demenais
- Genetic Variation and Human Diseases Unit (UMR-946), Institut National de la Santé et de la Recherche Médicale (INSERM), Paris, France
| | | | - Veronica Hoiom
- Department of Oncology and Pathology, Cancer Centre, Karolinska Institutet, Stockholm, Sweden
| | - Anne E Cust
- Sydney School of Public Health and Melanoma Institute Australia, University of Sydney, Sydney, NSW, Australia
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, CA, USA
| | - Stephen B Gruber
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Richard P Gallagher
- British Columbia Cancer and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, BC, Canada
| | | | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Terence Dwyer
- George Institute for Global Health, Nuffield Department of Obstetrics and Gynaecology, University of Oxford, Oxford, UK
| | - Nancy E Thomas
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, USA
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Susana Puig
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer, and CIBER de Enfermedades Raras, Barcelona, Spain
| | - Miriam Potrony
- Melanoma Unit, Dermatology Department, Hospital Clinic Barcelona, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi I Sunyer, and CIBER de Enfermedades Raras, Barcelona, Spain
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncologia, Valencia, Spain
| | - Paola Ghiorzo
- Department of Internal Medicine and Medical Specialties, University of Genoa and Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Menin
- Diagnostic Immunology and Molecular Oncology Unit, Veneto Institute of Oncology, IOV-IRCCS, Padua, Italy
| | | | - Monica Rodolfo
- Department of Research, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Emanuela Passoni
- Department of Pathophysiology and Transplantation, University of Milan, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Federica Baldini
- Division of Melanoma, Sarcoma and Rare Cancer, European Institute of Oncology IRCCS, Milan, Italy
| | - Gabriella Guida
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Alexandros Stratigos
- 1st Department of Dermatology, Andreas Sygros Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Fezal Ozdemir
- Department of Dermatology, Faculty of Medicine, University of Ege, Izmir, Turkey
| | - Fabrizio Ayala
- Melanoma Unit, Cancer Immunotherapy and Innovative Therapies, IRCCS Istituto Nazionale dei Tumori, Fondazione G Pascale, Napoli, Italia
| | - Ricardo Fernandez-de-Misa
- Dermatology Service, University Hospital Nuestra Senora de Candelaria, Santa Cruz de Tenerife, Spain
| | - Pietro Quaglino
- Dermatologic Clinic, Department of Medical Sciences, University of Torino, Turin, Italy
| | - Gloria Ribas
- Department of Medical Oncology and Haematology, Fundación Investigación Clínico de Valencia, INCLIVA Instituto de Investigación Sanitaria, Valencia, Spain
| | - Antonella Romanini
- US Ambulatori Melanomi, Sarcomi e Tumori Rari, UO Oncologia Medica 1, Azienda Ospedaliero-Universitaria Santa Chiara, Pisa, Italy
| | - Emilia Migliano
- Plastic Surgery, San Gallicano Dermatological Institute, IRCCS, Rome, Italy
| | - Ignazio Stanganelli
- Skin Cancer Unit, IRCCS Scientific Institute of Romagna for the Study and Treatment of Cancer and University of Parma, Meldola, Italy
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, H Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | | | - Jose Carlos García-Borrón
- Department of Biochemistry, Molecular Biology, and Immunology, University of Murcia and IMIB-Arrixaca, Murcia, Spain
| | - Hongmei Nan
- Department of Epidemiology, Richard M Fairbanks School of Public Health, Melvin & Bren Simon Cancer Center, Indiana University, Indianapolis, IN, USA
| | - Maria Teresa Landi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Julian Little
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Julia Newton-Bishop
- Section of Epidemiology and Biostatistics, Institute of Medical Research at St James', University of Leeds, Leeds, UK
| | - Francesco Sera
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, UK
| | - Maria Concetta Fargnoli
- Department of Dermatology and Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Sara Raimondi
- Molecular and Pharmaco-Epidemiology Unit, Department of Experimental Oncology, European Institute of Oncology IRCCS, Milan, Italy.
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Mishra K, Barnhill RL, Paddock LE, Fine JA, Berwick M. Histopathologic variables differentially affect melanoma survival by age at diagnosis. Pigment Cell Melanoma Res 2019; 32:593-600. [PMID: 30706692 DOI: 10.1111/pcmr.12770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 12/14/2018] [Accepted: 01/21/2019] [Indexed: 11/30/2022]
Abstract
We evaluated clinical, phenotypic, behavioral, and histopathologic variables in relationship to melanoma-specific survival by age at diagnosis among 650 population-based melanoma patients in Connecticut, with 20 years of follow-up. Only one variable, skin awareness, was significantly associated with melanoma mortality in both groups. The variables that differed between the age-groups were anatomic site, Breslow thickness, histologic subtype, mitoses, tumor-infiltrating lymphocytes (TILs), and solar elastosis. Head and neck melanoma, Breslow thickness, nodular melanoma, and solar elastosis were all significantly more likely to be associated with mortality among the older subjects; among the younger subjects, the presence of mitoses was associated with an increased probability of dying and TILs were associated with a reduced risk of mortality.
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Affiliation(s)
- Kriti Mishra
- School of Medicine, University of New Mexico, Albuquerque, New Mexico
| | | | - Lisa E Paddock
- Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey
| | | | - Marianne Berwick
- School of Medicine, University of New Mexico, Albuquerque, New Mexico
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Abstract
Melanoma rates have increased in populations that are mainly European. The main etiologic factor is ultraviolet radiation, from the sun as well as artificial tanning devices. Host factors such as skin color, number of nevi, hair and eye color and tanning ability are critical factors in modifying an individual's response to the sun. Genetic factors interact with host factors and environmental factors to increase risk. This review summarizes our current knowledge of environment and genetics on melanoma risk and on gene-environment interaction.
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Affiliation(s)
- Anne E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Australia
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Asdigian NL, Barón AE, Morelli JG, Mokrohisky ST, Aalborg J, Dellavalle RP, Daley MF, Berwick M, Muller KE, Box NF, Crane LA. Trajectories of Nevus Development From Age 3 to 16 Years in the Colorado Kids Sun Care Program Cohort. JAMA Dermatol 2018; 154:1272-1280. [PMID: 30208471 PMCID: PMC6248123 DOI: 10.1001/jamadermatol.2018.3027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Accepted: 07/13/2018] [Indexed: 11/14/2022]
Abstract
Importance Nevi are a risk factor for melanoma and other forms of skin cancer, and many of the same factors confer risk for both. Understanding childhood nevus development may provide clues to possible causes and prevention of melanoma. Objectives To describe nevus acquisition from the ages of 3 to 16 years among white youths and evaluate variation by sex, Hispanic ethnicity, and body sites that are chronically vs intermittently exposed to the sun. Design, Setting, and Participants This annual longitudinal observational cohort study of nevus development was conducted between June 1, 2001, and October 31, 2014, among 1085 Colorado youths. Data analysis was conducted between February 1, 2015, and August 31, 2017. Main Outcomes and Measures Total nevus counts on all body sites and on sites chronically and intermittently exposed to the sun separately. Results A total of 557 girls and 528 boys (150 [13.8%] Hispanic participants) born in 1998 were included in this study. Median total body nevus counts increased linearly among non-Hispanic white boys and girls between the age of 3 years (boys, 6.31; 95% CI, 5.66-7.03; and girls, 6.61; 95% CI, 5.96-7.33) and the age of 16 years (boys, 81.30; 95% CI, 75.95-87.03; and girls, 77.58; 95% CI, 72.68-82.81). Median total body nevus counts were lower among Hispanic white children (boys aged 16 years, 51.45; 95% CI, 44.01-60.15; and girls aged 16 years, 53.75; 95% CI, 45.40-63.62) compared with non-Hispanic white children, but they followed a largely linear trend that varied by sex. Nevus counts on body sites chronically exposed to the sun increased over time but leveled off by the age of 16 years. Nevus counts on sites intermittently exposed to the sun followed a strong linear pattern through the age of 16 years. Hispanic white boys and girls had similar nevus counts on sites intermittently exposed to the sun through the age of 10 years, but increases thereafter were steeper for girls, with nevus counts surpassing those of boys aged 11 to 16 years. Conclusions and Relevance Youths are at risk for nevus development beginning in early childhood and continuing through midadolescence. Patterns of nevus acquisition differ between boys and girls, Hispanic and non-Hispanic white youths, and body sites that are chronically exposed to the sun and body sites that are intermittently exposed to the sun. Exposure to UV light during this period should be reduced, particularly on body sites intermittently exposed to the sun, where nevi accumulate through midadolescence in all children. Increased attention to sun protection appears to be merited for boys, in general, because they accumulated more nevi overall, and for girls, specifically, during the adolescent years.
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Affiliation(s)
- Nancy L. Asdigian
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Anna E. Barón
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Joseph G. Morelli
- Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
| | | | - Jenny Aalborg
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Robert P. Dellavalle
- Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
- Dermatology Service, US Department of Veterans Affairs Rocky Mountain Regional Medical Center, Aurora, Colorado
| | - Matthew F. Daley
- Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Institute for Health Research, Kaiser Permanente Colorado, Aurora
| | - Marianne Berwick
- Department of Internal Medicine, School of Medicine, University of New Mexico, Albuquerque
- Department of Dermatology, School of Medicine, University of New Mexico, Albuquerque
| | - Keith E. Muller
- Health Outcomes & Biomedical Informatics, College of Medicine, University of Florida, Gainesville
| | - Neil F. Box
- Department of Dermatology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
| | - Lori A. Crane
- Department of Community and Behavioral Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora
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Thomas NE, Edmiston SN, Orlow I, Kanetsky PA, Luo L, Gibbs DC, Parrish EA, Hao H, Busam KJ, Armstrong BK, Kricker A, Cust AE, Anton-Culver H, Gruber SB, Gallagher RP, Zanetti R, Rosso S, Sacchetto L, Dwyer T, Ollila DW, Begg CB, Berwick M, Conway K. Inherited Genetic Variants Associated with Melanoma BRAF/NRAS Subtypes. J Invest Dermatol 2018; 138:2398-2404. [PMID: 29753029 PMCID: PMC6200630 DOI: 10.1016/j.jid.2018.04.025] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 04/08/2018] [Indexed: 10/16/2022]
Abstract
BRAF and NRAS mutations arise early in melanoma development, but their associations with low-penetrance melanoma susceptibility loci remain unknown. In the Genes, Environment and Melanoma Study, 1,223 European-origin participants had their incident invasive primary melanomas screened for BRAF/NRAS mutations and germline DNA genotyped for 47 single-nucleotide polymorphisms identified as low-penetrant melanoma-risk variants. We used multinomial logistic regression to simultaneously examine each single-nucleotide polymorphism's relationship to BRAF V600E, BRAF V600K, BRAF other, and NRAS+ relative to BRAF-/NRAS- melanoma adjusted for study features. IRF4 rs12203592*T was associated with BRAF V600E (odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.43-0.79) and V600K (OR = 0.65, 95% CI = 0.41-1.03), but not BRAF other or NRAS+ melanoma. A global test of etiologic heterogeneity (Pglobal = 0.001) passed false discovery (Pglobal = 0.0026). PLA2G6 rs132985*T was associated with BRAF V600E (OR = 1.32, 95% CI = 1.05-1.67) and BRAF other (OR = 1.82, 95% CI = 1.11-2.98), but not BRAF V600K or NRAS+ melanoma. The test for etiologic heterogeneity (Pglobal) was 0.005. The IRF4 rs12203592 associations were slightly attenuated after adjustment for melanoma-risk phenotypes. The PLA2G6 rs132985 associations were independent of phenotypes. IRF4 and PLA2G6 inherited genotypes may influence melanoma BRAF/NRAS subtype development.
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Affiliation(s)
- Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA.
| | - Sharon N Edmiston
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - David C Gibbs
- Department of Epidemiology, Emory University, Atlanta, Georgia, USA
| | - Eloise A Parrish
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Honglin Hao
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Bruce K Armstrong
- School of Public and Global Health, The University of Western Australia, Perth, Australia
| | - Anne Kricker
- Sydney School of Public Health, The University of Sydney, Sydney, Australia
| | - Anne E Cust
- Sydney School of Public Health, The University of Sydney, Sydney, Australia; Melanoma Institute Australia, The University of Sydney, North Sydney, Australia
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, California, USA
| | - Stephen B Gruber
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
| | - Richard P Gallagher
- British Columbia Cancer and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Lidia Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy; Politecnico di Torino, Turin, Italy
| | - Terence Dwyer
- George Institute for Global Health, Nuffield Department of Obstetrics and Gynecology, University of Oxford, Oxford, UK
| | - David W Ollila
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Surgery, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, New Mexico, USA
| | - Kathleen Conway
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina, USA; Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, North Carolina, USA; Department of Epidemiology, University of North Carolina, Chapel Hill, North Carolina, USA
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40
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Zhao Y, Schaafsma E, Gorlov IP, Hernando E, Thomas NE, Shen R, Turk MJ, Berwick M, Amos CI, Cheng C. A Leukocyte Infiltration Score Defined by a Gene Signature Predicts Melanoma Patient Prognosis. Mol Cancer Res 2018; 17:109-119. [PMID: 30171176 DOI: 10.1158/1541-7786.mcr-18-0173] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 06/27/2018] [Accepted: 08/20/2018] [Indexed: 12/21/2022]
Abstract
Melanoma is the most aggressive type of skin cancer in the United States with an increasing incidence. Melanoma lesions often exhibit high immunogenicity, with infiltrating immune cells playing important roles in regression of tumors occurring spontaneously or caused by therapeutic treatment. Computational and experimental methods have been used to estimate the abundance of immune cells in tumors, but their applications are limited by the requirement of large gene sets or multiple antibodies. Although the prognostic role of immune cells has been appreciated, a systematic investigation of their association with clinical factors, genomic features, prognosis and treatment response in melanoma is still lacking. This study, identifies a 25-gene signature based on RNA-seq data from The Cancer Genome Atlas (TCGA)-Skin Cutaneous Melanoma (TCGA-SKCM) dataset. This signature was used to calculate sample-specific Leukocyte Infiltration Scores (LIS) in six independent melanoma microarray datasets and scores were found to vary substantially between different melanoma lesion sites and molecular subtypes. For metastatic melanoma, LIS was prognostic in all datasets with high LIS being associated with good survival. The current approach provided additional prognostic information over established clinical factors, including age, tumor stage, and gender. In addition, LIS was predictive of patient survival in stage III melanoma, and treatment efficacy of tumor-specific antigen vaccine. IMPLICATIONS: This study identifies a 25-gene signature that effectively estimates the level of immune cell infiltration in melanoma, which provides a robust biomarker for predicting patient prognosis.
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Affiliation(s)
- Yanding Zhao
- Department of Biomedical Data Science, The Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire.,Department of Molecular and Systems Biology, The Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire
| | - Evelien Schaafsma
- Department of Biomedical Data Science, The Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire.,Department of Molecular and Systems Biology, The Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire
| | - Ivan P Gorlov
- Norris Cotton Cancer Center, The Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire
| | - Eva Hernando
- Department of Pathology, New York University School of Medicine, New York, New York
| | - Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina
| | - Ronglai Shen
- Department of Neurology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mary Jo Turk
- Norris Cotton Cancer Center, The Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire.,Department of Microbiology and Immunology, The Geisel School of Medicine at Dartmouth College, New Hampshire
| | - Marianne Berwick
- Department of Internal Medicine and Department of Dermatology, University of New Mexico, Albuquerque, New Mexico
| | | | - Chao Cheng
- Department of Biomedical Data Science, The Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire. .,Department of Molecular and Systems Biology, The Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire.,Norris Cotton Cancer Center, The Geisel School of Medicine at Dartmouth College, Lebanon, New Hampshire
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41
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Berwick M, Gorlov IP, Orlow I, Ringelberg C, Ernstoff M, Parker J, Gerstenblith M, Thompson C, Hernando E, Busam K, Lezcano C, Corrales S, Leong S, Thomas NE, Amos CI. Abstract 3682: Expression levels of genes in primary melanoma associated with clinically meaningful characteristics. Cancer Res 2018. [DOI: 10.1158/1538-7445.am2018-3682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Melanoma survival appears to be improving; however, between 13-68% of individuals with melanoma diagnosed with Stages II-III ultimately die from their melanoma. Factors influencing melanoma survival include sex, age, clinical stage, lymph node involvement and several primary tumor characteristics, such as Breslow thickness, presence of infiltrating lymphocytes (TILs), mitotic rate and ulceration. Identification of genes whose expression in primary tumors is associated with these key tumor/patient characteristics can shed light on molecular mechanisms of melanoma survival. Here we show results from a gene expression analysis of 32 formalin-fixed, paraffin embedded (FFPE) primary melanomas with extensive clinical annotation. We extracted RNA, and measured the expression of 760 genes selected based on published evidence of association with melanoma initiation or outcome using NanoString. The Cancer Genome Atlas (TCGA) data on primary melanomas was used for validation of nominally significant associations. We identified 5 genes that were significantly associated with the presence of TILs in the combined analysis of both datasets after adjustment for multiple testing using the Benjamini-Hochberg false discovery rate method: IL1R2, PPL, PLA2G3, RASAL1, and SGK2. We also identified two genes significantly associated with lymph node status (PIK3CG and IL2RA), and two genes significantly associated with sex (KDM5C and KDM6A). We found that LEF1 was significantly associated with Breslow thickness and CCNA2 with mitosis. These results demonstrate that genetic expression in primary tumors is associated with clinically meaningful characteristics of cutaneous melanoma.
Citation Format: Marianne Berwick, Ivan P. Gorlov, Irene Orlow, Carol Ringelberg, Marc Ernstoff, Joel Parker, Meg Gerstenblith, Cheryl Thompson, Eva Hernando, Klaus Busam, Cecilia Lezcano, Sergio Corrales, Siok Leong, Nancy E. Thomas, Christopher I. Amos. Expression levels of genes in primary melanoma associated with clinically meaningful characteristics [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 3682.
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Affiliation(s)
- Marianne Berwick
- 1Univ. of New Mexico Health Sciences Ctr. - Albuquerque, Albuquerque, NM
| | | | - Irene Orlow
- 3Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Joel Parker
- 5University of North Carolina, Chapel Hill, NC
| | | | | | - Eva Hernando
- 8New York University Medical Center, New Yrok, NY
| | - Klaus Busam
- 9Memorial Sloan Kettering Cancer Center, New Yrok, NY
| | | | | | - Siok Leong
- 3Memorial Sloan Kettering Cancer Center, New York, NY
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42
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Mishra K, Berwick M. 168 The IRF4 single nucleotide polymorphism rs12203592 Is associated with stage and anatomic site In melanoma. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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43
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Erdal S, McCarthy BJ, Gurule N, Berwick M, Gonzales E, Byrd J, Flores K, Shimek J, Il'yasova D, Ali-Osman F, Bigner DD, Davis FG, Leyba AN, White KAM. Application of mutagen sensitivity assay in a glioma case-control study. Toxicol Rep 2018; 5:183-188. [PMID: 29854587 PMCID: PMC5977159 DOI: 10.1016/j.toxrep.2017.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 12/07/2017] [Accepted: 12/08/2017] [Indexed: 12/03/2022] Open
Abstract
MSA is an appropriate molecular epidemiology tool in case control studies. Case-control status/exposure categories are not associated with the number of breaks. Cell lines of glioma patients did not show reduced DNA repair capacity in response to acrylamide in the MSA assay.
Few risk factors for glioma have been identified other than ionizing radiation. The alkylating agent acrylamide is a compound found in both occupational and the general environment and identified as one of the forty known or suspected neurocarcinogens in animal models. The mutagen sensitivity assay (MSA) has been used to indirectly show reduced DNA repair capacity upon exposure to ionizing radiation in those with glioma compared to controls. In this study, MSA was used to assess its applicability to a glioma case-control study and to test the hypothesis that subjects with glioma may have lower DNA repair capacity after exposure to selected potential human neurocarcinogens (i.e. acrylamide), compared to controls. Approximately 50 case and 50 control subjects were identified from a clinic-based study that investigated environmental risk factors for glioma, who completed an exposure survey, and had frozen immortalized lymphocytes available. A total of 50 metaphase spreads were read and reported for each participant. The association of case-control status with MSA for acrylamide, i.e. breaks per spread, was examined by multivariable logistic regression models. The mean number of breaks per slide was similar between hospital-based controls and cases. In addition, case-control status or exposure categories were not associated with the number of breaks per spread. Although the MSA has been shown as a useful molecular epidemiology tool for identifying individuals at higher risk for cancer, our data do not support the hypothesis that glioma patients have reduced DNA repair capacity in response to exposure to acrylamide. Further research is needed before the MSA is utilized in large-scale epidemiological investigations of alkylating agents.
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Affiliation(s)
- Serap Erdal
- Divisions of Environmental, Occupational Health Science, University of Illinois at Chicago, Chicago, IL, United States
| | - Bridget J McCarthy
- Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States.,University of Illinois at Chicago Cancer Center, University of Illinois at Chicago, Chicago, IL, United States
| | - Natalia Gurule
- Department of Cancer Biology, University of Colorado Anschutz Medical Campus, United States
| | - Marianne Berwick
- Molecular Epidemiology Lab, University of New Mexico, Albuquerque, NM, United States.,Division of Epidemiology, University of New Mexico, Albuquerque, NM, United States
| | - Emily Gonzales
- Molecular Epidemiology Lab, University of New Mexico, Albuquerque, NM, United States
| | - Johanna Byrd
- Molecular Epidemiology Lab, University of New Mexico, Albuquerque, NM, United States
| | - Kristina Flores
- UNM Cancer Center, University of New Mexico, Albuquerque, NM, United States
| | - JoAnna Shimek
- Department of Environmental Health, Indiana University Bloomington, IN, United States
| | - Dora Il'yasova
- Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, NC, United States.,Preston Robert Tisch Brain Tumor Center at Duke, Duke University Medical Center, Durham, NC, United States
| | - Francis Ali-Osman
- Department of Surgery, Duke University Medical Center, Durham, NC, United States.,Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, NC, United States.,Preston Robert Tisch Brain Tumor Center at Duke, Duke University Medical Center, Durham, NC, United States.,Pediatric Brain Tumor Foundation Institute at Duke, Duke University Medical Center, Durham, NC, United States
| | - Darell D Bigner
- Department of Pathology, Duke University Medical Center, Durham, NC, United States.,Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, NC, United States.,Preston Robert Tisch Brain Tumor Center at Duke, Duke University Medical Center, Durham, NC, United States.,Pediatric Brain Tumor Foundation Institute at Duke, Duke University Medical Center, Durham, NC, United States
| | - Faith G Davis
- Epidemiology and Biostatistics, University of Illinois at Chicago, Chicago, IL, United States.,University of Illinois at Chicago Cancer Center, University of Illinois at Chicago, Chicago, IL, United States.,School of Public Health, University of Alberta, Edmonton, Alberta, Canada
| | - Alexis N Leyba
- UNM Cancer Center, University of New Mexico, Albuquerque, NM, United States
| | - Kirsten A M White
- Molecular Epidemiology Lab, University of New Mexico, Albuquerque, NM, United States
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Orlow I, Shi Y, Kanetsky PA, Thomas NE, Luo L, Corrales-Guerrero S, Cust AE, Sacchetto L, Zanetti R, Rosso S, Armstrong BK, Dwyer T, Venn A, Gallagher RP, Gruber SB, Marrett LD, Anton-Culver H, Busam K, Begg CB, Berwick M. The interaction between vitamin D receptor polymorphisms and sun exposure around time of diagnosis influences melanoma survival. Pigment Cell Melanoma Res 2017; 31:287-296. [PMID: 28990310 DOI: 10.1111/pcmr.12653] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 09/28/2017] [Indexed: 12/17/2022]
Abstract
Evidence on the relationship between the vitamin D pathway and outcomes in melanoma is growing, although it is not always clear. We investigated the impact of measured levels of sun exposure at diagnosis on associations of vitamin D receptor gene (VDR) polymorphisms and melanoma death in 3336 incident primary melanoma cases. Interactions between six SNPs and a common 3'-end haplotype were significant (p < .05). These SNPs, and a haplotype, had a statistically significant association with survival among subjects exposed to high UVB in multivariable regression models and exerted their effect in the opposite direction among those with low UVB. SNPs rs1544410/BsmI and rs731236/TaqI remained significant after adjustment for multiple testing. These results suggest that the association between VDR and melanoma-specific survival is modified by sun exposure around diagnosis, and require validation in an independent study. Whether the observed effects are dependent or independent of vitamin D activation remains to be determined.
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Affiliation(s)
- Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Yang Shi
- Biostatistics Shared Resource, University of New Mexico Comprehensive Cancer Center, Albuquerque, NM, USA
| | - Peter A Kanetsky
- Department of Cancer Epidemiology, Moffitt Cancer Center, Tampa, FL, USA
| | - Nancy E Thomas
- Department of Dermatology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Li Luo
- Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
| | - Sergio Corrales-Guerrero
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Anne E Cust
- Cancer Epidemiology and Prevention Research, Sydney School of Public Health, The University of Sydney, Camperdown, NSW, Australia
| | - Lidia Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Bruce K Armstrong
- School of Global and Population Health, The University of Western Australia, Perth, WA, Australia
| | - Terence Dwyer
- Nuffield Department of Obstetrics and Gynecology, The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Richard P Gallagher
- Cancer Control Research, British Columbia Cancer Research Centre, Vancouver, BC, Canada
| | - Stephen B Gruber
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA, USA
| | - Loraine D Marrett
- Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada
| | - Hoda Anton-Culver
- Department of Epidemiology, School of Medicine, University of California at Irvine, Irvine, CA, USA
| | - Klaus Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Marianne Berwick
- Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
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- Department of Internal Medicine, Division of Epidemiology, Biostatistics and Preventive Medicine, University of New Mexico Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM, USA
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45
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Vernali S, Waxweiler WT, Dillon PM, Kanetsky PA, Orlow I, Luo L, Busam KJ, Kricker A, Armstrong BK, Anton-Culver H, Gruber SB, Gallagher RP, Zanetti R, Rosso S, Sacchetto L, Dwyer T, Cust AE, Ollila DW, Begg CB, Berwick M, Thomas NE. Association of Incident Amelanotic Melanoma With Phenotypic Characteristics, MC1R Status, and Prior Amelanotic Melanoma. JAMA Dermatol 2017; 153:1026-1031. [PMID: 28746718 DOI: 10.1001/jamadermatol.2017.2444] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance We previously reported that survival is poorer from histopathologically amelanotic than pigmented melanoma because of more advanced stage at diagnosis. Identifying patients at risk of amelanotic melanoma might enable earlier diagnosis and improved survival; however, the phenotypic characteristics and underlying genetics associated with amelanotic melanoma are unknown. Objective To determine whether phenotypic characteristics, carriage of MC1R variants, and history of amelanotic melanoma are associated with histopathologically amelanotic melanoma. Design, Setting, and Participants The Genes, Environment, and Melanoma (GEM) study is an international cohort study that enrolled patients with incident primary cutaneous melanomas from population-based and hospital-based cancer registries (1998 to 2003). The GEM participants included here were 2387 patients with data for phenotypes, MC1R genotype, and primary melanomas scored for histopathologic pigmentation. Of these 2387 patients with incident melanomas scored for pigmentation, 527 had prior primary melanomas also scored for pigmentation. Main Outcomes and Measures Associations of phenotypic characteristics (freckles, nevi, phenotypic index) and MC1R status with incident amelanotic melanomas were evaluated using logistic regression models adjusted for age, sex, study center, and primary status (single or multiple primary melanoma); odds ratios (ORs) and 95% CIs are reported. Association of histopathologic pigmentation between incident and prior melanomas was analyzed using an exact logistic regression model. Results This study included 2387 patients (1065 women, 1322 men; mean [SD] age at diagnosis, 58.3 [16.1] years) and 2917 primary melanomas. In a multivariable model including phenotypic characteristics, absence of back nevi, presence of many freckles, and a sun-sensitive phenotypic index were independently associated with amelanotic melanoma. Carriage of MC1R variants was associated with amelanotic melanoma but lost statistical significance in a model with phenotype. Further, patients with incident primary amelanotic melanomas were more likely to have had a prior primary amelanotic melanoma (OR, 4.62; 95% CI, 1.25-14.13) than those with incident primary pigmented melanomas. Conclusions and Relevance Absence of back nevi, presence of many freckles, a sun-sensitive phenotypic index, and prior amelanotic melanoma increase odds for development of amelanotic melanoma. An increased index of suspicion for melanoma in presenting nonpigmented lesions and more careful examination for signs of amelanotic melanoma during periodic skin examination in patients at increased odds of amelanotic melanoma might lead to earlier diagnosis and improved survival.
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Affiliation(s)
- Steven Vernali
- Department of Dermatology, University of North Carolina, Chapel Hill
| | | | | | - Peter A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida
| | - Irene Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York
| | - Li Luo
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque
| | - Klaus J Busam
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York
| | - Anne Kricker
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - Bruce K Armstrong
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | | | - Stephen B Gruber
- USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles
| | - Richard P Gallagher
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Roberto Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Stefano Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - Lidia Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy.,Politecnico di Torino, Turin, Italy.,Universitá degli Studi di Torino, Turin, Italy
| | - Terence Dwyer
- George Institute for Global Health, Nuffield Department of Obstetrics and Gynecology, University of Oxford, England
| | - Anne E Cust
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
| | - David W Ollila
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill.,Department of Surgery, University of North Carolina, Chapel Hill
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque
| | - Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill
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Gibbs DC, Ward SV, Orlow I, Cadby G, Kanetsky PA, Luo L, Busam KJ, Kricker A, Armstrong BK, Cust AE, Anton-Culver H, Gallagher RP, Zanetti R, Rosso S, Sacchetto L, Ollila DW, Begg CB, Berwick M, Thomas NE. Functional melanoma-risk variant IRF4 rs12203592 associated with Breslow thickness: a pooled international study of primary melanomas. Br J Dermatol 2017; 177:e180-e182. [PMID: 28667740 DOI: 10.1111/bjd.15784] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- D C Gibbs
- Department of Epidemiology, Emory University, Atlanta, GA, U.S.A
| | - S V Ward
- Centre for Genetic Origins of Health and Disease, The University of Western Australia, Crawley, Western Australia, Australia.,Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, NY, U.S.A
| | - I Orlow
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, NY, U.S.A
| | - G Cadby
- Centre for Genetic Origins of Health and Disease, The University of Western Australia, Crawley, Western Australia, Australia
| | - P A Kanetsky
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, U.S.A
| | - L Luo
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, NM, U.S.A
| | - K J Busam
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, NY, U.S.A
| | - A Kricker
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - B K Armstrong
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - A E Cust
- Sydney School of Public Health, The University of Sydney, Sydney, New South Wales, Australia.,Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia
| | - H Anton-Culver
- Department of Epidemiology, University of California, Irvine, CA, U.S.A
| | - R P Gallagher
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - R Zanetti
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - S Rosso
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy
| | - L Sacchetto
- Piedmont Cancer Registry, Centre for Epidemiology and Prevention in Oncology in Piedmont, Turin, Italy.,Politecnico di Torino, Turin, Italy
| | - D W Ollila
- Department of Surgery, University of North Carolina, Chapel Hill, NC, U.S.A.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, U.S.A
| | - C B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, NY, U.S.A
| | - M Berwick
- Department of Internal Medicine, University of New Mexico Cancer Center, University of New Mexico, Albuquerque, NM, U.S.A
| | - N E Thomas
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC, U.S.A.,Department of Dermatology, University of North Carolina, Chapel Hill, NC, U.S.A
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47
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Healy ME, Hill D, Berwick M, Edgar H, Gross J, Hunley K. Social-group identity and population substructure in admixed populations in New Mexico and Latin America. PLoS One 2017; 12:e0185503. [PMID: 28977000 PMCID: PMC5627912 DOI: 10.1371/journal.pone.0185503] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/13/2017] [Indexed: 12/13/2022] Open
Abstract
We examined the relationship between continental-level genetic ancestry and racial and ethnic identity in an admixed population in New Mexico with the goal of increasing our understanding of how racial and ethnic identity influence genetic substructure in admixed populations. Our sample consists of 98 New Mexicans who self-identified as Hispanic or Latino (NM-HL) and who further categorized themselves by race and ethnic subgroup membership. The genetic data consist of 270 newly-published autosomal microsatellites from the NM-HL sample and previously published data from 57 globally distributed populations, including 13 admixed samples from Central and South America. For these data, we 1) summarized the major axes of genetic variation using principal component analyses, 2) performed tests of Hardy Weinberg equilibrium, 3) compared empirical genetic ancestry distributions to those predicted under a model of admixture that lacked substructure, 4) tested the hypotheses that individuals in each sample had 100%, 0%, and the sample-mean percentage of African, European, and Native American ancestry. We found that most NM-HL identify themselves and their parents as belonging to one of two groups, conforming to a region-specific narrative that distinguishes recent immigrants from Mexico from individuals whose families have resided in New Mexico for generations and who emphasize their Spanish heritage. The “Spanish” group had significantly lower Native American ancestry and higher European ancestry than the “Mexican” group. Positive FIS values, PCA plots, and heterogeneous ancestry distributions suggest that most Central and South America admixed samples also contain substructure, and that this substructure may be related to variation in social identity. Genetic substructure appears to be common in admixed populations in the Americas and may confound attempts to identify disease-causing genes and to understand the social causes of variation in health outcomes and social inequality.
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Affiliation(s)
- Meghan E. Healy
- Department of Anthropology, University of New Mexico, Albuquerque, NM, United States of America
| | - Deirdre Hill
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States of America
| | - Marianne Berwick
- Department of Internal Medicine, University of New Mexico, Albuquerque, NM, United States of America
| | - Heather Edgar
- Department of Anthropology, University of New Mexico, Albuquerque, NM, United States of America
| | - Jessica Gross
- Department of Anthropology, University of New Mexico, Albuquerque, NM, United States of America
| | - Keith Hunley
- Department of Anthropology, University of New Mexico, Albuquerque, NM, United States of America
- * E-mail:
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48
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Berwick M. Editorial: When Is Correlation Causation? J Natl Cancer Inst 2017; 109:3835766. [DOI: 10.1093/jnci/djx087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 04/04/2017] [Indexed: 11/12/2022] Open
Affiliation(s)
- Marianne Berwick
- Affiliation of author: Division of Epidemiology, Biostatistics and Cancer Prevention, Department of Internal Medicine, University of New Mexico, Albuquerque, NM
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49
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Schwitzer E, Orlow I, Zabor EC, Begg CB, Berwick M, Thomas NE, Kanetsky PA, Jones LW. No association between prediagnosis exercise and survival in patients with high-risk primary melanoma: A population-based study. Pigment Cell Melanoma Res 2017; 30:424-427. [PMID: 28397350 DOI: 10.1111/pcmr.12594] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
| | - Irene Orlow
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Emily C Zabor
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Colin B Begg
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Nancy E Thomas
- University of North Carolina, Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | | | - Lee W Jones
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
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50
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Mauguen A, Zabor EC, Thomas NE, Berwick M, Seshan VE, Begg CB. Defining Cancer Subtypes With Distinctive Etiologic Profiles: An Application to the Epidemiology of Melanoma. J Am Stat Assoc 2017; 112:54-63. [PMID: 28603323 DOI: 10.1080/01621459.2016.1191499] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
We showcase a novel analytic strategy to identify sub-types of cancer that possess distinctive causal factors, i.e. sub-types that are "etiologically" distinct. The method involves the integrated analysis of two types of study design: an incident series of cases with double primary cancers with detailed information on tumor characteristics that can be used to define the sub-types; a case-series of incident cases with information on known risk factors that can be used to investigate the specific risk factors that distinguish the sub-types. The methods are applied to a rich melanoma dataset with detailed information on pathologic tumor factors, and comprehensive information on known genetic and environmental risk factors for melanoma. Identification of the optimal sub-typing solution is accomplished using a novel clustering analysis that seeks to maximize a measure that characterizes the distinctiveness of the distributions of risk factors across the sub-types and that is a function of the correlations of tumor factors in the case-specific tumor pairs. This analysis is challenged by the presence of extensive missing data. If successful, studies of this nature offer the opportunity for efficient study design to identify unknown risk factors whose effects are concentrated in defined sub-types.
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Affiliation(s)
- Audrey Mauguen
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Emily C Zabor
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Nancy E Thomas
- Department of Dermatology, University of North Carolina, Chapel Hill, NC.,Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Marianne Berwick
- Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, NC
| | - Venkatraman E Seshan
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
| | - Colin B Begg
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY
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