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Ranieri J, Di Giacomo D, Guerra F, Cilli E, Martelli A, Ciciarelli V, Ventura A, Fargnoli MC. Early Diagnosis of Melanoma and Breast Cancer in Women: Influence of Body Image Perception. IJERPH 2022; 19:ijerph19159264. [PMID: 35954618 PMCID: PMC9368107 DOI: 10.3390/ijerph19159264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 07/23/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022]
Abstract
The diagnosis of melanoma and breast cancer may impact many aspects of life with significant reductions in emotional functioning and quality of life. The aim of the study was to analyze the emotional traits of female patients with oncological in early-stage diagnosis, investigating predictors for psychological distress and analyzing body image perception. An observational study was conducted, A sample of 84 female cancer patients (age range 30–55 years) with melanoma (n = 42) and breast cancer diagnosis (n = 42). The examined emotional variables were psychological distress; depression, stress, and anxiety; metacognitions; and body self-perception. Findings showed higher psychological distress in breast cancer than in melanoma patients (p = 0.00), which was related to lower positive self-perception of body image (p = 0.03). Furthermore, psychological distress was negatively correlated with consequences of clinical treatment on body image, and low well-being affected the social interaction and well-being with own body. There was no significant difference between cancer staging and timing from diagnosis. Prevention and therapeutic psychological protocols might be adapted and tailored to the unmet needs of the patients in medical treatments to promote and enhance the Quality of Life in survivorship.
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Affiliation(s)
- Jessica Ranieri
- Department of Life, Health and Environmental Sciences (MESVA), University of L’Aquila, P.le S. Tommasi 1, 67010 L’Aquila, Italy; (J.R.); (D.D.G.); (F.G.); (E.C.)
| | - Dina Di Giacomo
- Department of Life, Health and Environmental Sciences (MESVA), University of L’Aquila, P.le S. Tommasi 1, 67010 L’Aquila, Italy; (J.R.); (D.D.G.); (F.G.); (E.C.)
| | - Federica Guerra
- Department of Life, Health and Environmental Sciences (MESVA), University of L’Aquila, P.le S. Tommasi 1, 67010 L’Aquila, Italy; (J.R.); (D.D.G.); (F.G.); (E.C.)
| | - Eleonora Cilli
- Department of Life, Health and Environmental Sciences (MESVA), University of L’Aquila, P.le S. Tommasi 1, 67010 L’Aquila, Italy; (J.R.); (D.D.G.); (F.G.); (E.C.)
| | - Alessandra Martelli
- Campus Universitario “Aurelio Saliceti”, University of Teramo, Via Renato Balzarini 1, 64100 Teramo, Italy;
| | - Valeria Ciciarelli
- UOSD Oncological and General Dermatology, Via Lorenzo Natali 1, 67100 Padova, Italy; (V.C.); (A.V.)
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, Via Vetoio, 67100 L’Aquila, Italy
| | - Alessandra Ventura
- UOSD Oncological and General Dermatology, Via Lorenzo Natali 1, 67100 Padova, Italy; (V.C.); (A.V.)
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, Via Vetoio, 67100 L’Aquila, Italy
| | - Maria Concetta Fargnoli
- UOSD Oncological and General Dermatology, Via Lorenzo Natali 1, 67100 Padova, Italy; (V.C.); (A.V.)
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, Via Vetoio, 67100 L’Aquila, Italy
- Correspondence:
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2
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Rocco T, Ventura A, Ciciarelli V, Fargnoli MC. Pigmented lesions with unusual penile localisation: Usefulness of reflectance confocal microscopy - Report of 2 cases. Australas J Dermatol 2021; 62:e456-e458. [PMID: 33970486 PMCID: PMC8453986 DOI: 10.1111/ajd.13615] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 02/22/2021] [Accepted: 02/27/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Tea Rocco
- Dermatology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | - Alessandra Ventura
- Dermatology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | - Valeria Ciciarelli
- Dermatology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
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Gualdi G, Caravello S, Frasci F, Giuliani F, Moro R, Fargnoli MC, Ciciarelli V, Argenziano G, Giorgio CM, Requena C, Nagore E, Sanmartín O, Martorell A, Fantini F, Calzavara-Pinton P, Amerio P. Intralesional Methotrexate for the Treatment of Advanced Keratinocytic Tumors: A Multi-Center Retrospective Study. Dermatol Ther (Heidelb) 2020; 10:769-777. [PMID: 32535811 PMCID: PMC7367996 DOI: 10.1007/s13555-020-00400-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 04/10/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction Keratinocyte tumors (KT) are frequently observed. Surgery is the treatment gold standard. In some cases, a surgical approach might not be the best option. Radiotherapy (RT) and systemic treatments can frequently cause side effects or be contraindicated. Intralesional methotrexate (MTX) can be a conservative yet effective alternative. We decided to evaluate the effectiveness and safety of intralesional chemotherapy with MTX for the treatment of squamous cell carcinoma (SCC), keratoacanthoma (KA), and basal cell carcinoma (BCC). Methods All patients had a histologically confirmed diagnosis of BCC, SCC, or KA and no indication to surgery or RT. MTX was injected subcutaneously proceeding from the periphery of the lesion toward the center. Different protocols in terms of dose, frequency, and length of treatment were used to compare them. Treatment efficacy was evaluated in terms of tumor size reduction. Patients were divided into three groups: responders (improvement of more than 50%), partial responders (< 50%), and non-responders (no improvement or worsening). All data were analyzed using the chi-squared test (χ2). Results Thirty-five patients were included. Twenty-one patients suffered from SCC, 12 from KA, and 2 from BCC. KA showed a higher response rate than SCC and BCC. For AK, 92% of patients had a complete resolution; 8% were partial responders. For SCC, 47.6% of cases were responders and 14.3% partial responders, while 38% non-responders. All BCCs showed no improvement. A treatment protocol of weekly injections, performed for 4 to 6 weeks, was the most efficient. Doses of 25 mg/ml per session seemed to be most effective. About one third of our patients developed side effects with mild anemia being the most frequent. Conclusions For selected cases, intralesional MTX can be a safe and effective option for the treatment of KT, especially in case of KA and, to a lesser extent, SCC.
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Affiliation(s)
- Giulio Gualdi
- Department of Medicine and Aging Science, Dermatologic Clinic, University G. D'Annunzio, Chieti Pescara, Italy
| | - Simone Caravello
- Department of Dermatology, Spedali Civili di Brescia, University of Brescia, Brescia, Italy.
| | | | - Federica Giuliani
- Department of Medicine and Aging Science, Dermatologic Clinic, University G. D'Annunzio, Chieti Pescara, Italy
| | - Ruggero Moro
- Escuela de Doctorado, Universidad Católica de Valencia San Vicente Mártir, València, Spain.,Dermatologia, Clinica San Carlo, Paderno Dugnano, Italy
| | - Maria C Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Valeria Ciciarelli
- Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | | | | | - Celia Requena
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain
| | - Eduardo Nagore
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | - Onofre Sanmartín
- Department of Dermatology, Instituto Valenciano de Oncología, València, Spain.,School of Medicine, Universidad Católica de Valencia San Vicente Mártir, València, Spain
| | | | - Fabrizio Fantini
- Department of Dermatology, Ospedale "Manzoni" Lecco, Lecco, Italy
| | | | - Paolo Amerio
- Department of Medicine and Aging Science, Dermatologic Clinic, University G. D'Annunzio, Chieti Pescara, Italy
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Affiliation(s)
- Valeria Ciciarelli
- Dermatology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | - Alessio Cortellini
- Medical Oncology, St. Salvatore Hospital, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alessandra Ventura
- Dermatology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
| | | | - Corrado Ficorella
- Medical Oncology, St. Salvatore Hospital, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Concetta Fargnoli
- Dermatology, Department of Biotechnological and Applied Clinical Science, University of L'Aquila, L'Aquila, Italy
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5
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Pellegrini C, Cardelli L, Padova MD, Nardo LD, Ciciarelli V, Rocco T, Cipolloni G, Clementi M, Cortellini A, Ventura A, Leocata P, Fargnoli MC. Intra-patient Heterogeneity of BRAF and NRAS Molecular Alterations in Primary Melanoma and Metastases. Acta Derm Venereol 2020; 100:adv00040. [PMID: 31774543 PMCID: PMC9128895 DOI: 10.2340/00015555-3382] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Mutations in MAPK signalling genes are driver events in melanoma, and have therapeutic relevance in the metastatic and adjuvant setting. This study evaluated the intra-patient heterogeneity of BRAF, NRAS and c-KIT mutational status between 30 primary melanomas and 39 related metastases, using molecular analysis and immunohistochemistry. BRAF mutations were identified in 46.7% of primary melanomas and 48.7% of metastases and NRAS mutations in 20% and 25.6%, respectively. Intra-patient heterogeneity was detected in 13.3% of patients for both BRAF and NRAS genes and was not associated with clinico-pathological characteristics of melanomas or metastases. High consistency was observed between immunostaining and molecular methods for BRAFV600E (k = 0.90; p < 0.001) and NRASQ61R (k = 0.87; p < 0.001). These findings demonstrate a relevant intra-patient heterogeneity between primary and metastatic lesions that is independent of clinical variables and methodological approach.
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Affiliation(s)
- Cristina Pellegrini
- Dermatology Unit, Department of Biotechnological and Applied Clinical Science , University of L'Aquila, Via Vetoio, Coppito, IT-67100 L'Aquila, Italy
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6
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Pellegrini C, Cardelli L, Di Padova M, Di Nardo L, Ciciarelli V, Rocco T, leocata P, Fargnoli M. 481 Exploring the molecular discordance between primary and metastatic melanoma. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.531] [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: 10/26/2022]
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Ventura A, Pellegrini C, Cardelli L, Rocco T, Ciciarelli V, Peris K, Fargnoli MC. Telomeres and Telomerase in Cutaneous Squamous Cell Carcinoma. Int J Mol Sci 2019; 20:ijms20061333. [PMID: 30884806 PMCID: PMC6470499 DOI: 10.3390/ijms20061333] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 03/08/2019] [Accepted: 03/11/2019] [Indexed: 11/16/2022] Open
Abstract
The role of telomere biology and telomerase activation in skin cancers has been investigated in melanoma and basal cell carcinoma but limited evidence is available for cutaneous squamous cell carcinoma (cSCC). We will review the current knowledge on the role of telomere and telomerase pathway in cSCC pathogenesis. At the somatic level, both long and short telomere lengths have been described in cSCC. This telomere dichotomy is probably related to two different mechanisms of tumour initiation which determines two tumour subtypes. Telomere shortening is observed during the invasive progression from in situ forms of cSCC, such as Bowen's disease (BD) and actinic keratosis (AK), to invasive cSCC. At the germline level, controversial results have been reported on the association between constitutive telomere length and risk of cSCC. Approximately 75⁻85% of cSCC tumours are characterized by a high level of telomerase activity. Telomerase activation has been also reported in AKs and BD and in sun-damaged skin, thus supporting the hypothesis that UV modulates telomerase activity in the skin. Activating TERT promoter mutations have been identified in 32⁻70% of cSCCs, with the majority showing the UV-signature. No significant correlation was observed between TERT promoter mutations and cSCC clinico-pathological features. However, TERT promoter mutations have been recently suggested to be independent predictors of an adverse outcome. The attention on telomere biology and telomerase activity in cSCC is increasing for the potential implications in the development of effective tools for prognostic assessment and of therapeutic strategies in patients with cutaneous cSCC.
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Affiliation(s)
- Alessandra Ventura
- Department of Dermatology, Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Cristina Pellegrini
- Department of Dermatology, Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Ludovica Cardelli
- Department of Dermatology, Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Tea Rocco
- Department of Dermatology, Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Valeria Ciciarelli
- Department of Dermatology, Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Ketty Peris
- Institute of Dermatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Università Cattolica del Sacro Cuore, 00186 Rome, Italy.
| | - Maria Concetta Fargnoli
- Department of Dermatology, Department of Applied Clinical Sciences and Biotechnologies, University of L'Aquila, 67100 L'Aquila, Italy.
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8
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Cortellini A, Buti S, Santini D, Perrone F, Giusti R, Tiseo M, Bersanelli M, Michiara M, Grassadonia A, Brocco D, Tinari N, De Tursi M, Zoratto F, Veltri E, Marconcini R, Malorgio F, Garufi C, Russano M, Anesi C, Zeppola T, Filetti M, Marchetti P, Botticelli A, Antonini Cappellini GC, De Galitiis F, Vitale MG, Sabbatini R, Bracarda S, Berardi R, Rinaldi S, Tudini M, Silva RR, Pireddu A, Atzori F, Chiari R, Ricciuti B, Iacono D, Migliorino MR, Rossi A, Porzio G, Cannita K, Ciciarelli V, Fargnoli MC, Ascierto PA, Ficorella C. Clinical Outcomes of Patients with Advanced Cancer and Pre-Existing Autoimmune Diseases Treated with Anti-Programmed Death-1 Immunotherapy: A Real-World Transverse Study. Oncologist 2019; 24:e327-e337. [PMID: 30796151 DOI: 10.1634/theoncologist.2018-0618] [Citation(s) in RCA: 119] [Impact Index Per Article: 23.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 01/07/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Patients with a history of autoimmune diseases (AIDs) have not usually been included in clinical trials with immune checkpoint inhibitors. MATERIALS AND METHODS Consecutive patients with advanced cancer, treated with anti-programmed death-1 (PD-1) agents, were evaluated according to the presence of pre-existing AIDs. The incidence of immune-related adverse events (irAEs) and clinical outcomes were compared among subgroups. RESULTS A total of 751 patients were enrolled; median age was 69 years. Primary tumors were as follows: non-small cell lung cancer, 492 (65.5%); melanoma, 159 (21.2%); kidney cancer, 94 (12.5%); and others, 6 (0.8%). Male/female ratio was 499/252. Eighty-five patients (11.3%) had pre-existing AIDs, further differentiated in clinically active (17.6%) and inactive (82.4%). Among patients with pre-existing AIDs, incidence of irAEs of any grade was significantly higher when compared with patients without AIDs (65.9% vs. 39.9%). At multivariate analysis, both inactive (p = .0005) and active pre-existing AIDs (p = .0162), female sex (p = .0004), and Eastern Cooperative Oncology Group Performance Status <2 (p = .0030) were significantly related to a higher incidence of irAEs of any grade. No significant differences were observed regarding grade 3/4 irAEs and objective response rate among subgroups. Pre-existing AIDs were not significantly related with progression-free survival and overall survival. CONCLUSION This study quantifies the increased risk of developing irAEs in patients with pre-existing AIDs who had to be treated with anti-PD-1 immunotherapy. Nevertheless, the incidence of grade 3/4 irAEs is not significantly higher when compared with control population. The finding of a greater incidence of irAEs among female patients ranks among the "hot topics" in gender-related differences in immuno-oncology. IMPLICATIONS FOR PRACTICE Patients with a history of autoimmune diseases (AIDs) have not usually been included in clinical trials with immune checkpoint inhibitors but are frequent in clinical practice. This study quantifies the increased risk of developing immune-related adverse events (irAEs) in patients with pre-existing AIDs who had to be treated with anti-programmed death-1 immunotherapy. Nevertheless, their toxicities are mild and the incidence of grade 3/4 irAEs is not significantly higher compared with those of controls. These results will help clinicians in everyday practice, improving their ability to offer a proper counselling to patients, in order to offer an immunotherapy treatment even to patients with pre-existing autoimmune disease.
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Affiliation(s)
- Alessio Cortellini
- Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Sebastiano Buti
- Medical Oncology, University Hospital of Parma, Parma, Italy
| | | | - Fabiana Perrone
- Medical Oncology, University Hospital of Parma, Parma, Italy
| | - Raffaele Giusti
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Marcello Tiseo
- Medical Oncology, University Hospital of Parma, Parma, Italy
| | | | - Maria Michiara
- Medical Oncology, University Hospital of Parma, Parma, Italy
| | - Antonino Grassadonia
- Department of Medical, Oral & Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Davide Brocco
- Clinical Oncology Unit, S.S. Annunziata Hospital, Chieti, Italy
| | - Nicola Tinari
- Department of Medical, Oral & Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | - Michele De Tursi
- Department of Medical, Oral & Biotechnological Sciences, University G. D'Annunzio, Chieti-Pescara, Italy
| | | | - Enzo Veltri
- Medical Oncology, Santa Maria Goretti Hospital, Latina, Italy
| | - Riccardo Marconcini
- Department of Oncology, University Hospital of Pisa, Istituto Toscano Tumori, Pisa, Italy
| | | | - Carlo Garufi
- Medical Oncology, "Santo Spirito" Hospital, Pescara, Italy
| | - Marco Russano
- Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Cecilia Anesi
- Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Tea Zeppola
- Medical Oncology, Campus Bio-Medico University, Rome, Italy
| | - Marco Filetti
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | - Paolo Marchetti
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Rome, Italy
| | - Andrea Botticelli
- Department of Clinical and Molecular Medicine, Sant'Andrea Hospital, Sapienza University of Rome, Rome, Italy
| | | | | | | | | | | | - Rossana Berardi
- Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Ancona, Italy
| | - Silvia Rinaldi
- Oncology Clinic, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Ancona, Italy
| | | | | | | | - Francesco Atzori
- Medical Oncology Unit, University Hospital of Cagliari, Cagliari, Italy
| | - Rita Chiari
- Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Biagio Ricciuti
- Medical Oncology, Santa Maria della Misericordia Hospital, Perugia, Italy
| | - Daniela Iacono
- Pulmonary Oncology Unit, St. Camillo Forlanini Hospital, Rome, Italy
| | | | - Antonio Rossi
- Medical Oncology, IRCCS Casa Sollievo della Sofferenza Hospital, San Giovanni Rotondo, Italy
| | - Giampiero Porzio
- Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Katia Cannita
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Valeria Ciciarelli
- Dermatology, San Salvatore Hospital, L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Maria Concetta Fargnoli
- Dermatology, San Salvatore Hospital, L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Paolo Antonio Ascierto
- Melanoma, Cancer Immunotherapy and Development Therapeutics Unit, Istituto Nazionale Tumori-IRCCS Fondazione "G. Pascale", Naples, Italy
| | - Corrado Ficorella
- Medical Oncology, St. Salvatore Hospital, L'Aquila, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
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Abstract
Background An estimated 5%-10% of all cutaneous melanoma cases occur in families. This review describes susceptibility genes currently known to be involved in melanoma predisposition, genetic testing of familial melanoma patients, and management implications. Results CDKN2A is the major high-penetrance susceptibility gene with germline mutations identified in 20%-40% of melanoma families. A positive CDKN2A mutation status has been associated with a high number of affected family members, multiple primary melanomas, pancreatic cancer, and early age at melanoma onset. Mutations in the other melanoma predisposition genes-CDK4, BAP1, TERT, POT1, ACD, TERF2IP, and MITF-are rare, overall contributing to explain a further 10% of familial clustering of melanoma. The underlying genetic susceptibility remains indeed unexplained for half of melanoma families. Genetic testing for melanoma is currently recommended only for CDKN2A and CDK4, and, at this time, the role of multigene panel testing remains under debate. Individuals from melanoma families must receive genetic counseling to be informed about the inclusion criteria for genetic testing, the probability of an inconclusive result, the genetic risk for melanoma and other cancers, and the debatable role of medical management. They should be counseled focusing primarily on recommendations on appropriate lifestyle, encouraging skin self-examination, and regular dermatological screening. Conclusions Genetic testing for high-penetrance melanoma susceptibility genes is recommended in melanoma families after selection of the appropriate candidates and adequate counseling of the patient. All patients and relatives from melanoma kindreds, irrespective of their mutation status, should be encouraged to adhere to a correct ultraviolet exposure, skin self-examination, and surveillance by physicians.
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Affiliation(s)
- Mariarita Rossi
- Department of Dermatology, DISCAB, University of L'Aquila, L'Aquila, Italy
| | | | - Ludovica Cardelli
- Department of Dermatology, DISCAB, University of L'Aquila, L'Aquila, Italy
| | - Valeria Ciciarelli
- Department of Dermatology, DISCAB, University of L'Aquila, L'Aquila, Italy
| | - Lucia Di Nardo
- Department of Dermatology, DISCAB, University of L'Aquila, L'Aquila, Italy.,Institute of Dermatology, Catholic University, Rome, Italy
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10
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Pellegrini C, Maturo MG, Di Nardo L, Ciciarelli V, Gutiérrez García-Rodrigo C, Fargnoli MC. Understanding the Molecular Genetics of Basal Cell Carcinoma. Int J Mol Sci 2017; 18:ijms18112485. [PMID: 29165358 PMCID: PMC5713451 DOI: 10.3390/ijms18112485] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 11/12/2017] [Accepted: 11/21/2017] [Indexed: 12/20/2022] Open
Abstract
Basal cell carcinoma (BCC) is the most common human cancer and represents a growing public health care problem. Several tumor suppressor genes and proto-oncogenes have been implicated in BCC pathogenesis, including the key components of the Hedgehog pathway, PTCH1 and SMO, the TP53 tumor suppressor, and members of the RAS proto-oncogene family. Aberrant activation of the Hedgehog pathway represents the molecular driver in basal cell carcinoma pathogenesis, with the majority of BCCs carrying somatic point mutations, mainly ultraviolet (UV)-induced, and/or copy-loss of heterozygosis in the PTCH1 gene. Recent advances in sequencing technology allowed genome-scale approaches to mutation discovery, identifying new genes and pathways potentially involved in BCC carcinogenesis. Mutational and functional analysis suggested PTPN14 and LATS1, both effectors of the Hippo–YAP pathway, and MYCN as new BCC-associated genes. In addition, emerging reports identified frequent non-coding mutations within the regulatory promoter sequences of the TERT and DPH3-OXNAD1 genes. Thus, it is clear that a more complex genetic network of cancer-associated genes than previously hypothesized is involved in BCC carcinogenesis, with a potential impact on the development of new molecular targeted therapies. This article reviews established knowledge and new hypotheses regarding the molecular genetics of BCC pathogenesis.
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Affiliation(s)
- Cristina Pellegrini
- Department of Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Maria Giovanna Maturo
- Department of Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Lucia Di Nardo
- Department of Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Valeria Ciciarelli
- Department of Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Carlota Gutiérrez García-Rodrigo
- Department of Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
| | - Maria Concetta Fargnoli
- Department of Dermatology, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, 67100 L'Aquila, Italy.
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