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Ehlers M, Schmidt M, Mattes-Gyorgy K, Antke C, Enczmann J, Schlensog M, Japp A, Haase M, Allelein S, Dringenberg T, Giesel F, Esposito I, Schott M. BRAFV600E and BRAF-WT Specific Antitumor Immunity in Papillary Thyroid Cancer. Horm Metab Res 2022; 54:852-858. [PMID: 36427494 DOI: 10.1055/a-1971-7019] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
One feature of papillary thyroid cancer (PTC) is the frequently present somatic BRAFV600E mutation. PTCs are also characterized by a lymphocytic infiltration, which may correlate with an improved clinical outcome. The objective of the study was the characterization of BRAFV600E specific anti-immunity in PTC patients and correlation analyses with the clinical outcome. Fourteen HLA A2 positive PTC patients were included into the study of whom tumor tissue samples were also available. Of those, 8 PTC patients revealed a somatic BRAFV600E mutation. All PTC patients were also MHC class II typed. Tetramer analyses for detection of MHC class I and MHC class II-restricted, BRAFV600E epitope-specific T cells using unstimulated and peptide-stimulated T cells were performed; correlation analyses between MHC phenotypes, T cell immunity, and the clinical course were performed. In regard to unstimulated T cells, a significantly higher amount of BRAFV600E epitope specific T cells was detected compared to a control tetramer. Importantly, after overnight peptide stimulation a significantly higher number of BRAFV600E positive and BRAF WT epitope-specific T cells could be seen. In regard to the clinical course, however, no significant differences were seen, neither in the context of the initial tumor size, nor in the context of lymph node metastases or peripheral metastastic spread. In conclusion, we clearly demonstrated a BRAF-specific tumor immunity in PTC-patients which is, however, independent of a BRAFV600E status of the PTC patients.
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Affiliation(s)
- Margret Ehlers
- Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Mathias Schmidt
- Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | | | - Christina Antke
- Clinic for Nuclear Medicine, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Juergen Enczmann
- Institute for Transplantation Diagnostics and Cell Therapeutics, Heinrich Heine University, Duesseldorf, Germany
| | - Martin Schlensog
- Institute of Pathology, Heinrich Heine University, Duesseldorf, Germany
| | - Anna Japp
- Institute of Pathology, Heinrich Heine University, Duesseldorf, Germany
| | - Matthias Haase
- Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Stephanie Allelein
- Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Till Dringenberg
- Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Frederik Giesel
- Clinic for Nuclear Medicine, University Hospital Duesseldorf, Duesseldorf, Germany
| | - Irene Esposito
- Institute of Pathology, Heinrich Heine University, Duesseldorf, Germany
| | - Matthias Schott
- Division for Specific Endocrinology, Medical Faculty, University Hospital Duesseldorf, Duesseldorf, Germany
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Murciano-Goroff YR, Pak T, Mondaca S, Flynn JR, Montecalvo J, Rekhtman N, Halpenny D, Plodkowski AJ, Wu SL, Kris MG, Paik PK, Riely GJ, Yu HA, Rudin CM, Hellmann MD, Land JD, Buie LW, Heller G, Lito P, Yaeger R, Drilon A, Liu D, Li BT, Offin M. Immune biomarkers and response to checkpoint inhibition of BRAF V600 and BRAF non-V600 altered lung cancers. Br J Cancer 2022; 126:889-898. [PMID: 34963703 PMCID: PMC8927094 DOI: 10.1038/s41416-021-01679-1] [Citation(s) in RCA: 2] [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: 05/10/2021] [Revised: 12/06/2021] [Accepted: 12/15/2021] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND While 2-4% of lung cancers possess alterations in BRAF, little is known about the immune responsiveness of these tumours. METHODS Clinical and genomic data were collected from 5945 patients with lung cancers whose tumours underwent next-generation sequencing between 2015 and 2018. Patients were followed through 2020. RESULTS In total, 127 patients with metastatic BRAF-altered lung cancers were identified: 29 tumours had Class I mutations, 59 had Class II/III alterations, and 39 had variants of unknown significance (VUS). Tumour mutation burden was higher in Class II/III than Class I-altered tumours (8.8 mutations/Mb versus 4.9, P < 0.001), but this difference was diminished when stratified by smoking status. The overall response rate to immune checkpoint inhibitors (ICI) was 9% in Class I-altered tumours and 26% in Class II/III (P = 0.25), with median time on treatment of 1.9 months in both groups. Among patients with Class I-III-altered tumours, 36-month HR for death in those who ever versus never received ICI was 1.82 (1.17-6.11). Nine patients were on ICI for >2 years (two with Class I mutations, two with Class II/III alterations, and five with VUS). CONCLUSIONS A subset of patients with BRAF-altered lung cancers achieved durable disease control on ICI. However, collectively no significant clinical benefit was seen.
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Affiliation(s)
| | - Terry Pak
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sebastian Mondaca
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jessica R Flynn
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Joseph Montecalvo
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Natasha Rekhtman
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Darragh Halpenny
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrew J Plodkowski
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Stephanie L Wu
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mark G Kris
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Paul K Paik
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gregory J Riely
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Helena A Yu
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Charles M Rudin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Matthew D Hellmann
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Josiah D Land
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Larry W Buie
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Glenn Heller
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Piro Lito
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Rona Yaeger
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Alexander Drilon
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Dazhi Liu
- Department of Pharmacy, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Bob T Li
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Michael Offin
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Jia X, Li B, Wang H, Yan Z. Clinical Features, Molecular Alterations and Prognosis of Colorectal Adenocarcinoma With Mucinous Component in Chinese Patients. Appl Immunohistochem Mol Morphol 2021; 29:765-772. [PMID: 34081634 DOI: 10.1097/pai.0000000000000950] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 05/04/2021] [Indexed: 11/26/2022]
Abstract
Mucinous adenocarcinoma (MAC) is conventionally diagnosed by WHO definition when the extracellular mucin is >50% of the tumor area, while tumors with <50% mucin are designated as having a mucinous component. The study is aimed at analyzing the clinicopathologic characteristics, mutation spectrum, and prognosis of colorectal adenocarcinoma with mucinous component (CAWMC). Mutation analyses for exon 2 to 4 of KRAS gene and exon 15 of BRAF gene were performed by Sanger sequencing. Expression of DNA mismatch repairs and P53 proteins were evaluated by immunohistochemistry. Density of tumor-infiltrating lymphocyte (TIL) status was scored. We also evaluated the percentage of glands producing mucin and the morphology of the different tumor cell types in mucin pools. We retrospectively analyzed the prognosis of 43 patients with stage II/III. The overall frequencies of KRAS and BRAF mutations were 36% and 8%, respectively. Patients with MAC exhibiting high levels of mucin were related to the increase of tumor diameter (P=0.038) but were not associated with any of the other clinicopathologic parameters. The proportion or variable morphology of mucinous component did not stratify progression-free survival in stage II/III cases. TIL was the most significant predictor of progression-free survival among stage II/III CAWMC. It is interesting to note that signet ring cell carcinoma does not portend a worse prognosis for patients with high TIL levels. Combining use the grade of TIL status with the WHO grade of the entire tumor can help identify patients with a high risk of recurrence more accurately.
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Affiliation(s)
| | | | - Hui Wang
- Surgery, ZhongShan-XuHui Hospital, FuDan University, Shanghai, China
| | - Zhe Yan
- Surgery, ZhongShan-XuHui Hospital, FuDan University, Shanghai, China
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Abstract
Children with Langerhnans cell histiocytosis (LCH) develop granulomatous lesions with characteristic clonal CD207+ dendritic cells that can arise as single lesions or life-threatening disseminated disease. Despite the wide range of clinical presentations, LCH lesions are histologically indistinguishable based on severity of disease, and uncertain classification as an immune versus neoplastic disorder has historically challenged the development of optimal clinical strategies for patients with LCH. Recently, activating somatic mutations in MAPK pathway genes, most notably BRAFV600E, have been discovered in almost all cases of LCH. Further, the stage of myeloid differentiation in which the mutation arises defines the extent of disease and risk of developing LCH-associated neurodegeneration. MAPK activation in LCH precursor cells drives myeloid differentiation, inhibits migration, and inhibits apoptosis, resulting in accumulation of resilient pathologic dendritic cells that recruit and activate T cells. Recurrent somatic mutations in MAPK pathway genes have also been identified in related histiocytic disorders: juvenile xanthogranuloma, Erdheim-Chester disease, and Rosai-Dorfman disease. New insights into pathogenesis support reclassification of these conditions as a myeloid neoplastic disorders. Continued research will uncover opportunities to identify novel targets and inform personalized therapeutic strategies based on cell of origin, somatic mutation, inherited risk factors, and residual disease.
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Affiliation(s)
- Nitya Gulati
- Texas Children's Hospital Cancer and Hematology Center, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Carl E Allen
- Texas Children's Hospital Cancer and Hematology Center, Houston, Texas, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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5
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Erickson LA, Chen B. Papillary Thyroid Carcinoma BRAF Immunopositivity. Mayo Clin Proc 2021; 96:267-268. [PMID: 33413831 DOI: 10.1016/j.mayocp.2020.11.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Lori A Erickson
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | - Beiyun Chen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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Rashid FA, Tabassum S, Khan MS, Ansari HR, Asif M, Sheikh AK, Sameer Aga S. VE1 immunohistochemistry is an adjunct tool for detection of BRAF V600E mutation: Validation in thyroid cancer patients. J Clin Lab Anal 2020; 35:e23628. [PMID: 33305405 PMCID: PMC7891529 DOI: 10.1002/jcla.23628] [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] [Received: 08/03/2020] [Revised: 09/09/2020] [Accepted: 09/17/2020] [Indexed: 12/12/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most common endocrine malignancy among other endocrine tumors, and BRAFV600E is a frequent genetic mutation occurring in the disease. Although different molecular techniques, most importantly sequencing has been widely recognized as a gold standard but molecular diagnosis remains an expensive, laborious, and time‐intensive process. Recently, immunohistochemistry (IHC) with anti‐BRAF V600E (VE1) antibody has increased practical utility and implemented clinically for the detection of BRAFV600E mutation. Therefore, the study aimed to evaluate diagnostic accuracy of VE1 IHC for detecting the BRAFV600E mutation frequency and clinical implementation in diagnostic laboratories. In this study, 72 formalin fixed paraffin‐embedded tissues (FFPE) were used to determine the BRAFV600E mutation status using IHC and Sanger sequencing. The mutation was found in 29% and 28% cases using IHC and Sanger sequencing, respectively. Furthermore, the results showed 100% sensitivity, 98.07% specificity, 95.2% positive predictive value, and 100% negative predictive value. Notably, significant associations were found between BRAFV600E status and tumor stage, tumor focality, and extrathyroidal extensions, respectively. VE1 IHC was found to be a highly sensitive, specific, and diagnostically accurate method in this cohort. Therefore, BRAFV600E detection through IHC has been considered as the best tailored technique for routine pathology laboratories.
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Affiliation(s)
- Faiza A. Rashid
- Department of Biological SciencesInternational Islamic UniversityIslamabadPakistan
| | - Sobia Tabassum
- Department of Biological SciencesInternational Islamic UniversityIslamabadPakistan
| | - Mosin S. Khan
- Government Medical College Srinagar and Associated SMHS and Superspeciality HospitalSrinagarIndia
| | - Hifzur R. Ansari
- King Abdullah International Medical Research CenterKing Saud bin Abdulaziz University for Health SciencesMinistry of National Guard Health AffairsJeddahSaudi Arabia
| | - Muhammad Asif
- Department of HistopathologyArmed Forces Institute of Pathologycentral Military HospitalRawalpindiPakistan
| | - Ahmareen K. Sheikh
- Department of PathologyPakistan Institute of Medical SciencesIslamabadPakistan
| | - Syed Sameer Aga
- Basic Medical SciencesCollege of Medicine‐ JeddahKing Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research CenterMinistry of National Guard Health AffairsJeddahKingdom of Saudi Arabia
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7
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Zhao J, Chen AX, Gartrell RD, Silverman AM, Aparicio L, Chu T, Bordbar D, Shan D, Samanamud J, Mahajan A, Filip I, Orenbuch R, Goetz M, Yamaguchi JT, Cloney M, Horbinski C, Lukas RV, Raizer J, Rae AI, Yuan J, Canoll P, Bruce JN, Saenger YM, Sims P, Iwamoto FM, Sonabend AM, Rabadan R. Immune and genomic correlates of response to anti-PD-1 immunotherapy in glioblastoma. Nat Med 2019; 25:462-469. [PMID: 30742119 PMCID: PMC6810613 DOI: 10.1038/s41591-019-0349-y] [Citation(s) in RCA: 498] [Impact Index Per Article: 99.6] [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: 08/23/2018] [Accepted: 01/08/2019] [Indexed: 12/19/2022]
Abstract
Immune checkpoint inhibitors have been successful across several tumor types; however, their efficacy has been uncommon and unpredictable in glioblastomas (GBM), where <10% of patients show long-term responses. To understand the molecular determinants of immunotherapeutic response in GBM, we longitudinally profiled 66 patients, including 17 long-term responders, during standard therapy and after treatment with PD-1 inhibitors (nivolumab or pembrolizumab). Genomic and transcriptomic analysis revealed a significant enrichment of PTEN mutations associated with immunosuppressive expression signatures in non-responders, and an enrichment of MAPK pathway alterations (PTPN11, BRAF) in responders. Responsive tumors were also associated with branched patterns of evolution from the elimination of neoepitopes as well as with differences in T cell clonal diversity and tumor microenvironment profiles. Our study shows that clinical response to anti-PD-1 immunotherapy in GBM is associated with specific molecular alterations, immune expression signatures, and immune infiltration that reflect the tumor's clonal evolution during treatment.
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Affiliation(s)
- Junfei Zhao
- Department of Systems Biology, Columbia University, New York, NY, USA
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Andrew X Chen
- Department of Systems Biology, Columbia University, New York, NY, USA
| | - Robyn D Gartrell
- Department of Pediatrics, Pediatric Hematology/Oncology/SCT, Columbia University Irving Medical Center, New York, NY, USA
| | - Andrew M Silverman
- Department of Pediatrics, Pediatric Hematology/Oncology/SCT, Columbia University Irving Medical Center, New York, NY, USA
| | - Luis Aparicio
- Department of Systems Biology, Columbia University, New York, NY, USA
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Tim Chu
- Department of Systems Biology, Columbia University, New York, NY, USA
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Darius Bordbar
- Department of Pediatrics, Pediatric Hematology/Oncology/SCT, Columbia University Irving Medical Center, New York, NY, USA
| | - David Shan
- Department of Pediatrics, Pediatric Hematology/Oncology/SCT, Columbia University Irving Medical Center, New York, NY, USA
| | - Jorge Samanamud
- Department of Neurosurgery, Columbia University, New York, NY, USA
| | - Aayushi Mahajan
- Department of Neurosurgery, Columbia University, New York, NY, USA
| | - Ioan Filip
- Department of Systems Biology, Columbia University, New York, NY, USA
| | - Rose Orenbuch
- Department of Systems Biology, Columbia University, New York, NY, USA
| | - Morgan Goetz
- Department of Biomedical Engineering, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jonathan T Yamaguchi
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael Cloney
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Craig Horbinski
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Rimas V Lukas
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Jeffrey Raizer
- Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Ali I Rae
- Department of Neurological Surgery, Oregon Health & Sciences University, Portland, OR, USA
| | - Jinzhou Yuan
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Peter Canoll
- Department of Pathology and Cell Biology, Columbia University, New York, NY, USA
| | - Jeffrey N Bruce
- Department of Neurosurgery, Columbia University, New York, NY, USA
| | - Yvonne M Saenger
- Department of Medicine, Hematology/Oncology, Columbia University Irving Medical Center, New York, NY, USA
| | - Peter Sims
- Department of Biomedical Informatics, Columbia University, New York, NY, USA
| | - Fabio M Iwamoto
- Department of Neurology, College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA.
| | - Adam M Sonabend
- Department of Neurological Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Raul Rabadan
- Department of Systems Biology, Columbia University, New York, NY, USA.
- Department of Biomedical Informatics, Columbia University, New York, NY, USA.
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Postow MA. Does adjuvant therapy for high-risk melanoma with either immunotherapy or targeted therapy affect therapeutic choices at relapse? Clin Adv Hematol Oncol 2018; 16:353-355. [PMID: 29851931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Michael A Postow
- Melanoma and Immunotherapeutics Service, Memorial Sloan Kettering Cancer Center, New York, New York
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9
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Nsengimana J, Laye J, Filia A, O’Shea S, Muralidhar S, Poźniak J, Droop A, Chan M, Walker C, Parkinson L, Gascoyne J, Mell T, Polso M, Jewell R, Randerson-Moor J, Cook GP, Bishop DT, Newton-Bishop J. β-Catenin-mediated immune evasion pathway frequently operates in primary cutaneous melanomas. J Clin Invest 2018; 128:2048-2063. [PMID: 29664013 PMCID: PMC5919828 DOI: 10.1172/jci95351] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [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: 05/31/2017] [Accepted: 02/27/2018] [Indexed: 12/19/2022] Open
Abstract
Immunotherapy prolongs survival in only a subset of melanoma patients, highlighting the need to better understand the driver tumor microenvironment. We conducted bioinformatic analyses of 703 transcriptomes to probe the immune landscape of primary cutaneous melanomas in a population-ascertained cohort. We identified and validated 6 immunologically distinct subgroups, with the largest having the lowest immune scores and the poorest survival. This poor-prognosis subgroup exhibited expression profiles consistent with β-catenin-mediated failure to recruit CD141+ DCs. A second subgroup displayed an equally bad prognosis when histopathological factors were adjusted for, while 4 others maintained comparable survival profiles. The 6 subgroups were replicated in The Cancer Genome Atlas (TCGA) melanomas, where β-catenin signaling was also associated with low immune scores predominantly related to hypomethylation. The survival benefit of high immune scores was strongest in patients with double-WT tumors for BRAF and NRAS, less strong in BRAF-V600 mutants, and absent in NRAS (codons 12, 13, 61) mutants. In summary, we report evidence for a β-catenin-mediated immune evasion in 42% of melanoma primaries overall and in 73% of those with the worst outcome. We further report evidence for an interaction between oncogenic mutations and host response to melanoma, suggesting that patient stratification will improve immunotherapeutic outcomes.
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Affiliation(s)
- Jérémie Nsengimana
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Jon Laye
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Anastasia Filia
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
- National Heart and Lung Institute, Imperial College, London, United Kingdom
| | - Sally O’Shea
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Sathya Muralidhar
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Joanna Poźniak
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Alastair Droop
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
- Medical Research Council (MRC) Medical Bioinformatics Centre, University of Leeds, Leeds, United Kingdom
| | - May Chan
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Christy Walker
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Louise Parkinson
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Joanne Gascoyne
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Tracey Mell
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Minttu Polso
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Rosalyn Jewell
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
- Yorkshire Regional Genetics Service, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom
| | | | - Graham P. Cook
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - D. Timothy Bishop
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
| | - Julia Newton-Bishop
- Leeds Institute of Cancer and Pathology, University of Leeds, Leeds, United Kingdom
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Godoy-Gijón E, Yuste-Chaves M, Santos-Briz Á. BRAF Mutation Status Concordance Between Primary Cutaneous Melanomas and Corresponding Metastases: A Review of the Latest Evidence. Actas Dermosifiliogr 2017; 108:894-901. [PMID: 28711165 DOI: 10.1016/j.ad.2016.12.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 09/29/2016] [Revised: 12/06/2016] [Accepted: 12/31/2016] [Indexed: 11/22/2022] Open
Abstract
The identification of B-Raf proto-oncongene (BRAF) mutation and the emergence of targeted therapy marked a turning point in the treatment of melanoma. The study of mutation status concordance between primary tumors and metastases in this cancer has major treatment implications as it facilitates the selection of candidates for targeted therapy. This review analyzes the evidence on the level of mutation status concordance between primary tumors and different types of metastases in cutaneous melanoma and provides an overview of the advantages and disadvantages of the various methods used to detect BRAF mutations.
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Affiliation(s)
- E Godoy-Gijón
- Servicio de Dermatología, Complejo Asistencial de Zamora, Zamora, España.
| | - M Yuste-Chaves
- Servicio de Dermatología, Complejo Asistencial Universitario de Salamanca, Salamanca, España
| | - Á Santos-Briz
- Servicio de Anatomía Patológica, Complejo Asistencial Universitario de Salamanca, Salamanca, España
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Abstract
INTRODUCTION Ten to fifteen percent of melanoma patients develop distant or unresectable metastasis requiring systemic treatment. Around 45% of the patients diagnosed with metastatic cutaneous melanoma harbor a BRAFV600 mutation and derive benefit from combined targeted therapy with MAPK pathway inhibitors. These offer a rapid response that translates into improvement of symptoms and increased quality of life. However, resistance often develops with subsequent progressive disease. Immunotherapy with checkpoint inhibitors may be offered to BRAF-mutated and wild-type patients and is associated with longer and durable responses that can continue over years. Areas covered: In this review, the authors discuss the late evidence for targeted and immunotherapy in melanoma patients, as well as therapy sequencing. Immunotherapy in special populations is also addressed. Expert opinion: Effective treatments are currently available. However, there are still unanswered questions of the best therapy sequence, the clear superiority of combined immunotherapy versus monotherapy in all patients, and therapy duration. Since different promising treatments will become available, clinical trials comparing the diverse options in terms of safety, efficacy and cost- effectiveness are required to make the right decisions. Consequently, patients should be encouraged to participate in clinical trials, whenever possible.
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Affiliation(s)
- Teresa Amaral
- a Center for Dermatooncology, Department of Dermatology , University Hospital Tuebingen , Tuebingen , Germany
- b Portuguese Air Force Health Direction , Lisbon , Portugal
| | - Francisco Meraz-Torres
- a Center for Dermatooncology, Department of Dermatology , University Hospital Tuebingen , Tuebingen , Germany
| | - Claus Garbe
- a Center for Dermatooncology, Department of Dermatology , University Hospital Tuebingen , Tuebingen , Germany
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12
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Barabadze E, Munjishvili V, Burkadze G. BRAF ANTIBODY EXPRESSION IN DIFFERENT TYPES OF THYROID NODULAR LESIONS. Georgian Med News 2017:107-113. [PMID: 29099711] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Major problems haunt the physicians who need to delineate the best management strategy for their patients with thyroid nodule is the identification of the most aggressive cases, especially among papillary thyroid cancers, which would benefit from more aggressive therapy and follow up. Beyond its strong correlation with PTC, the BRAF mutation is well described to associate with poor prognosis. The aim of our study was to identify BRAF antibody expression in different hystotypes of the thyroid nodules and assessment of it expression according to the tumor aggressiveness. Immunohistochemical staining was performed in 54 of surgically resected thyroid nodules, including malignant and benign cases, grouped according to the tumor aggressiveness. We have used selected thyroid specific markers: BRAF antibody, CD-56, CK-19, HBME-1 and KI-67. Adenomatous hyperplasia's and follicular lesions doesn't reveal positivity to the expression of BRAF antibody. Encapsulated papillary carcinomas included in our work revealed negative or very poor positivity of BRAF antibody. This fact strengthen the hypothesis that encapsulated papillary carcinomas have an indolent behavior and is genetically distinct from infiltrative tumors. We revealed 55,5% positivity of BRAF antibody in the cases of papillary microcarcinomas, this fact creates a need for more cautious approach to this type of tumors. The degree of BRAF antibody expression increased with a rising of tumor aggressiveness in our histopathologic groups (P<0,005). All cases of papillary carcinoma with multinodular involvement and extrathyroid extension revealed moderate or strong positivity of BRAF antibody expression.
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Affiliation(s)
- E Barabadze
- Davit Tvildiani Medical University, Tbilisi, Georgia
| | - V Munjishvili
- Davit Tvildiani Medical University, Tbilisi, Georgia
| | - G Burkadze
- Davit Tvildiani Medical University, Tbilisi, Georgia
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13
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Milne P, Bigley V, Bacon CM, Néel A, McGovern N, Bomken S, Haniffa M, Diamond EL, Durham BH, Visser J, Hunt D, Gunawardena H, Macheta M, McClain KL, Allen C, Abdel-Wahab O, Collin M. Hematopoietic origin of Langerhans cell histiocytosis and Erdheim-Chester disease in adults. Blood 2017; 130:167-175. [PMID: 28512190 PMCID: PMC5524529 DOI: 10.1182/blood-2016-12-757823] [Citation(s) in RCA: 111] [Impact Index Per Article: 15.9] [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: 12/16/2016] [Accepted: 04/24/2017] [Indexed: 12/15/2022] Open
Abstract
Langerhans cell histiocytosis (LCH) and Erdheim-Chester disease (ECD) are rare histiocytic disorders induced by somatic mutation of MAPK pathway genes. BRAFV600E mutation is the most common mutation in both conditions and also occurs in the hematopoietic neoplasm hairy cell leukemia (HCL). It is not known if adult LCH or ECD arises from hematopoietic stem cells (HSCs), nor which potential blood borne precursors lead to the formation of histiocytic lesions. In this study, BRAFV600E allele-specific polymerase chain reaction was used to map the neoplastic clone in 20 adults with LCH, ECD, and HCL. BRAFV600E was tracked to classical monocytes, nonclassical monocytes, and CD1c+ myeloid dendritic cells (DCs) in the blood, and mutations were observed in HSCs and myeloid progenitors in the bone marrow of 4 patients. The pattern of involvement of peripheral blood myeloid cells was indistinguishable between LCH and ECD, although the histiocytic disorders were distinct to HCL. As reported in children, detection of BRAFV600E in peripheral blood of adults was a marker of active multisystem LCH. The healthy counterparts of myeloid cells affected by BRAF mutation had a range of differentiation potentials depending on exogenous signals. CD1c+ DCs acquired high langerin and CD1a with granulocyte-macrophage colony-stimulating factor and transforming growth factor β alone, whereas CD14+ classical monocytes required additional notch ligation. Both classical and nonclassical monocytes, but not CD1c+ DCs, made foamy macrophages easily in vitro with macrophage colony-stimulating factor and human serum. These studies are consistent with a hematopoietic origin and >1 immediate cellular precursor in both LCH and ECD.
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MESH Headings
- Adult
- Alleles
- Antigens, CD/genetics
- Antigens, CD/immunology
- Antigens, CD1/genetics
- Antigens, CD1/immunology
- Bone Marrow Cells/immunology
- Bone Marrow Cells/pathology
- Cell Differentiation
- Dendritic Cells/immunology
- Dendritic Cells/pathology
- Diagnosis, Differential
- Erdheim-Chester Disease/diagnosis
- Erdheim-Chester Disease/genetics
- Erdheim-Chester Disease/immunology
- Erdheim-Chester Disease/pathology
- Female
- Foam Cells/immunology
- Foam Cells/pathology
- Gene Expression
- Glycoproteins/genetics
- Glycoproteins/immunology
- Granulocyte-Macrophage Colony-Stimulating Factor/genetics
- Granulocyte-Macrophage Colony-Stimulating Factor/immunology
- Hematopoietic Stem Cells/immunology
- Hematopoietic Stem Cells/pathology
- Histiocytosis, Langerhans-Cell/diagnosis
- Histiocytosis, Langerhans-Cell/genetics
- Histiocytosis, Langerhans-Cell/immunology
- Histiocytosis, Langerhans-Cell/pathology
- Humans
- Immunophenotyping
- Lectins, C-Type/genetics
- Lectins, C-Type/immunology
- Lipopolysaccharide Receptors/genetics
- Lipopolysaccharide Receptors/immunology
- Male
- Mannose-Binding Lectins/genetics
- Mannose-Binding Lectins/immunology
- Monocytes/immunology
- Monocytes/pathology
- Mutation
- Proto-Oncogene Proteins B-raf/genetics
- Proto-Oncogene Proteins B-raf/immunology
- Receptors, Notch/genetics
- Receptors, Notch/immunology
- Transforming Growth Factor beta/genetics
- Transforming Growth Factor beta/immunology
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Affiliation(s)
| | | | - Chris M Bacon
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom
- Department of Cellular Pathology, Newcastle upon Tyne Hospitals National Health Service Foundation Trust, Newcastle upon Tyne, United Kingdom
| | - Antoine Néel
- Internal Medicine Department, Hôtel-Dieu University Hopital, Nantes, France
| | | | - Simon Bomken
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Eli L Diamond
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Johannes Visser
- East Midlands Children's and Young Persons' Integrated Cancer Service, Leicester Children's Hospital, Leicester, United Kingdom
| | - David Hunt
- Medical Research Council Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, United Kingdom
| | - Harsha Gunawardena
- Rheumatology Department, North Bristol National Health Service Trust, Bristol, United Kingdom
| | - Mac Macheta
- Blackpool Teaching Hospitals National Health Service Foundation Trust, Blackpool, United Kingdom; and
| | - Kenneth L McClain
- Texas Children's Cancer Center, Baylor College of Medicine, Houston, TX
| | - Carl Allen
- Texas Children's Cancer Center, Baylor College of Medicine, Houston, TX
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Abstract
There has been a therapeutic revolution in the treatment of metastatic melanoma over the past decade. Patients presenting with inoperable disease have several therapeutic options, which can include both targeted and immune therapy. Immune checkpoint inhibitors have demonstrated an improvement in overall survival and led to some durable responses. However, toxicity, especially in combination regimens, can be severe. Adverse events should be anticipated, diagnosed as early as possible, monitored, and managed. Combination BRAF and MEK inhibition has also been shown to improve overall survival in patients with V600E-mutated melanoma. Responses to therapy are often rapid, and treatment is not associated with immune-related adverse events. Current trials are under way to determine which option is optimal as frontline therapy for patients with V600E melanoma. In patients with progressive disease despite standard therapies, clinical trials are recommended. There are several promising agents in development.
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Affiliation(s)
- Melinda Yushak
- From the Winship Cancer Institute of Emory University, Atlanta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; Institute Gustave Roussy, Villejuif, France
| | - Paul Chapman
- From the Winship Cancer Institute of Emory University, Atlanta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; Institute Gustave Roussy, Villejuif, France
| | - Caroline Robert
- From the Winship Cancer Institute of Emory University, Atlanta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; Institute Gustave Roussy, Villejuif, France
| | - Ragini Kudchadkar
- From the Winship Cancer Institute of Emory University, Atlanta, GA; Memorial Sloan Kettering Cancer Center, New York, NY; Institute Gustave Roussy, Villejuif, France
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15
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Jin YJ, Sun L, Yang L, Xing R, Liu XY. [Significance of v-raf murine sarcoma viral oncogene homologue B1 in rheumatoid arthritis]. Beijing Da Xue Xue Bao Yi Xue Ban 2016; 48:947-950. [PMID: 27987495] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To detect serum v-raf murine sarcoma viral oncogene homologue B1 (BRAF) protein levels and to investigate their clinical significance in rheumatoid arthritis (RA) patients. METHODS Serum samples were obtained from 78 RA patients, 32 osteoarthritis (OA) patients, 16 systemic lupus erythematosus (SLE) patients, 16 gout patients, 16 ankylosing spondylitis (AS) patients, 16 Sjogren syndrome (SS) patients and 30 healthy controls. BRAF protein in the sera was examined by enzyme-linked immunosorbent assay (ELISA). The associations between BRAF levels and the clinical features including age, sex, disease duration, swelling joints, tenderness joints, duration of moning stiffness, joint deformity, visual assessment scale (VAS) and extra articular manifestations and laboratory parameters including erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), disease activity score in 28 joints (DAS28), anti-cyclic citrullinated peptide (CCP) antibody, antikeratin antibody, antnuclear antibody (ANA), immunoglobulin and cytokines, such as TNF-α, IL-1β, IL-6 and IL-17A in RA patients were evaluated. Data analyses were performed by using SPSS 19.0 program. RESULTS The serum BRAF protein levels in the RA patients were significantly higher than those of other rheumatic diseases groups including OA, SLE, AS, SS, gout patients and healthy controls, the P value was 0.002, <0.001, <0.001, <0.001, 0.001 and <0.001 respectively. The level of serum BRAF protein in the RA patients showed a positive correlation with the rheumatoid factor (P=0.009) and IgA levels (P=0.006), but no correlation with clinical features, such as age and duration or other laboratory parameters, including CRP, ESR, anti-CCP antibody, IgM, IgG, TNF-α, IL-1β, IL-6 and IL-17A. The RA patients were further divided into normal levels of BRAF protein group and elevated levels of BRAF protein group. Compared with the clinical features and laboratory indexes of normal and elevated levels of BRAF protein groups in the RA patients, there was no significant difference between the two groups in age, duration, DAS28, CRP, ESR, RF, anti-CCP, IgA, IgG, IgM, TNF-α or IL-6. CONCLUSION The elevated level of BRAF protein in the RA patients showed that BRAF might play a role in the pathogenesis of RA. Further researches on BRAF gene expression may help to clarify the role of BRAF in RA.
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Affiliation(s)
- Y J Jin
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China
| | - L Sun
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China
| | - L Yang
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China
| | - R Xing
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China
| | - X Y Liu
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China
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16
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Schafroth C, Galván JA, Centeno I, Koelzer VH, Dawson HE, Sokol L, Rieger G, Berger MD, Hädrich M, Rosenberg R, Nitsche U, Schnüriger B, Langer R, Inderbitzin D, Lugli A, Zlobec I. VE1 immunohistochemistry predicts BRAF V600E mutation status and clinical outcome in colorectal cancer. Oncotarget 2015; 6:41453-63. [PMID: 26496026 PMCID: PMC4747166 DOI: 10.18632/oncotarget.6162] [Citation(s) in RCA: 16] [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: 09/22/2015] [Accepted: 10/04/2015] [Indexed: 12/20/2022] Open
Abstract
AIM VE1 is a monoclonal antibody detecting mutant BRAFV(600E) protein by immunohistochemistry. Here we aim to determine the inter-observer agreement and concordance of VE1 with mutational status, investigate heterogeneity in colorectal cancers and metastases and determine the prognostic effect of VE1 in colorectal cancer patients. METHODS Concordance of VE1 with mutational status and inter-observer agreement were tested on a pilot cohort of colorectal cancers (n = 34), melanomas (n = 23) and thyroid cancers (n = 8). Two prognostic cohorts were evaluated (n = 259, Cohort 1 and n = 226, Cohort 2) by multiple-punch tissue microarrays. VE1 staining on preoperative biopsies (n = 118 patients) was compared to expression in resections. Primary tumors and metastases from 13 patients were tested for VE1 heterogeneity using a tissue microarray generated from all available blocks (n = 100 blocks). RESULTS Inter-observer agreement was 100% (kappa = 1.0). Concordance between VE1 and V600E mutation was 98.5%. Cohort 1: VE1 positivity (seen in 13.5%) was associated with older age (p = 0.0175) and MLH1 deficiency (p < 0.0001). Cohort 2: VE1 positivity (seen in 12.8%) was associated with female gender (p = 0.0016), right-sided tumor location (p < 0.0001), higher tumor grade (p < 0.0001) and mismatch repair (MMR)-deficiency (p < 0.0001). In survival analysis, MMR status and postoperative therapy were identified as possible confounding factors. Adjusting for these features, VE1 was an unfavorable prognostic factor. Preoperative biopsy staining matched resections in all cases except one. No heterogeneity was found across any primary/metastatic tumor blocks. CONCLUSION VE1 is highly concordant for V600E and homogeneously expressed suggesting staining can be analysed on resection specimens, preoperative biopsies, metastatic lesions and tissue microarrays.
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Affiliation(s)
- Christian Schafroth
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
| | - José A. Galván
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
| | - Irene Centeno
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
| | - Viktor H. Koelzer
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
- Division of Clinical Pathology, Institute of Pathology, University of Bern, Bern, Switzerland
| | - Heather E. Dawson
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
- Division of Clinical Pathology, Institute of Pathology, University of Bern, Bern, Switzerland
| | - Lena Sokol
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
| | - Gregor Rieger
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
- Division of Clinical Pathology, Institute of Pathology, University of Bern, Bern, Switzerland
| | - Martin D. Berger
- Department of Medical Oncology, Bern University Hospital, Bern, Switzerland
| | - Marion Hädrich
- Visceral Surgery and Medicine, Bern University Hospital, Bern, Switzerland
| | - Robert Rosenberg
- Department of Surgery, Kantonsspital Baselland, Liestal, Switzerland
| | - Ulrich Nitsche
- Department of Surgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Beat Schnüriger
- Visceral Surgery and Medicine, Bern University Hospital, Bern, Switzerland
| | - Rupert Langer
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
- Division of Clinical Pathology, Institute of Pathology, University of Bern, Bern, Switzerland
| | - Daniel Inderbitzin
- Visceral Surgery and Medicine, Bern University Hospital, Bern, Switzerland
- Department of Surgery, Tiefenau Hospital, Bern, Switzerland
| | - Alessandro Lugli
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
- Division of Clinical Pathology, Institute of Pathology, University of Bern, Bern, Switzerland
| | - Inti Zlobec
- Translational Research Unit, Institute of Pathology, Bern University Hospital, Bern, Switzerland
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17
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Verlinden I, van den Hurk K, Clarijs R, Willig AP, Stallinga CMHA, Roemen GMJM, van den Oord JJ, Zur Hausen A, Speel EJM, Winnepenninckx VJL. BRAFV600E immunopositive melanomas show low frequency of heterogeneity and association with epithelioid tumor cells: a STROBE-compliant article. Medicine (Baltimore) 2014; 93:e285. [PMID: 25526463 PMCID: PMC4603111 DOI: 10.1097/md.0000000000000285] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 10/10/2014] [Accepted: 10/28/2014] [Indexed: 12/26/2022] Open
Abstract
Treatment of BRAFV600E-mutant melanoma by small molecule inhibitors that target BRAFV600E or MEK kinases is increasingly used in clinical practice and significantly improve patient outcome. However, patients eventually become resistant and therapeutic improvement is required. Molecular diversity within individual tumors (intratumor heterogeneity) and between tumors within a single patient (intrapatient heterogeneity) poses a significant challenge to precision medicine. Using immunohistochemistry, we determined the extent of BRAFV600E intratumor and intrapatient heterogeneity and the influence of morphological heterogeneity in a large series of 171 melanomas of 81 patients. The BRAFV600E mutation rate found in our melanoma series is 44%, with none of 22 (0%) melanoma in situ, 23 of 56 (41%) primary tumors, 28 of 59 (48%) regional metastases, and 24 of 34 (71%) distant metastases harboring the mutation. In general, a diffuse homogeneous immunostaining was seen, even in tumors consisting of more than one cell type, that is, epithelioid, spindle, and/or small cell types. Nevertheless, BRAFV600E-mutant melanomas more often had a purely epithelioid cell population (P=0.063), that is more evident among distant metastases (P=0.014). Only two of 75 (3%) mutated specimens (one primary and one metastasis) displayed heterogeneous BRAFV600E expression. The primary tumor was also morphologically heterogeneous and exclusively displayed BRAFV600E in the epithelioid component, confirming an association between BRAFV600E and epithelioid cells. Twenty-eight of 30 patients (93%) had concordant BRAFV600E mutation status between their tumors. Taken together, BRAFV600E intratumor and intrapatient heterogeneity in melanoma is diminutive, nevertheless, the identified exceptions will have important implications for the clinical management of this disease.
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Affiliation(s)
- Ivana Verlinden
- From the Department of Pathology, Maastricht University Medical Centre, Maastricht, The Netherlands (IV, KvdH, CMHAS, GMJMR, AzH, E-JMS, VJLW); GROW-School for Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands (KvdH, AzH, E-JMS, VJLW); Department of Clinical Pathology, Atrium Medical Centre Parkstad, Heerlen, The Netherlands (RC); Department of Pathology, St. Laurentius ziekenhuis, Roermond, The Netherlands (APW); and Laboratory of Translational Cell & Tissue Research and Department of Pathology, University Hospital, KULeuven, Leuven, Belgium (JJvdO)
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18
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Akarca AU, Shende VH, Ramsay AD, Diss T, Pane-Foix M, Rizvi H, Calaminici MR, Grogan TM, Linch D, Marafioti T. BRAF V600E mutation-specific antibody, a sensitive diagnostic marker revealing minimal residual disease in hairy cell leukaemia. Br J Haematol 2013; 162:848-51. [PMID: 23848818 DOI: 10.1111/bjh.12429] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
MESH Headings
- Antibodies, Monoclonal/chemistry
- Antibodies, Monoclonal/immunology
- Antibody Specificity
- Biomarkers, Tumor/analysis
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Humans
- Immunohistochemistry
- Leukemia, Hairy Cell/diagnosis
- Leukemia, Hairy Cell/genetics
- Leukemia, Hairy Cell/immunology
- Leukemia, Hairy Cell/pathology
- Mutation/immunology
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/genetics
- Neoplasm, Residual/immunology
- Neoplasm, Residual/pathology
- Proto-Oncogene Proteins B-raf/genetics
- Proto-Oncogene Proteins B-raf/immunology
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19
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Ott PA, Henry T, Baranda SJ, Frleta D, Manches O, Bogunovic D, Bhardwaj N. Inhibition of both BRAF and MEK in BRAF(V600E) mutant melanoma restores compromised dendritic cell (DC) function while having differential direct effects on DC properties. Cancer Immunol Immunother 2013; 62:811-22. [PMID: 23306863 PMCID: PMC11028975 DOI: 10.1007/s00262-012-1389-z] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [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: 08/31/2012] [Accepted: 12/13/2012] [Indexed: 01/08/2023]
Abstract
PURPOSE Dendritic cells (DCs) can induce strong tumor-specific T-cell immune responses. Constitutive upregulation of the mitogen-activated protein kinase (MAPK) pathway by a BRAF(V600) mutation, which is present in about 50 % of metastatic melanomas, may be linked to compromised function of DCs in the tumor microenvironment. Targeting both MEK and BRAF has shown efficacy in BRAF(V600) mutant melanoma. METHODS We co-cultured monocyte-derived human DCs with melanoma cell lines pretreated with the MEK inhibitor U0126 or the BRAF inhibitor vemurafenib. Cytokine production (IL-12 and TNF-α) and surface marker expression (CD80, CD83, and CD86) in DCs matured with the Toll-like receptor 3/Melanoma Differentiation-Associated protein 5 agonist polyI:C was examined. Additionally, DC function, viability, and T-cell priming capacity were assessed upon direct exposure to U0126 and vemurafenib. RESULTS Cytokine production and co-stimulation marker expression were suppressed in polyI:C-matured DCs exposed to melanoma cells in co-cultures. This suppression was reversed by MAPK blockade with U0126 and/or vemurafenib only in melanoma cell lines carrying a BRAF(V600E) mutation. Furthermore, when testing the effect of U0126 directly on DCs, marked inhibition of function, viability, and DC priming capacity was observed. In contrast, vemurafenib had no effect on DC function across a wide range of dose concentrations. CONCLUSIONS BRAF(V600E) mutant melanoma cells modulate DC through the MAPK pathway as its blockade can reverse suppression of DC function. MEK inhibition negatively impacts DC function and viability if applied directly. In contrast, vemurafenib does not have detrimental effects on important functions of DCs and may therefore be a superior candidate for combination immunotherapy approaches in melanoma patients.
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Affiliation(s)
- Patrick A Ott
- New York University Cancer Institute, New York University School of Medicine, 522 First Avenue, SRB 1303, New York, NY, 10016, USA.
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20
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Bullock M, O'Neill C, Chou A, Clarkson A, Dodds T, Toon C, Sywak M, Sidhu SB, Delbridge LW, Robinson BG, Learoyd DL, Capper D, von Deimling A, Clifton-Bligh RJ, Gill AJ. Utilization of a MAB for BRAF(V600E) detection in papillary thyroid carcinoma. Endocr Relat Cancer 2012; 19:779-84. [PMID: 22997209 DOI: 10.1530/erc-12-0239] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Identification of BRAF(V600E) in thyroid neoplasia may be useful because it is specific for malignancy, connotes a worse prognosis, and is the target of novel therapies currently under investigation. Sanger sequencing is the 'gold standard' for mutation detection but is subject to sampling error and requires resources beyond many diagnostic pathology laboratories. In this study, we compared immunohistochemistry (IHC) using a BRAF(V600E) mutation-specific MAB to Sanger sequencing on DNA from formalin-fixed paraffin-embedded tissue, in a well-characterized cohort of 101 papillary thyroid carcinoma (PTC) patients. For all cases, an IHC result was available; however, five cases failed Sanger sequencing. Of the 96 cases with molecular data, 68 (71%) were BRAF(V600E) positive by IHC and 59 (61%) were BRAF(V600E) positive by sequencing. Eleven cases were discordant. One case was negative by IHC and initially positive by sequencing. Repeat sequencing of that sample and sequencing of a macrodissected sample were negative for BRAF(V600E). Of ten cases positive by IHC but negative by sequencing on whole sections, repeat sequencing on macrodissected tissue confirmed the IHC result in seven cases (suggesting that these were false negatives of sequencing on whole sections). In three cases, repeat sequencing on recut tissue remained negative (including using massive parallel sequencing), but these cases demonstrated relatively low neoplastic cellularity. We conclude that IHC for BRAF(V600E) is more sensitive and specific than Sanger sequencing in the routine diagnostic setting and may represent the new gold standard for detection of BRAF(V600E) mutation in PTC.
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Affiliation(s)
- M Bullock
- Hormones and Cancer Group, Cancer Genetics Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, Sydney, New South Wales, Australia
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21
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Herlyn D. Highlights of novel melanoma therapies presented at the 8th International Congress of the Society for Melanoma Research (SMR) Tampa, FL, November 9-11, 2011. Cancer Immunol Immunother 2012; 61:949-51. [PMID: 22392191 PMCID: PMC11028657 DOI: 10.1007/s00262-012-1228-2] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Accepted: 02/16/2012] [Indexed: 10/28/2022]
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22
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Zhang X, Zhao JX, Sun L, Li R, Liu XY, Li ZG. [Significance of the detection of anti-v-raf murine sarcoma viral oncogene homologue B1 antibodies in the diagnostic practice of rheumatoid arthritis]. Beijing Da Xue Xue Bao Yi Xue Ban 2012; 44:195-198. [PMID: 22516986] [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] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
OBJECTIVE To clarify the clinical significance of the antibody against v-raf murine sarcoma viral oncogene homologue B1 (BRAF) in the diagnostic practice of rheumatoid arthritis (RA). METHODS In the study, 112 patients with RA, 112 patients with other rheumatic diseases,and 73 healthy individuals were recruited . With recombinant human BRAF protein as antigen, we examined the level of anti-BRAF antibody in all the patients by enzyme-linked immunosorbent assay(ELISA), The clinical data of the RA patients were collected simultaneously, and analysed statistically by using SPSS 13.0. RESULTS The positive rate of anti-BRAF antibody was 53.6% in the RA patients, which was significantly higher than that of the normal control group (4.1%,P<0.01)and other rheumatic diseases groups (P all<0.01)except osteoarthritis group. The titer of anti-BRAF antibody was also notably higher in the patients with RA than in other rheumatic diseases and normal control groups(P all <0.01).The diagnostic sensitivity and specificity of anti-BRAF antibody for RA were 53.6% and 84.3% respectively. The positive rate of anti-BRAF antibody in rheumatoid factor, anti-cyclic citrullinated peptide antibody, antikeratin antibody,antiperinuclear factor negative groups were 52.6%,38.2%, 30.3% and 31.0%respectively. It showed significant negative correlation between the titer of anti-BRAF antibody and patient's age, disease duration and the level of CRP. CONCLUSION The anti-BRAF antibody contributes to the diagnosis of RA, and may act as a supplement of other autoantibodies.
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Affiliation(s)
- Xia Zhang
- Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China
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Capper D, Berghoff AS, Magerle M, Ilhan A, Wöhrer A, Hackl M, Pichler J, Pusch S, Meyer J, Habel A, Petzelbauer P, Birner P, von Deimling A, Preusser M. Immunohistochemical testing of BRAF V600E status in 1,120 tumor tissue samples of patients with brain metastases. Acta Neuropathol 2012; 123:223-33. [PMID: 22012135 DOI: 10.1007/s00401-011-0887-y] [Citation(s) in RCA: 162] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Revised: 10/04/2011] [Accepted: 10/05/2011] [Indexed: 01/28/2023]
Abstract
Brain metastases (BM) are frequent and carry a dismal prognosis. BRAF V600E mutations are found in a broad range of tumor types and specific inhibitors targeting BRAF V600E protein exist. We analyzed tumoral BRAF V600E-mutant protein expression using the novel mutation-specific antibody VE1 in a series of 1,120 tumor specimens (885 BM, 157 primary tumors, 78 extra-cranial metastases) of 874 BM patients. In 85 cases, we performed validation of immunohistochemical results by BRAF exon 15 gene sequencing. BRAF V600E protein was expressed in BM of 42/76 (55.3%) melanomas, 1/15 (6.7%) ovarian cancers, 4/72 (5.5%) colorectal cancers, 1/355 (0.3%) lung cancers, 2/6 thyroid cancers and 1/2 choriocarcinomas. BRAF V600E expression showed high intra-tumoral homogeneity and was similar in different tumor manifestations of individual patients. VE1 immunohistochemistry and BRAF exon 15 sequencing were congruent in 68/70 (97.1%) cases, but VE1 immunostaining identified small BRAF V600E expressing tumor cell aggregates in 10 cases with inconclusive genetic results. Melanoma patients with BRAF V600E mutant protein expressing tumors were significantly younger at diagnosis of the primary tumor and at operation of BM than patients with non-mutated tumors. In conclusion, expression of BRAF V600E mutant protein occurs in approximately 6% of BM and is consistent in different tumor manifestations of the same patient. Thus, BRAF V600E inhibiting therapies seem feasible in selected BM patients. Immunohistochemical visualization of V600E-mutant BRAF protein is a promising tool for patient stratification. An integrated approach combining both, VE1 immunohistochemistry and genetic analysis may increase the diagnostic accuracy of BRAF mutation analysis.
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Affiliation(s)
- David Capper
- Department of Neuropathology, Institute of Pathology, Ruprecht-Karls-University, Heidelberg, Germany
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Li W, Wang W, Sun S, Sun Y, Pan Y, Wang L, Zhang R, Zhang K, Li J. Autoantibodies against the catalytic domain of BRAF are not specific serum markers for rheumatoid arthritis. PLoS One 2011; 6:e28975. [PMID: 22174938 PMCID: PMC3236235 DOI: 10.1371/journal.pone.0028975] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 11/17/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Autoantibodies to the catalytic domain of v-raf murine sarcoma viral oncogene homologue B1 (BRAF) have been recently identified as a new family of autoantibodies involved in rheumatoid arthritis (RA). The objective of this study was to determine antibody responses to the catalytic domain of BRAF in RA and other autoimmune diseases. The association between RA-related clinical indices and these antibodies was also assessed. METHODOLOGY/PRINCIPAL FINDINGS The presence of autoantibodies to the catalytic domain of BRAF (anti-BRAF) or to peptide P25 (amino acids 656-675 of the catalytic domain of BRAF; anti-P25) was determined in serum samples from patients with RA, primary Sjögren's syndrome (pSS), systemic lupus erythematosus (SLE), and healthy controls by using indirect enzyme-linked immunosorbent assays (ELISAs) based on the recombinant catalytic domain of BRAF or a synthesized peptide, respectively. Associations of anti-BRAF or anti-P25 with disease variables of RA patients were also evaluated. Our results show that the BRAF-specific antibodies anti-BRAF and anti-P25 are equally present in RA, pSS, and SLE patients. However, the erythrocyte sedimentation rate (ESR) used to detect inflammation was significantly different between patients with and without BRAF-specific antibodies. The anti-BRAF-positive patients were found to have prolonged disease, and active disease occurred more frequently in anti-P25-positive patients than in anti-P25-negative patients. A weak but significant correlation between anti-P25 levels and ESRs was observed (r = 0.319, p = 0.004). CONCLUSIONS/SIGNIFICANCE The antibody response against the catalytic domain of BRAF is not specific for RA, but the higher titers of BRAF-specific antibodies may be associated with increased inflammation in RA.
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Affiliation(s)
- Wenli Li
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, People's Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Wei Wang
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, People's Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Shipeng Sun
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, People's Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yu Sun
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, People's Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Yang Pan
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, People's Republic of China
- Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Lunan Wang
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, People's Republic of China
| | - Rui Zhang
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, People's Republic of China
| | - Kuo Zhang
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, People's Republic of China
| | - Jinming Li
- National Center for Clinical Laboratories, Beijing Hospital, Beijing, People's Republic of China
- * E-mail:
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25
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Melanoma vaccine may be close. Health News 2006; 12:15. [PMID: 16862649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Somasundaram R, Swoboda R, Caputo L, Otvos L, Weber B, Volpe P, van Belle P, Hotz S, Elder DE, Marincola FM, Schuchter L, Guerry D, Czerniecki BJ, Herlyn D. Human leukocyte antigen-A2-restricted CTL responses to mutated BRAF peptides in melanoma patients. Cancer Res 2006; 66:3287-93. [PMID: 16540682 DOI: 10.1158/0008-5472.can-05-1932] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [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] [Indexed: 11/16/2022]
Abstract
Mutated BRAF (BRAF(V600E)) is a potential immunotherapeutic target for melanoma because of its tumor specificity and expression in the majority of these lesions derived from different patients. BRAF(V600E) is expressed intracellularly and not on the cell surface, therefore providing a target for T cells but not B cells. Demonstration of patients' T cell responses to BRAF(V600E) would suggest the feasibility of active specific immunotherapy targeting the mutation in these patients. In the present study, BRAF(V600E) peptides with putative binding sites for human leukocyte antigen (HLA)-A2 were used to stimulate T lymphocytes of HLA-A2-positive melanoma patients. Four of five patients with BRAF(V600E)-positive lesions showed lymphoproliferative responses to BRAF(V600E) peptide stimulation. These responses were specific for the mutated epitope and HLA-A2 was restricted in three patients. Lymphocytes from these three patients were cytotoxic against HLA-A2-matched BRAF(V600E)-positive melanoma cells. None of the four patients with BRAF(V600E)-negative lesions and none of five healthy donors had lymphoproliferative responses specific for the mutated epitope. The high prevalence (approximately 50%) of HLA-A2 among melanoma patients renders HLA-A2-restricted BRAF(V600E) peptides attractive candidate vaccines for these patients.
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Fensterle J, Becker JC, Potapenko T, Heimbach V, Vetter CS, Bröcker EB, Rapp UR. B-Raf specific antibody responses in melanoma patients. BMC Cancer 2004; 4:62. [PMID: 15361259 PMCID: PMC518968 DOI: 10.1186/1471-2407-4-62] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2004] [Accepted: 09/12/2004] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mutations of the BRAF gene are the most common genetic alteration in melanoma. Moreover, BRAF mutations are already present in benign nevi. Being overexpressed and mutated, B-Raf is a potential target for the immune system and as this mutation seems to be an early event, a humoral immune response against this antigen might serve as a diagnostic tool for detection of high risk patients. METHODS 372 sera of 148 stage IV melanoma patients and 119 sera of non-melanoma patients were screened for B-Raf, B-Raf V599E and C-Raf specific antibodies by an ELISA assay. Sera were screened for specific total Ig and for IgG. Serum titers were compared with a two tailed Mann-Whitney U test. Sera with titers of 1:300 or higher were termed positive and groups were compared with a two tailed Fisher's exact test. RESULTS B-Raf specific antibodies recognizing both B-Raf and B-Raf V599E were detected in 8.9% of the sera of melanoma patients and in 2,5% of the control group. Raf specific IgG was detected in some patients at very low levels. B-Raf specific antibody responses did not correlate with clinical parameters but in some cases, B-Raf antibodies emerged during disease progression. CONCLUSION These findings imply that B-Raf is immunogenic in melanoma patients and that it might serve as a potential target for immunotherapy. However, B-Raf specific antibodies emerge at rather late stages of melanoma progression and are present only with a low frequency indicating that spontaneous B-Raf specific antibodies are not an early marker for melanoma, but rather may serve as a therapeutic target.
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Affiliation(s)
- Joachim Fensterle
- Institut für Medizinische Strahlenkunde und Zellforschung (MSZ), University Clinics of Würzburg, Versbacher Str. 5, 97078 Würzburg, Germany
| | - Jürgen C Becker
- Department of Dermatology, University Clinics of Würzburg, 97078 Würzburg, Germany
| | - Tamara Potapenko
- Institut für Medizinische Strahlenkunde und Zellforschung (MSZ), University Clinics of Würzburg, Versbacher Str. 5, 97078 Würzburg, Germany
| | - Veronika Heimbach
- Institut für Medizinische Strahlenkunde und Zellforschung (MSZ), University Clinics of Würzburg, Versbacher Str. 5, 97078 Würzburg, Germany
| | - Claudia S Vetter
- Department of Dermatology, University Clinics of Würzburg, 97078 Würzburg, Germany
| | - Eva B Bröcker
- Department of Dermatology, University Clinics of Würzburg, 97078 Würzburg, Germany
| | - Ulf R Rapp
- Institut für Medizinische Strahlenkunde und Zellforschung (MSZ), University Clinics of Würzburg, Versbacher Str. 5, 97078 Würzburg, Germany
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