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Milicevic S, Cemazar M, Ivancic AK, Gasljevic G, Bosnjak M, Sersa G, Peric B. Electrochemotherapy of Melanoma Cutaneous Metastases in Organ Transplant Recipients: A Systematic Review of Preclinical and Clinical Studies. Int J Mol Sci 2023; 24:ijms24098335. [PMID: 37176042 PMCID: PMC10179383 DOI: 10.3390/ijms24098335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 04/27/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023] Open
Abstract
Cutaneous melanoma is a highly aggressive form of skin cancer. The development of immune checkpoint inhibitors (ICIs) has revolutionized the management of advanced melanoma, led to durable responses, and improved overall survival. However, the success of ICIs in melanoma treatment is influenced by the tumor microenvironment (TME) which plays a critical role in regulating the immune response to the tumor. Understanding the mechanisms underlying this interaction is crucial to optimizing the efficiency of ICIs. Electrochemotherapy (ECT) has been shown to enhance the efficacy of ICIs in melanoma treatment by inducing tumor cell death and facilitating the release of tumor antigens which can subsequently be recognized and targeted by the immune system. Moreover, ECT has been reported to modulate the TME, leading to increased infiltration of immune cells and a more favorable immunological profile. In this review, we summarize the available knowledge of changes in TME after ECT of melanoma cutaneous metastasis and highlight the differences in tumor-infiltrating immune cells between immunocompetent and immunosuppressed organisms. In addition, we showed that ECT can be an effective and safe procedure for organ transplant recipients. Furthermore, repeated ECT may enhance immune activation and probably induce a bystander effect by trained immunity.
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Affiliation(s)
- Sara Milicevic
- Institute of Oncology Ljubljana, Zaloska Cesta 2, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia
| | - Maja Cemazar
- Institute of Oncology Ljubljana, Zaloska Cesta 2, 1000 Ljubljana, Slovenia
- Faculty of Health Sciences, University of Primorska, Polje 42, 6310 Izola, Slovenia
| | | | - Gorana Gasljevic
- Institute of Oncology Ljubljana, Zaloska Cesta 2, 1000 Ljubljana, Slovenia
| | - Masa Bosnjak
- Institute of Oncology Ljubljana, Zaloska Cesta 2, 1000 Ljubljana, Slovenia
- Faculty of Pharmacy, University of Ljubljana, Askerceva Cesta 7, 1000 Ljubljana, Slovenia
| | - Gregor Sersa
- Institute of Oncology Ljubljana, Zaloska Cesta 2, 1000 Ljubljana, Slovenia
- Faculty of Health Sciences, University of Ljubljana, Zdravstvena Pot 5, 1000 Ljubljana, Slovenia
| | - Barbara Peric
- Institute of Oncology Ljubljana, Zaloska Cesta 2, 1000 Ljubljana, Slovenia
- Faculty of Medicine, University of Ljubljana, Zaloska 2, 1000 Ljubljana, Slovenia
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González-Cruz C, Ferrándiz-Pulido C, García-Patos Briones V. Melanoma in Solid Organ Transplant Recipients. ACTAS DERMO-SIFILIOGRAFICAS 2020; 112:216-224. [PMID: 33197437 DOI: 10.1016/j.ad.2020.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/20/2020] [Accepted: 11/02/2020] [Indexed: 12/19/2022] Open
Abstract
In this review, we analyze the 3 clinical scenarios related to the development of melanoma in solid organ transplant recipients: melanoma in patients with a history of the tumor prior to a transplant, de novo melanoma following a transplant, and melanoma of donor origin. The main factors to consider in organ-transplant candidates with a history of melanoma are tumor stage, presence or absence of residual disease, and time from diagnosis to transplantation. Solid organ transplant recipients have a greater risk of melanoma than immunocompetent individuals. Mortality is also higher in this population, especially in patients with advanced melanoma, as treatment is especially challenging. Clinical history and physical examination provide the most useful information for preventing donor-to-recipient transmission of melanoma. Donor-derived melanoma has a very poor prognosis.
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Affiliation(s)
- C González-Cruz
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron. Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, España.
| | - C Ferrándiz-Pulido
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron. Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
| | - V García-Patos Briones
- Servicio de Dermatología, Hospital Universitari Vall d'Hebron. Facultad de Medicina, Universitat Autònoma de Barcelona, Barcelona, España
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Abstract
This study aimed to evaluate the association of KIT mutations with clinicopathologic features of melanomas using a meta-analysis and to identify differences between Asian and White populations using subgroup analyses. We selected 32 studies from the literature including 5224 patients. The pooled data were combined, and odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. Heterogeneity and publication bias were also determined. KIT mutations were reported in 497 (9.5%) of 5224 patients with melanomas, and were associated significantly with age, clinical melanoma subtype, anatomic location, and chronic sun-damage (CSD), but not with sex, histological type, Breslow thickness, ulceration, mitotic rate, or tumor stage. The incidence of KIT mutation was significantly higher in older individuals (OR=1.296, 95% CI: 1.025-1.641; P=0.031), and showed a positive association with mucosal melanoma (OR=1.363, 95% CI: 1.094-1.697; P=0.006), acral melanoma (OR=1.374, 95% CI: 1.123-1.682; P=0.02), and CSD (OR=1.880, 95% CI: 1.127-3.136; P=0.016), but a negative relationship with melanomas arising in non-CSD skin (OR=0.562, 95% CI: 0.392-0.805; P=0.002). The frequency of KIT mutations was associated negatively with melanomas located on the extremities. KIT mutations, which are critical in the genetic pathogenesis of melanomas, define a unique subtype of melanoma associated closely with older age, and acral, mucosal, or CSD sites, but not associated with any histological features or tumor stage. Although the KIT mutation rate is higher in White than Asian populations, no significant difference in clinical association with KIT mutations was detected between the two groups.
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Howard MD, Su JC, Chong AH. Skin Cancer Following Solid Organ Transplantation: A Review of Risk Factors and Models of Care. Am J Clin Dermatol 2018; 19:585-597. [PMID: 29691768 DOI: 10.1007/s40257-018-0355-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The number of solid organ transplants has been increasing annually worldwide. Advances in transplantation surgery and community awareness of organ donation have been key contributors. Combined with increased understanding of immunosuppression, there are a growing number of solid organ transplant recipients in the community as a result of improved long-term outcomes. There remains a high incidence of deaths worldwide post-transplant due to non-melanoma skin cancer (NMSC), which has greater morbidity and mortality in this population than in the general community. Many transplant candidates are not screened prior to organ transplantation and not followed up dermatologically after transplant. After a comprehensive review of the MEDLINE database, we present an update of literature on risk factors for melanoma and non-melanoma skin cancer development in transplant recipients. Medications used by transplant recipients, including immunosuppressants and antibiotics, are discussed along with their respective risks of skin cancer development. We conclude with evidence-based recommendations for models of care, including patient education and dermatological review of transplant recipients.
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Wylomanski S, Denis MG, Théoleyre S, Bouquin R, Vallée A, Knol AC, Saint-Jean M, Peuvrel L, Dréno B, Quéreux G. BRAF mutations might be more common than supposed in vulvar melanomas. Exp Dermatol 2018; 27:210-213. [PMID: 29178146 DOI: 10.1111/exd.13472] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/26/2017] [Indexed: 11/27/2022]
Abstract
Data on BRAF, NRAS and KIT mutations are scarce in patients with vulvo-vaginal melanomas and are associated with important therapeutic issues. We investigated their prevalence in a cohort of patients with female lower genital tract melanomas between 2003 and 2017. Of the 22 patients, 5 (22.7%) harboured a BRAF mutation, which was much higher than the rate of 5% reported in the literature. One patient, who was tested negative on the primary melanoma, had a NRAS mutation in a cutaneous metastasis. Our data provide a rationale for prospective and repeated mutations testing in female lower genital tract melanomas.
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Affiliation(s)
- Sophie Wylomanski
- Department of Obstetrics and Gynecology, Nantes University Hospital, Nantes, France
| | - Marc G Denis
- INSERM U 1232, Nantes, France
- Department of Biochemistry, Nantes University Hospital, Nantes, France
| | - Sandrine Théoleyre
- INSERM U 1232, Nantes, France
- Department of Biochemistry, Nantes University Hospital, Nantes, France
| | - Réjane Bouquin
- Department of Obstetrics and Gynecology, Nantes University Hospital, Nantes, France
| | - Audrey Vallée
- INSERM U 1232, Nantes, France
- Department of Biochemistry, Nantes University Hospital, Nantes, France
| | - Anne-Chantal Knol
- INSERM U 1232, Nantes, France
- Immuno-Dermatology Laboratory, Nantes University Hospital, Nantes, France
| | - Mélanie Saint-Jean
- INSERM U 1232, Nantes, France
- Immuno-Dermatology Laboratory, Nantes University Hospital, Nantes, France
- Department of Dermatology, Nantes University Hospital, Nantes, France
- INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France
| | - Lucie Peuvrel
- INSERM U 1232, Nantes, France
- Immuno-Dermatology Laboratory, Nantes University Hospital, Nantes, France
- Department of Dermatology, Nantes University Hospital, Nantes, France
- INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France
| | - Brigitte Dréno
- INSERM U 1232, Nantes, France
- Immuno-Dermatology Laboratory, Nantes University Hospital, Nantes, France
- Department of Dermatology, Nantes University Hospital, Nantes, France
- INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France
| | - Gaëlle Quéreux
- INSERM U 1232, Nantes, France
- Immuno-Dermatology Laboratory, Nantes University Hospital, Nantes, France
- Department of Dermatology, Nantes University Hospital, Nantes, France
- INSERM CIC 1413, Clinical Investigation Center, Nantes University Hospital, Nantes, France
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