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Orlova KV, Fedyanin MY, Simanenkov KE, Dergunov AS, Goldshmidt PR. Real-world efficacy of the first line therapy with prolgolimab in patients with metastatic melanoma: interim results of the FORA (FOrteca Real practice Assessment) observational study. J Mod Onco 2023. [DOI: 10.26442/18151434.2022.4.202035] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background. Novel agents immune checkpoint inhibitors fundamentally changed the prognosis for life in patients with metastatic and/or inoperable melanoma. The development, studies, and approval of a new original PD1 inhibitor in Russia in 2020 prompted the professional community to conduct a prospective observational study in the Russian Federation to assess the real-world efficacy and safety of prolgolimab, as real-world patients differ from the refined population in clinical trials.
Aim. To evaluate the real-world efficacy and safety of prolgolimab in patients with metastatic and/or inoperable melanoma.
Materials and methods. From October 2020 to October 2022, the study enrolled 700 patients with metastatic and/or inoperable melanoma receiving prolgolimab in real clinical settings in oncological institutions of various levels in the Russian Federation. The main inclusion criteria were: pathology-confirmed diagnosis of melanoma, metastatic and/or inoperable type, use of prolgolimab outside of clinical trials, and signed informed consent by the patient. Objective response rate (ORR) was considered the main criterion for evaluating the efficacy of therapy, and the safety criterion was the incidence of grade 34 adverse events. Statistical analysis was performed using the SPSS 20.0 software package.
Results. The ORR for patients with skin melanoma treated with prolgolimab in the first line therapy (n= 207/337) was 48.3% (n=100), the disease stabilization was reported in 30.4% (n=63), and progression in 21.3% (n=44) of patients. There were no significant differences in response to therapy between patients with/without BRAF mutation, although ORR was higher in patients with BRAF mutation: the ORR for patients with BRAF mutation was 57.9% (n=33), and for BRAF non-mutated patients, 44.4% (n=52; p=0.222). At a median follow-up of 5 months, the median PFS was 10 months (95% confidence interval 7.3512.64). The incidence of grade 34 treatment-related adverse events according to CTCAE 5.0 was 2% (n=12), and 12% (n=82) for grade 12 adverse events.
Conclusion. The results confirm the high efficacy and satisfactory tolerability of prolgolimab in patients with metastatic and/or inoperable melanoma in real-world settings. There were no significant differences in ORR between patients with or without BRAF mutation.
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Samoylenko I, Stroganova A, Shakhray E, Orlova KV, Akhmetianova A, Demidov LV. Evaluation of treatment patterns in patients with BRAF-mutant cutaneous melanoma in adjuvant setting in real practice. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e21573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21573 Background: Mutation in BRAF is a crucial biomarker for treatment choice in patient with locally advanced or metastatic melanoma. In patient with BRAF wild-type (WT) melanoma aPD1 is the preferred treatment regimen. In patients with BRAF V600 mutant melanoma combined targeted therapy (cTT) could also be chosen as adjuvant treatment, which significantly improves OS. Methods: We conducted a retrospective continuous study of all melanoma patients, who were tested for BRAF mutation by RT-PCR in 2020 (COIVD-19 pandemic year) in our institution and analyzed adjuvant therapy options they received. Patient demographics, mutational status, disease stage, treatment regimens and treatment outcomes were collected from electronic medical records. Results: Between January 2020 and December 2020, tumor samples from 297 pts were tested for BRAF mutations. The mean pts age was 58.2 years (95% CI 51.2 to 60.3) and 130 (43.7%) were male. BRAF mutations were detected in 147 (49.5%) patients. Most common mutation was V600E (140 out of 147 samples, 88.4%) and V600K (13 out of 147, 8.84%). We also found K601N, K601E, L597R and V600M mutations (in one sample each). Among 150 BRAF wild type samples 44 were also tested for NRAS mutations and in 13 (29.54%) pts NRAS mutations were detected: Q61R – in 6 (46.15%) pts, Q61L – in 2 (15.38%) pts, Q61K – in 3 (23.08%) pts, G12E – in 1 (7.69%) pt, and G12D - in 1 (7.69%) pt . Also among 150 BRAF wild type samples 56 were tested for KIT mutations and only one sample were found to harbour D186V mutation . Among BRAF-positive pts at time of the genetic test performed stage I CM had 11 (7.48%) out of 147 pts, stage II - 13 (8.84%) pts, stage III - 67 (45.57%) pts, and stage IV - 43 (29.25%) pts. In 13 (8.84%) pts stage could not be clearly identified. In most cases (32 out of 67, 47.76%) monotherapy with aPD1 was given as adjuvant treatment in stage III pts where as only 6 (8.95%) patients received cTT, 7 pts (10.41%) received IFN-alfa and 22 pts (32.84%) received no or were given with other treatment (Table). Median DFS did not differ significantly between treatment cohorts. Conclusions: In our retrospective study we found that among stage III BRAF-mutant patients monotherapy with aPD1 was the most common adjuvant treatment regimen. In some patients with stage III disease IFN-alfa is still given. More studies are needed to define best adjuvant treatment for BRAF mutant stage III melanoma pts.[Table: see text]
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Affiliation(s)
- Igor Samoylenko
- N.N.Blokhin NMRC of Oncology MoH of Russia, Moscow, Russian Federation
| | - Anna Stroganova
- N.N.Blokhin NMRC of Oncology MoH of Russia, Moscow, Russian Federation
| | | | | | | | - Lev V. Demidov
- N.N.Blokhin NMRC of Oncology MoH of Russia, Moscow, Russian Federation
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Samoylenko I, Zaretsky AR, Chudakova LV, Drozd OV, Garanina OE, Shlivko IL, Zinovev G, Baryshnikov KA, Orlova KV, Maximova T, Sinelnikov I, Kim A, Mikhaylova IN, Demidov LV. Multicenter prospective clinical trial of molecular genetic markers for non-invasive differential diagnosis of benign and malignant melanocytic skin lesions. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e21581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21581 Background: Improving the accuracy of non-invasive diagnosis of skin tumors is becoming an urgent problem, given the clear increase in the incidence of melanoma in many countries. Dermoscopy and examination by an experienced dermatologist can reduce the NNE to 5–10 per melanoma (M) detected, however, achieving even this, clearly suboptimal, rate requires a long specialist training. Methods: We report results of prospective nonrandomized trial evaluating sensitivity and specificity of RNA profiling of cytological samples from adhesive transparent patches (ATP) applied to skin lesions. Routine pathology reports were obtained for all surgery samples. RNA extracted from ATP specimens (N = 126) was tested for mRNA expression of PRAME and LINC00518 genes. GAPDH was used as a reference gene. Sample was considered marker-positive if either PRAME or LINC00518 expression was detected. Results: Between June 2021 and November 2021, 126 pts undegoing excisional biopsy of skin lesions were included in the study at 5 centers. On pathology, invasive M was detected in 49 (38.9%) patients (mean Breslow thickness was 2.41 mm [95%CI 1,44 to 3.37]), M in situ in 6 (4.8%), non-melanoma skin cancer in 4 (3.2%) and dysplastic nevus in 56 (44.4%). In the day of preplanned excision ATP was applied to the target lesion for 5–6 min and sent to the central lab. Amplifiable mRNA was found in all 126 ATP samples. 82 samples of 126 (65,1%) tested marker-positive. Sensitivity of RNA profiling for detection of skin cancers reached 88.14% (95% CI 77.07% – 95.09%), while specificity was only 53.85% (41.03% – 66.30%), with PPV of 63.41% (56.74% – 69.61%), NPV of 83.33% (70.65% – 91.22%) and accuracy of 70.16% (61.29% – 78.04%). Among the seven false negative results there were 3 M in situ and 4 invasive M. Conclusions: RNA profiling of skin ATP specimens is feasible and has high sensitivity but rather low specificity. Randomized studies are needed to evaluate if this technique can add anything to dermoscopy or other noninvasive diagnostic modalities. Clinical trial information: NCT04353050. [Table: see text]
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Affiliation(s)
- Igor Samoylenko
- N.N.Blokhin NMRC of Oncology MoH of Russia, Moscow, Russian Federation
| | - Andrew R Zaretsky
- Department of Molecular Technologies Research Institute of Translational Medicine N. I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Lidia V Chudakova
- Department of Molecular Technologies Research Institute of Translational Medicine N. I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Oleg V Drozd
- Department of Molecular Technologies Research Institute of Translational Medicine N. I. Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, Moscow, Russian Federation
| | - Oksana E Garanina
- Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russian Federation
| | - Irena L Shlivko
- Federal State Budgetary Educational Institution of Higher Education «Privolzhsky Research Medical University» of the Ministry of Health of the Russian Federation, Nizhny Novgorod, Russian Federation
| | - Grigory Zinovev
- N.N. Petrov NMRC of Oncology MoH of Russia, Saint-Petersburg, Russian Federation
| | | | | | - Tatiana Maximova
- N.N.Blokhin NMRC of Oncology MoH of Russia, Moscow, Russian Federation
| | - Igor Sinelnikov
- Melanoma Unit Russia “Israeli Medical Research Center”, Moscow, Russian Federation
| | - Anna Kim
- Chaika Clinics, Moscow, Russian Federation
| | | | - Lev V. Demidov
- N.N.Blokhin NMRC of Oncology MoH of Russia, Moscow, Russian Federation
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Orlova KV, Ledin E, Zhukova NV, Orlova R, Protsenko S, Novik A, Moiseenko FV, Naskhletashvili D, Demidov LV. The role of surgery (metastasectomy) in advanced BRAF positive melanoma during modern therapy. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e21512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e21512 Background: Improved overall survival in patients undergoing metаstasectomy for melanoma have been reported in several retrospective studies before era of modern therapy in melanoma. Rapid progress in BRAF and MEK targeted therapy (TT) and immunotherapy (IT) has led to significant improvements in objective response rates and survival rates in advanced melanoma patients. Unfortunately, part of patients have a resistance to modern therapy in one or more lesions. In 2019 Nelson DW et al published data when surgery followed by modern therapy in 47 matched pairs was associated with higher 5-year melanoma-specific survival (MSS) versus modern therapy alone (58.8% vs. 38.9%, p = 0.049). But data about modern therapy in BRAF + advanced melanoma with metastasectomy during therapy are limited. Methods: We conducted an observational retrospective chart review study and evaluated a subset of patients which underwent surgery (metastasectomy) with V600 BRAF-mutant advanced melanoma, who received therapy in a real-world setting in Russia. Survival analyses were performed using the Kaplan-Meier method, Log-rank, chi-square and Fisher exact tests were used for comparison between groups. Results: The observed population included 382 patients in Russia. The date of the first enrollment after all approvals was 8 October 2018, and the date of the last completed register was 27 April 2019. Among 382 patients, 107 (28%) patients received surgical treatment for advanced melanoma during modern therapy (removal of metastases from the brain, lungs, soft tissues and other organs). Surgery during first line therapy was performed in 60pts (56%), as second – in 25pts (23.4%) and third or higher line in 22pts (20.6%). Comparison of overall survival curves for all patients depending on the surgical treatment showed that the survival in the subgroup of patients with the presence of surgical treatment was higher than among patients who did not undergo metastasectomy: 24-months OS was 76.7 (95%CI, 65.6 – 84.6) and 53.7% (95%CI, 46.4-60.4), p = 0,0027). Conclusions: Our findings suggest that resection of distant metastases associated with improved overall survival despite all limitations in retrospective nature of the study. While modern systemic therapy have improved outcomes in advanced melanoma, metastasectomy remains associated with favorable survival. Surgery have to be a part of multidisciplinary care for patients with advanced melanoma.
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Affiliation(s)
| | | | - Natalia V. Zhukova
- Saint-Petersburg State University, Medical Faculty, Saint-Petersburg, Russian Federation
| | - Rashida Orlova
- Saint-Petersburg State University, Saint-Petersburg, Russian Federation
| | - Svetlana Protsenko
- N.N.Petrov National Medical Research Center of Oncology, Saint-Petersburg, Russian Federation
| | - Alexey Novik
- FSBI “N.N. Petrov National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, Saint Petersburg, Russian Federation
| | | | | | - Lev V. Demidov
- N.N.Blokhin NMRC of Oncology MoH of Russia, Moscow, Russian Federation
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Orlova KV, Ledin EV, Zhukova NV, Orlova RV, Karabina EV, Volkonskiy MV, Stroyakovskiy DL, Yurchenkov AN, Protsenko SA, Novik AV, Vorotilina LV, Moiseenko FV, Chang VL, Kazmin AI, Tkachenko SA, Gamaunov SV, Naskhletashvili DR, Samoylenko IV, Vikhrova AS, Utyashev IA, Kharkevich GY, Petenko NN, Shubina IZ, Demidov LV. Real-World Experience with Targeted Therapy in BRAF Mutant Advanced Melanoma Patients: Results from a Multicenter Retrospective Observational Study Advanced Melanoma in Russia (Experience) (ADMIRE). Cancers (Basel) 2021; 13:cancers13112529. [PMID: 34064013 PMCID: PMC8196785 DOI: 10.3390/cancers13112529] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [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: 04/06/2021] [Revised: 05/14/2021] [Accepted: 05/19/2021] [Indexed: 01/06/2023] Open
Abstract
Simple Summary Advanced melanoma is a highly aggressive disease with a poor prognosis. Recent clinical trials have shown that targeted therapy (TT) and immunotherapy (IT) lead to significant improvements in responses to treatment and the survival of advanced melanoma patients. However, little information is available in the form of real-world data on treatment patterns and clinical outcomes for patients with advanced BRAF V600 mutant melanoma. To approach this issue, we performed a retrospective study that involved 382 patients with advanced BRAF V600 mutant melanoma, who received TT in twelve medical centers. Our objectives were to evaluate clinical outcomes in real-world settings, as well as treatment patterns, adverse events, objective response rate (ORR), progression-free survival (PFS) and overall survival (OS). Considering these parameters, the results demonstrated the effectiveness of combined TT with BRAF plus MEK inhibitors in patients with brain metastases and across all lines of therapy, which was well-tolerated and manageable and showed a high safety profile. Abstract Clinical trials of targeted therapy (TT) and immunotherapy (IT) for highly aggressive advanced melanoma have shown marked improvements in response and survival rates. However, real-world data on treatment patterns and clinical outcomes for patients with advanced BRAF V600 mutant melanoma are ultimately scarce. The study was designed as an observational retrospective chart review study, which included 382 patients with advanced BRAF V600 mutant melanoma, who received TT in a real-world setting and were not involved in clinical trials. The data were collected from twelve medical centers in Russia. The objective response rates (ORRs) to combined BRAFi plus MEKi and to BRAFi mono-therapy were 57.4% and 39.8%, respectively. The median progression-free survival (PFS) and median overall survival (OS) were 9.2 months and 22.6 months, respectively, for the combined first-line therapy; 9.4 months and 16.1 months, respectively, for the combined second-line therapy; and 7.4 months and 17.1 months, respectively, for the combined third- or higher-line therapy. Analysis of treatment patterns demonstrated the effectiveness of the combined TT with BRAF plus MEK inhibitors in patients with brain metastases, rare types of BRAF mutations, and across lines of therapy, as well as a well-tolerated and manageable safety profile.
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Affiliation(s)
- Kristina V. Orlova
- FSBI “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 115478 Moscow, Russia; (D.R.N.); (I.V.S.); (A.S.V.); (G.Y.K.); (N.N.P.); (L.V.D.)
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
- Correspondence: (K.V.O.); (I.Z.S.)
| | | | - Natalia V. Zhukova
- SBHI of Saint-Petersburg “City Clinical Oncology Dispensary”, 197022 Saint Petersburg, Russia; (N.V.Z.); (R.V.O.)
- St Petersburg University, 199034 Saint Petersburg, Russia
| | - Rashida V. Orlova
- SBHI of Saint-Petersburg “City Clinical Oncology Dispensary”, 197022 Saint Petersburg, Russia; (N.V.Z.); (R.V.O.)
- St Petersburg University, 199034 Saint Petersburg, Russia
| | | | | | - Daniil L. Stroyakovskiy
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
- Moscow City Oncology Hospital No. 62, 143423 Moscow, Russia; (M.V.V.); (A.N.Y.)
| | | | - Svetlana A. Protsenko
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
- FSBI “N.N. Petrov National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 197758 Saint Petersburg, Russia;
| | - Alexey V. Novik
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
- FSBI “N.N. Petrov National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 197758 Saint Petersburg, Russia;
| | | | - Fedor V. Moiseenko
- FSBI “N.N. Petrov National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 197758 Saint Petersburg, Russia;
- SBHI “Saint-Petersburg Clinical Scientific and Practical Center for Specialized Types of Medical Care (Oncological)”, 197758 Saint Petersburg, Russia
| | - Victor L. Chang
- SBHI “Tambov Region Oncology Dispensary”, 392000 Tambov, Russia;
| | - Aleksandr I. Kazmin
- BHI of Voronezh Region “Voronezh Region Clinical Oncology Dispensary”, 394036 Voronezh, Russia;
| | - Svetlana A. Tkachenko
- SBHI of Kaluga Region “Kaluga Region Clinical Oncology Dispensary”, 248007 Kaluga, Russia;
| | - Sergey V. Gamaunov
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
- Chuvash Autonomous Institution “Republic Clinical Oncology Dispensary” of Chuvash Republic MoH, 428020 Cheboksary, Russia
| | - David R. Naskhletashvili
- FSBI “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 115478 Moscow, Russia; (D.R.N.); (I.V.S.); (A.S.V.); (G.Y.K.); (N.N.P.); (L.V.D.)
| | - Igor V. Samoylenko
- FSBI “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 115478 Moscow, Russia; (D.R.N.); (I.V.S.); (A.S.V.); (G.Y.K.); (N.N.P.); (L.V.D.)
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
| | - Anastasia S. Vikhrova
- FSBI “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 115478 Moscow, Russia; (D.R.N.); (I.V.S.); (A.S.V.); (G.Y.K.); (N.N.P.); (L.V.D.)
| | - Igor A. Utyashev
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
- Institute of Oncology, Hadassah Medical Moscow, 121205 Moscow, Russia
| | - Galina Yu. Kharkevich
- FSBI “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 115478 Moscow, Russia; (D.R.N.); (I.V.S.); (A.S.V.); (G.Y.K.); (N.N.P.); (L.V.D.)
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
| | - Natalia N. Petenko
- FSBI “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 115478 Moscow, Russia; (D.R.N.); (I.V.S.); (A.S.V.); (G.Y.K.); (N.N.P.); (L.V.D.)
| | - Irina Zh. Shubina
- FSBI “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 115478 Moscow, Russia; (D.R.N.); (I.V.S.); (A.S.V.); (G.Y.K.); (N.N.P.); (L.V.D.)
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
- Correspondence: (K.V.O.); (I.Z.S.)
| | - Lev V. Demidov
- FSBI “N.N. Blokhin National Medical Research Center of Oncology” of the Ministry of Health of the Russian Federation, 115478 Moscow, Russia; (D.R.N.); (I.V.S.); (A.S.V.); (G.Y.K.); (N.N.P.); (L.V.D.)
- Association Professional Melanoma Society (MELANOMA.PRO), 119192 Moscow, Russia; (D.L.S.); (S.A.P.); (A.V.N.); (S.V.G.); (I.A.U.)
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Emelyanova MA, Telysheva EN, Orlova KV, Ryabaya OO, Snigiryova GP, Abramov IS, Mikhailovich VM. Microarray-based analysis of the BRAF V600 mutations in circulating tumor DNA in melanoma patients. Cancer Genet 2020; 250-251:25-35. [PMID: 33249369 DOI: 10.1016/j.cancergen.2020.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 10/20/2020] [Accepted: 11/11/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Circulating tumor DNA (ctDNA) holds great potential for cancer therapy and can provide diagnostic and prognostic information before and during treatment. METHODS Plasma DNA samples from 97 melanoma patients, 20 healthy donors and 3 patients with benign skin tumors were analyzed by microarray analysis and droplet digital PCR (ddPCR). RESULTS A microarray for simultaneous detection of six BRAF V600 mutations in ctDNA has been developed. The method allows the detection of 0.05% mutated DNA from WT DNA background. For paired samples (pre-surgery plasma and tumor tissue) isolated from 74 patients, the concordance of genotypes between tumor DNA and ctDNA was 65% (48/74). BRAF mutations in ctDNA were detected in 27/50 patients with BRAF-positive tumors and in 3/24 patients with BRAF wild-type tumors. The presence of ctDNA BRAF mutations in 23 plasma samples from melanoma patients undergoing therapy correlated significantly with tumor progression (P=0.005). The increase in cell-free DNA levels measured by ddPCR also correlated with disease progression (P=0.02). The concordance of results obtained by microarray identification of BRAF mutations and those obtained by ddPCR was 91%. CONCLUSION The novel microarray-based approach can be a useful non-invasive tool for accurate identification of ctDNA BRAF mutations to monitor disease progression.
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Affiliation(s)
- Marina A Emelyanova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, 32 Vavilova St., Russian Federation
| | - Ekaterina N Telysheva
- Russian Scientific Center of Roentgen Radiology, Ministry of Healthcare of the Russian Federation, 117997 Moscow, Profsoyuznaya St. 86, Russian Federation
| | - Kristina V Orlova
- N.N. Blokhin National Medical Research Center for Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Kashirskoye shosse 24, Russian Federation
| | - Oxana O Ryabaya
- N.N. Blokhin National Medical Research Center for Oncology, Ministry of Health of the Russian Federation, 115478 Moscow, Kashirskoye shosse 24, Russian Federation
| | - Galina P Snigiryova
- Russian Scientific Center of Roentgen Radiology, Ministry of Healthcare of the Russian Federation, 117997 Moscow, Profsoyuznaya St. 86, Russian Federation
| | - Ivan S Abramov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, 32 Vavilova St., Russian Federation
| | - Vladimir M Mikhailovich
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, 32 Vavilova St., Russian Federation.
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Orlova KV, Yanus GA, Aleksakhina SN, Venina AR, Iyevleva AG, Demidov LV, Imyanitov EN. Lack of Response to Imatinib in Melanoma Carrying Rare KIT Mutation p.T632I. Case Rep Oncol 2019; 12:109-112. [PMID: 31043947 PMCID: PMC6477486 DOI: 10.1159/000495782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 11/01/2018] [Accepted: 11/22/2018] [Indexed: 11/19/2022] Open
Abstract
Approximately 15% of acral and mucous melanomas carry activating mutations in KIT oncogene. There is a diversity of spectrum of KIT mutations, with some of them rendering tumors responsive to imatinib, while others being imatinib-resistant or not studied yet. Here we present an acral melanoma patient with KIT р.T632I mutation, who failed to respond to imatinib.
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Affiliation(s)
- Kristina V Orlova
- Department of Biotherapy, N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - Grigory A Yanus
- Department of Tumor Growth Biology, N.N. Petrov National Medical Research Center of Oncology, Saint Petersburg, Russian Federation.,Department of Clinical Genetics, St.-Petersburg Pediatric Medical University, Saint Petersburg, Russian Federation
| | - Svetlana N Aleksakhina
- Department of Tumor Growth Biology, N.N. Petrov National Medical Research Center of Oncology, Saint Petersburg, Russian Federation
| | - Aigul R Venina
- Department of Tumor Growth Biology, N.N. Petrov National Medical Research Center of Oncology, Saint Petersburg, Russian Federation
| | - Aglaya G Iyevleva
- Department of Tumor Growth Biology, N.N. Petrov National Medical Research Center of Oncology, Saint Petersburg, Russian Federation.,Department of Clinical Genetics, St.-Petersburg Pediatric Medical University, Saint Petersburg, Russian Federation
| | - Lev V Demidov
- Department of Biotherapy, N.N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - Evgeny N Imyanitov
- Department of Tumor Growth Biology, N.N. Petrov National Medical Research Center of Oncology, Saint Petersburg, Russian Federation.,Department of Clinical Genetics, St.-Petersburg Pediatric Medical University, Saint Petersburg, Russian Federation.,Department of Oncology, I.I. Mechnikov North-Western Medical University, Saint Petersburg, Russian Federation.,Department of Oncology, St.-Petersburg State University, Saint Petersburg, Russian Federation
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Belysheva TS, Vishnevskaya YV, Nasedkina TV, Emelyanova MA, Abramov IS, Orlova KV, Lubchenko LN, Utyashev IA, Doroshenko MB, Demidov LV, Aliev MD. Melanoma arising in a Giant congenital melanocytic nevus: two case reports. Diagn Pathol 2019; 14:21. [PMID: 30782194 PMCID: PMC6381634 DOI: 10.1186/s13000-019-0797-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 09/04/2018] [Accepted: 02/10/2019] [Indexed: 12/22/2022] Open
Abstract
Background A giant congenital melanocytic nevus (GCMN) is found in 0.1% of live-born infants. If present, the lesion has a chance of about 6% to develop into malignant melanoma. Both children and adults can be affected by malignant melanoma arising in a giant congenital nevus. Up to 95% of GCMNs harbor NRAS mutations, and mutations in the BRAF, MC1R, TP53, and GNAQ genes have also been described. The individualization of therapy is required, but diagnostic and prognostic criteria remain controversial. Case presentations We report two cases: 1) melanoma arising in a giant congenital nevus during the first month of life complicated with neurocutaneous melanosis (NCM), and 2) melanoma arising in a giant congenital nevus during the first 6 months of life. Pathology, immunohistochemistry, and genetic analyses of tumor tissue were performed. The first case revealed only a non-pathogenic P72R polymorphism of the TP53 gene in the homozygote condition. For the second case, a Q61K mutation was detected in the NRAS gene. Conclusion Malignant melanoma associated with GCMN is rare and therefore poorly understood. Outcomes have been linked to the stage at diagnosis, but no additional pathological prognostic factors have been identified. The most frequent genetic event in giant CMNs is NRAS mutations, which was discovered in one of our cases. To accumulate evidence to improve disease prognosis and outcomes, children with congenital melanocytic nevus should be included in a systemic follow-up study from birth.
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Affiliation(s)
- Tatiana S Belysheva
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation
| | - Yana V Vishnevskaya
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation
| | - Tatiana V Nasedkina
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation.,Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russian Federation
| | - Marina A Emelyanova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russian Federation
| | - Ivan S Abramov
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation.,Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russian Federation
| | - Kristina V Orlova
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation.
| | - Ludmila N Lubchenko
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation
| | - Igor A Utyashev
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation
| | - Marina B Doroshenko
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation
| | - Lev V Demidov
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation
| | - Mamed D Aliev
- Federal State Budgetary Institution, "N.N. Blokhin Medical Research Center of Oncology" of the Ministry of Health of the Russian Federation, 115478 Kashirskoye shosse, 24, Moscow, Russian Federation
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Orlova KV, Nazarova VV, Delektorskaya VV, Vishnevskaya Y, Lesovaya EA, Tsyganova IV, Kirsanov KI, Yakubovskaya MG, Demidov LV. The prevalence of Merkel cell polyomavirus in Russian patients with Merkel cell carcinoma. J Clin Oncol 2018. [DOI: 10.1200/jco.2018.36.15_suppl.e21605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | - Y. Vishnevskaya
- N.N.Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | | | | | | | | | - Lev V. Demidov
- N.N.Blokhin Russian Cancer Research Center, Moscow, Russian Federation
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Orlova KV, Delektorskaya VV, Vishnevskaya YV, Kondratieva TT, Orel NF, Markovich AA, Demidov LV, Subramanian S. Somatostatin receptor type 2 expression in Merkel cell carcinoma as a prognostic factor. J Eur Acad Dermatol Venereol 2018; 32:e236-e237. [PMID: 29265481 DOI: 10.1111/jdv.14769] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- K V Orlova
- Department of Biotherapy, N. N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - V V Delektorskaya
- Department of Pathology, N. N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - Y V Vishnevskaya
- Department of Pathology, N. N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - T T Kondratieva
- Department of Pathology, N. N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - N F Orel
- Department of Chemotherapy, N. N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - A A Markovich
- Department of Chemotherapy, N. N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - L V Demidov
- Department of Biotherapy, N. N. Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - S Subramanian
- EAFO Educational & Research Center, Eurasian Federation of Oncology, Moscow, Russian Federation
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Samoylenko I, Kharkevich G, Petenko NN, Orlova KV, Sinelnikov I, Utyashev IA, Vikhrova A, Markina I, Demidov LV. Paclitaxel and carboplatin chemotherapy in patients with metaststic melanoma refractory to BRAF/MEK inhibitors. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.9552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Igor Samoylenko
- NN Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - Galina Kharkevich
- NN Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | | | | | - Igor Sinelnikov
- I.M. Sechenov First Moscow State Medical University, Moscow, Russia
| | - Igor A Utyashev
- NN Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | | | - Irina Markina
- NN Blokhin Russian Cancer Research Center, Moscow, Russian Federation
| | - Lev V. Demidov
- NN Blokhin Russian Cancer Research Center, Moscow, Russian Federation
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Subramanian S, Kanagavel D, Petenko NN, Orlova KV, Samoĭlenko IV, Demidov LV. [Use of docetaxel in treatment of squamous-cell carcinoma of head and neck]. Vopr Onkol 2011; 57:421-426. [PMID: 22191228] [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: 05/31/2023]
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