External quality assessment of BRAF molecular analysis in melanoma

The availability of BRAF inhibitors has given metastatic melanoma patients an effective new treatment choice and molecular testing to determine the presence or absence of a BRAF codon 600 mutation is pivotal in the clinical management of these patients. This molecular test must be performed accurately and appropriately to ensure that the patient receives the most suitable treatment in a timely manner. Laboratories have introduced such testing; however, some experience low sample throughput making it critical that an external quality assurance programme is available to help promote a high standard of testing, reporting and provide an educational aspect for BRAF molecular testing. Laboratories took part in three rounds of external quality assessment (EQA) during a 12-month period giving participants a measure of the accuracy of genotyping, clinical interpretation of the result and experience in testing a range of different samples. Formalin fixed paraffin embedded tissue sections from malignant melanoma patients were distributed to participants for BRAF molecular testing. The standard of testing was generally high but distribution of a mutation other than the most common, p.(Val600Glu), highlighted concerns with detection or reporting of the presence of rarer mutations. The main issues raised in the interpretation of the results were the importance of clear unambiguous interpretation of the result tailored to the patient and the understanding that the treatment is different from that given to other stratified medicine programmes. The variability in reporting and wide range of methodologies used indicate a continuing need for EQA in this field.

BRAF mutation testing algorithm for vemurafenib treatment in melanoma: recommendations from an expert panel.

The incidence of melanoma has increased rapidly over the past 30 years, and the disease is now the sixth most common cancer among men and women in the U.K. Many patients are diagnosed with or develop metastatic disease, and survival is substantially reduced in these patients. Mutations in the BRAF gene have been identified as key drivers of melanoma cells and are found in around 50% of cutaneous melanomas. Vemurafenib (Zelboraf(®) ; Roche Molecular Systems Inc., Pleasanton, CA, U.S.A.) is the first licensed inhibitor of mutated BRAF, and offers a new first-line option for patients with unresectable or metastatic melanoma who harbour BRAF mutations. Vemurafenib was developed in conjunction with a companion diagnostic, the cobas(®) 4800 BRAF V600 Mutation Test. The purpose of this paper is to make evidence-based recommendations to facilitate the implementation of BRAF mutation testing and targeted therapy in patients with metastatic melanoma in the U.K. The recommendations are the result of a meeting of an expert panel and have been reviewed by melanoma specialists and representatives of the National Cancer Research Network Clinical Study Group on behalf of the wider melanoma community. This article is intended to be a starting point for practical advice and recommendations, which will no doubt be updated as we gain further experience in personalizing therapy for patients with melanoma.

Boron uptake in normal melanocytes and melanoma cells and boron biodistribution study in mice bearing B16F10 melanoma for boron neutron capture therapy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Management and follow-up of a patient with Familial Atypical Multiple Mole-Melanoma (FAMMM) Syndrome

Introduction. Familial Atypical Multiple Mole-Melanoma Syndrome (FAMMM) is an autosomal dominant genodermatosis characterized by the presence of a high number of dysplastic nevi and family history of melanoma or pancreatic cancer. Melanomas in FAMMM patients tend to occur at a younger age, although they are clinically similar to sporadic melanomas in terms of overall survival. Case report. A 45 year-old woman with a family history of melanoma, a type II phototype and numerous (>100) nevi was admitted to our Department of Dermatology and Plastic Surgery. Over the past years, the patient underwent several surgical operations to remove pigmented lesions and two are dysplastic nevi. Since 1995, she underwent surgery to remove four melanomas. She is followed for skin examinations including dermoscopy. Conclusion. Identifying high-risk patients for melanoma represents a primary objective for the specialists that are involved in the management of this disease, especially in order to enact all the necessary surveillance and follow-up strategies.

Melanoma maligno da mucosa da cabeça e pescoço: casuística do IPO de Lisboa

Introdução: O melanoma maligno da mucosa (MMM) é uma doença rara com mau prognóstico. Material e Métodos: Estudo retrospetivo de 32 doentes do Instituto Português de Oncologia Francisco Gentil de Lisboa com MMM da cabeça e pescoço, no período de 1998 a 2012. Resultados: Dos 32 casos analisados a idade média foi de 70 anos. O tumor primário localizou-se na cavidade nasal e seios peri-nasais em 24 doentes e na cavidade oral em 8 casos. A maioria dos doentes (23) foi submetida a tratamento cirúrgico. Destes, 16 foram propostos para terapêutica complementar com Radioterapia. O tempo de seguimento variou de 26 dias a 10 anos. A sobrevida aos 5 anos foi de 18%. Conclusões: A maioria dos doentes apresentou um estadio avançado na altura do diagnóstico e, apesar dos tratamentos instituídos, verificou-se uma elevada mortalidade. O tratamento de escolha é a cirurgia. O papel da radioterapia continua a ser controverso.

Primary Melanoma of the Small Intestine with a Metastatic Lymph Mass in the Inguinal Canal: A Case Report

Objectives: We report a case of primary melanoma of the small intestine. Primary intestinal melanoma (PIM) is an extremely rare neoplasm for which the cause is unknown. Materials and methods: A 67-year-old man was admitted to our department due to abdominal pain, constipation, a large, hard inguinal mass and severe anaemia. Results: After laboratory data, imaging techniques and histopathological examination, the diagnosis was confirmed. A surgical resection of the intestinal neoplasm, treatment with BRAF inhibitors and radiation therapy to the inguinal mass were performed. Conclusion: PIM is rare and it is usually difficult to establish its exact origin.

Black Urine and Black Pleural Fluid: A Distinctive Presentation of Metastatic Melanoma

Metastatic melanoma is an uncommon clinical entity which can have an unusual presentation. We describe a patient with metastatic melanoma who presented with diffuse melanosis cutis, black urine and black pleural effusion. Very few medical conditions can cause black discoloration of body fluids, so this should prompt physicians to search for a number of potential underlying causes.

Síntese verde de nanopartículas de prata a partir de extrato aquoso do tubérculo de Curcuma longa associadas à quitosana e avaliação da atividade antitumoral in vitro em câncer de pele não melanoma (linhagem A431)

Dissertação (mestrado)—Universidade de Brasília, Instituto de Ciências Biológicas, Programa de Pós-Graduação Nanociência e Nanobiotecnologia, 2016.

Expresión de FOXP3 en células de melanoma murino como un mecanismo de evasión de la respuesta inmune tumoral

Foxp3 es un marcador clave para identificación y función células T reguladoras, además su expresión se ha observado en diferentes líneas celulares de cáncer. El objetivo de este estudio fue determinar si la expresión de Foxp3 en células de melanoma murino actúa como un mecanismo de evasión de la respuesta inmune tumoral, modificando citocinas involucradas en la fase de inmunoedición de cáncer y promoviendo la generación de células Treg. En este estudio se determinó por primera vez la expresión de Foxp3 en las células melanoma murino B16F10 wt, y diseñamos RNA de interferencia en contra de Foxp3, además de analizar la expresión de CD25 y producción de IL-2, INF-γ, TGF-β e IL-10 para determinar su papel in vitro. Para la evaluación del efecto de Foxp3 durante el desarrollo tumoral in vivo, se estableció una línea celular con silenciamiento de Foxp3 la cuál identificamos como B16F10.DMH1 y se montaron dos modelos de melanoma murino, uno inducido con células B16F10 wt y otro inducido con células B16F10.DMH1, y se analizó progresión tumoral, producción de citocinas, expresión de CD25, Foxp3 y poblaciones celulares CD4+ , CD4+CD25+ y CD4+CD25+ Foxp3+ en TIL’s y células de bazo. Nuestros resultados in vitro demuestran que las células B16F10 wt expresan Foxp3 a nivel de RNAm y proteína, y su localización celular es principalmente perinuclear, además se encontró que estas células expresan CD25, y una producción de citocinas del tipo INF-γ, TGF-β, IL-10 e IL-2. Se encontró que la expresión de Foxp3 afecta la proliferación en células B16F10, encontrando una correlación positiva entre la expresión de Foxp3, CD25 e IL-2. In vivo, el silenciamiento de Foxp3 en las células B16F10.DMH1 afectó el desarrollo del melanoma incrementando el tiempo de aparición de tumor, sobrevida y disminuyendo el peso de los tumores, encontrando una correlación positiva entre Foxp3, CD25, IL-2 e IL-10 y negativa con la producción de IFN-γ, además se determinó que Foxp3 intratumoral está correlacionado con la expresión y presencia de células Treg con fenotipo CD4+CD25+ Foxp3+ en el microambiente tumoral y con una disminución de células T CD4+ a nivel periférico, sin afectar a linfocitos T activados (CD4+CD25+ ). Estos datos sugieren que Foxp3, participa en el desarrollo de la tumorogénesis en melanoma murino in vitro e in vivo, con la capacidad de modular a citocinas, moléculas involucradas en el desarrollo tumoral, así como poblaciones celulares con fenotipo regulador en el tumor, pero no en periferia.

Community perceptions about the important signs of early melanoma

Detecting melanoma early often relies on patient concern about a particular pigmented lesion. However, it is not clear what specific features the public views as being important.Our purpose was to explore the importance persons place on various features of skin lesions when looking for early signs of melanoma.This study comprised 1148 respondents (participation rate, 78%) from 60 rural communities in Queensland, Australia, who participated in a telephone interview.The following features were considered important and are listed in order of importance: change in the lesion (clearly identified as the most important), more than one color, uneven edges, elevation, large size (the last three of equal importance), and hairiness of the lesion. Age, sex, education, self-efficacy, perceived knowledge, and recent self-examination influenced importance levels, but having a recent skin examination by a family physician did not.To increase the skin self-examination skills of the community, guidelines may have to become more specific and all opportunities fully utilized to educate the public. Article in Journal of the American Academy of Dermatology 36(1):33-9 · February 1997