A lack of significantly increased incidence of regression in second primary melanomas does not support an ‘immunization effect’

Zoller, Lilach; Mayer, Elisa; Itzhak, Ofer Ben; Bergman, Reuven

doi:10.1111/j.1600-0560.2010.01590.x

Cited by 11 publications

(6 citation statements)

References 14 publications

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“…33 However, this finding is controversial, and the reports about this phenomenon are conflicting. 4,33,34 In our study, OS was significantly less in the subgroup of patients with a mutation pattern concordant between incident and subsequent melanomas compared with that in the subgroup with a discordant mutation pattern. A possible explanation for this effect may be a potentiating effect of distinct mutations, but further studies are needed to support this concept.…”

Section: Survival and Prognostic Factorscontrasting

confidence: 38%

Varying Mutational Alterations in Multiple Primary Melanomas

Egberts

Bohne

Krüger

et al. 2016

The Journal of Molecular Diagnostics

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In melanoma, the mitogen-activated protein (MAP) kinase pathway plays a crucial oncogenic role. Recent studies identified additional genetic alterations, eg, TERT-promoter mutations. Up to 8% of melanoma patients present with multiple primary melanomas (MPMs). The pathogenesis is not fully understood, and data on the genetic diversity of MPMs are limited. To identify putative diagnostic and therapeutic consequences, we assessed the mutational status of the BRAF and NRAS genes and TERT promoter in patients with MPMs. The study cohort consisted of 96 patients with 237 malignant melanomas. The BRAF, NRAS, and TERT-promoter genotypes were assessed in all MPMs and were correlated with patients' clinicopathological characteristics. BRAF mutations were found in 84 melanomas (35.4%), NRAS mutations, in 33 (14.0%); and TERT-promoter mutations, in 112 (47.3%). Mutation patterns were concordant between first and subsequent primary tumors in 23.9% of patients and were discordant in 61.4% of patients. The genetic alterations were partially different in 14.7% of patients. By Cox regression analysis, only the NRAS mutation had a significant negative prognostic impact on time to progression to stage III (P = 0.016) and on distant metastasis-free survival (P = 0.032). In the majority of primary melanomas in patients with MPMs, BRAF, NRAS, and TERT-promoter genotypes were discordant. Thus, molecular testing for targeted therapy should be performed on metastatic tissue and not on primary tumors.

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Section: Survival and Prognostic Factorscontrasting

confidence: 38%

Varying Mutational Alterations in Multiple Primary Melanomas

Egberts

Bohne

Krüger

et al. 2016

The Journal of Molecular Diagnostics

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“…However, in a recent histopathologic study of melanomas from 18 patients with MPM, Zoller et al observed no difference in the incidence of regression between the first and second melanomas, leading those authors to conclude that the ''immunization effect'' may not occur in patients with MPM. 42 The current study is 1 of a few studies that have prospectively examined clinicopathologic variables in patients with SPM and MPM. 12,14,21,43 Among the variables examined was the anatomic location of tumors in the patients with MPM.…”

Section: Discussionmentioning

confidence: 99%

Single versus multiple primary melanomas

Hwa

Price

Belitskaya-Lévy

et al. 2012

Cancer

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BACKGROUND:In patients with multiple primary melanomas (MPM), mean tumor thickness tends to decrease from the first melanoma to the second melanoma, and prognosis may be improved compared with the prognosis for patients who have a single primary melanoma (SPM). In this study, the authors compared the clinicopathologic features of patients with MPM and SPM to better characterize the differences between these 2 groups and to determine whether or not there is an inherent difference in tumor aggression. METHODS: In total, 788 patients with melanoma who were enrolled prospectively in the Interdisciplinary Melanoma Cooperative Group database from 2002 to 2008 were studied. Patients with SPM and with MPM were compared with regard to clinical and primary melanoma characteristics. RESULTS: Of 788 patients with melanoma, 61 patients (7.7%) had 2 or more primary melanomas. The incidence of developing a second primary melanoma 1 year and 5 years after initial melanoma diagnosis was 4.1% and 8.7%, respectively, and most of the risk accumulated within the first year. The incidence of MPM was greater in patients aged !60 years than in those aged 60 years. The absence or presence of mitosis and other tumor characteristics did not differ significantly between patients with SPM and patients with MPM (P ¼ .61). CONCLUSIONS: No difference was observed in the presence or absence of mitoses, a marker of tumor proliferation, in SPM and MPM. Because it has been demonstrated that the presence of mitosis is a powerful prognostic marker, the current findings suggested that the tumors behave similarly in patients with SPM and patients with MPM. The authors concluded that differences in tumor thickness and prognosis between SPM and MPM more likely are caused by factors other than tumor biology, such as increased surveillance. Cancer 2012;118:4184-92.

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“…This is likely due to increased surveillance and earlier diagnosis [ 2 – 4 , 10 , 15 ], although theories of immune modulation [ 2 , 14 , 16 – 18 ] and less aggressive phenotypes have been proposed as well [ 2 , 3 , 5 ].…”

Section: Multiple Primary Melanomasmentioning

confidence: 99%

“…However, Zoller et al, 2010, examined 18 patients with MPM and found no significantly increased rate of regression comparing the first and the second primary melanoma [ 18 ].…”

Section: Multiple Primary Melanomasmentioning

confidence: 99%

Eleven Primary Melanomas, Colon Cancer, and Atypical Nevi in the Same Patient: A Case Report and Literature Review

Nielsen

Hölmich

2016

Case Reports in Dermatological Medicine

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Background. As the incidence of cutaneous malignant melanoma increases in the Caucasian population, an increasing population of melanoma survivors is at risk of developing multiple primary melanomas (MPM) as well as secondary primary cancers. Objective. To present a case of a patient with atypical nevi, 11 primary melanomas over 33 years, and colon cancer and to review the literature on multiple primary melanomas, atypical nevi, and correlation of nonmelanoma cancers. Conclusion. The literature indicates that patients with MPM are not uncommon, although 11 primary melanomas are rarely described, that patients with MPM may have a better survival than patients with single primary melanoma, that atypical nevi are a risk marker of not only melanoma in general but also MPM, and that melanoma patients have a significantly increased risk of developing nonmelanoma skin and other cancers, which may be even higher for patients with MPM.

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A lack of significantly increased incidence of regression in second primary melanomas does not support an ‘immunization effect’

Abstract: Our study does not provide evidence for a statistically significant increased rate of regression in second primary melanomas compared to the first primary melanomas, but larger groups of studied cases may be needed.

Cited by 11 publications

References 14 publications

Varying Mutational Alterations in Multiple Primary Melanomas

Varying Mutational Alterations in Multiple Primary Melanomas

Single versus multiple primary melanomas

Eleven Primary Melanomas, Colon Cancer, and Atypical Nevi in the Same Patient: A Case Report and Literature Review

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