Ethnic Differences Among Patients With Cutaneous Melanoma

Cormier, Janice N.; Xing, Yan; Ding, Meichun; Lee, Jeffrey E.; Mansfield, Paul F.; Gershenwald, Jeffrey E.; Ross, Merrick I.; Du, Xianglin L.

doi:10.1001/archinte.166.17.1907

Cited by 314 publications

(318 citation statements)

References 53 publications

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“…More importantly, due to the difference of predominant melanoma subtypes between Caucasians (mainly cutaneous melanomas) and Asians (mainly acral and mucosal melanomas; refs. [42][43][44][45], mTOR aberrations in acral and mucosal melanomas remain largely unknown. Our data have thus greatly filled this gap.…”

Section: Discussionmentioning

confidence: 99%

Analysis of mTOR Gene Aberrations in Melanoma Patients and Evaluation of Their Sensitivity to PI3K–AKT–mTOR Pathway Inhibitors

Kong

et al. 2016

Clinical Cancer Research

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Purpose: mTOR is a validated target in cancer. It remains to be determined whether melanoma patients bearing mTOR mutation could be selected for treatment with PI3K–AKT–mTOR pathway inhibitors. Experimental Design: A total of 412 melanoma samples were included. Gene aberrations in all exons of mTOR were detected by Sanger sequencing and confirmed by using Agilent's SureSelect Target Enrichment System. HEK293T cells stably expressing mTOR mutants were constructed by using transcription activator-like effector nucleases technique. Function of mTOR mutants and in vitro sensitivity of gain-of-function mTOR mutations to PI3K–AKT–mTOR pathway inhibitors were analyzed. Results: The overall incidence of somatic nonsynonymous mutations of mTOR was 10.4% (43/412). mTOR nonsynonymous mutations were relatively more frequent in acral (11.0%) and mucosal (14.3%) melanomas than in chronic sun-induced damage (CSD; 6.7%) and non-CSD (3.4%) melanomas. Of the 43 cases with mTOR mutations, 41 different mutations were detected, affecting 25 different exons. The median survival time for melanoma patients with mTOR nonsynonymous mutation was significantly shorter than that for patients without mTOR nonsynonymous mutation (P = 0.028). Transient expression of mTOR mutants in HEK293T cells strongly activated the mTOR–p70S6K pathway. In HEK293T cells with stable expression of H1968Y or P2213S mTOR mutants, LY294002 and AZD5363 showed higher potency than temsirolimus or BYL719 in inhibiting the PI3K–AKT–mTOR pathway and cell proliferation. Conclusions: mTOR nonsynonymous mutations are frequent in melanoma patients. mTOR nonsynonymous mutation may predict a worse prognosis of melanoma. Clinical trials with PI3K–AKT–mTOR pathway inhibitors may be beneficial for melanoma patients with specific mTOR mutations. Clin Cancer Res; 22(4); 1018–27. ©2015 AACR.

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Section: Discussionmentioning

confidence: 99%

Analysis of mTOR Gene Aberrations in Melanoma Patients and Evaluation of Their Sensitivity to PI3K–AKT–mTOR Pathway Inhibitors

Kong

et al. 2016

Clinical Cancer Research

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“…Moreover, we could not analyze the influence of racial differences because all our patients were white. 13,22 The lack of patients from other ethnicities is due to the fact that, until a few decades ago, Italy had minimal immigration. However, Italy has witnessed a substantial increase in immigration in the past few years, and future studies should take into account this change in the racial composition.…”

Section: Ses Status)mentioning

confidence: 99%

“…12 However, these databases are usually limited to general demographic characteristics such as age, sex, race, and ethnicity; they lack important information regarding education, current employment or occupational status, and family context. [10][11][12][13] In the absence of individual socioeconomic characteristics, several authors have used "area-based information" by linking patients through country, zip code, and census tract.…”

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confidence: 99%

Association of Socioeconomic Status With Breslow Thickness and Disease-Free and Overall Survival in Stage I-II Primary Cutaneous Melanoma

Mandalà¹,

Imberti²,

Piazzalunga

et al. 2011

Mayo Clinic Proceedings

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OBJECTIVE:To investigate the influence of socioeconomic status (SES) on Breslow thickness, disease-free survival, and overall survival in patients with stage I-II primary cutaneous melanoma (PCM). PATIENTS AND METHODS:The study consists of all consecutive patients who were diagnosed as having PCM and were treated and followed up at our hospital between November 1, 1998, and July 31, 2009. Pathologic and sociodemographic characteristics of the patients were obtained. We categorized SES into 3 levels: low (manual employees and skilled/unskilled workers, including farmers, with primary education level), middle (nonmanual employees and clerks with middle education level), and high (professionals, executives, administrators, and entrepreneurs with tertiary education).RESULTS: A total of 1443 consecutive patients were evaluated. In a multivariate logistic regression analysis, sex (female vs male: odds ratio [OR], 1.37; 95% confidence interval [CI], 1.08-1.75), SES (high vs middle: OR, 1.27; 95% CI, 0.96-1.69; high vs low: OR, 1.73; 95% CI, 1.26-2.38), age (<60 vs ≥60 years: OR, 1.35; 95% CI, 1.03-1.78), and family context (single vs living with relatives: OR, 1.37; 95% CI, 0.97-1.94) were the strongest correlates of Breslow thickness. Compared with high SES, the risk of melanoma-related death, adjusted for age and sex, was 7 times higher (hazard ratio, 7.44; 95% CI, 3.27-16.93) and almost 2 times higher (hazard ratio, 1.88; 95% CI, 1.04-3.39) in patients with low SES living alone or living with relatives, respectively. CONCLUSION:In patients with PCM, low SES is associated with thicker melanoma and a poorer clinical outcome. Proc. 2011;86(2):113-119 BT = Breslow thickness; CI = confidence interval; DFS = disease-free survival; HR = hazard ratio; OR = odds ratio; OS = overall survival; PCM = primary cutaneous melanoma; RECPAM = RECursive Partitioning and AMalgamation; SES = socioeconomic status Mayo Clin

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“…Yet despite this, skin of color articles that utilize direct interventions (such as focus groups or classes) in order to educate ethnic populations of skin cancer risk have also often excluded Native Americans 5 . None of five recent skin cancer interventions included such a participant.…”

Section: Reviewmentioning

confidence: 99%

“…For these reasons, it is becoming increasingly important for dermatologists to become more aware of their skin disease related needs. Despite their lower incidence of melanoma, Native Americans also have a lower 5-year survival rate of 69.8% versus 91% among Caucasians 5,6 . This may be due to a lower index of suspicion in these persons leading to delay in diagnosis and is particularly worrisome because the current data suggests that the incidence of this cancer is continuing to rise in this group.…”

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confidence: 99%

The Importance of Recognition of the Skin Cancer Risk of Native Americans: A Call to Action

et al. 2017

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Melanoma is a deadly skin cancer affecting a significant part of the U.S. population. People of color are more likely to face lower survival rates from melanoma and are more likely to be diagnosed at a later stage. Efforts to combat this have largely focused on Asian, Hispanic, and African American patients. Native Americans have been unfortunately excluded from such studies. This article is a call to action and is an effort to raise awareness for Native American inclusion in future skin cancer studies so their skin cancer knowledge and risk can be appropriately ascertained.

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Ethnic Differences Among Patients With Cutaneous Melanoma

Abstract: Melanoma is a public health concern for all ethnic populations. Differences in disease stage at presentation contributes to disparities in survival. Understanding melanoma in minority populations may lead to early detection and ultimately save lives.

Cited by 314 publications

References 53 publications

Analysis of mTOR Gene Aberrations in Melanoma Patients and Evaluation of Their Sensitivity to PI3K–AKT–mTOR Pathway Inhibitors

Analysis of mTOR Gene Aberrations in Melanoma Patients and Evaluation of Their Sensitivity to PI3K–AKT–mTOR Pathway Inhibitors

Association of Socioeconomic Status With Breslow Thickness and Disease-Free and Overall Survival in Stage I-II Primary Cutaneous Melanoma

The Importance of Recognition of the Skin Cancer Risk of Native Americans: A Call to Action

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