Melanoma Tumor Mutational Burden and Indoor Tanning Exposure.

IF 11.5 1区医学 Q1 DERMATOLOGY JAMA dermatology Pub Date : 2024-12-11 DOI:10.1001/jamadermatol.2024.4819

Grace B Hanrahan, Anita Giobbie-Hurder, Blair Allais, Jayne Vogelzang, Christopher Fay, Hillary C Tsibris

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Abstract

Importance: UV-induced mutagenesis leads to a higher tumor mutational burden (TMB) in cutaneous melanoma relative to other cancer types. TMB is an important prognostic marker in advanced melanoma; higher TMB is associated with greater clinical response to immune checkpoint inhibition and improved survival.

Objective: To evaluate the association between cutaneous melanoma TMB and indoor tanning exposure, as well as other demographic, dermatologic, and tumor characteristics.

Design, setting, and participants: This retrospective cohort study took place at Dana-Farber Cancer Institute, a tertiary-care cancer treatment center in Boston, Massachusetts, between 2013 and 2022. Patients with a diagnosis of cutaneous melanoma for whom next-generation sequencing data and tanning bed exposure history were available were included.

Exposures: Indoor tanning exposure history, tumor characteristics, demographics, and dermatologic history were collected via retrospective medical record review.

Main outcomes and measures: The association of tanning bed use with TMB was modeled using inverse probability of treatment weighted, multivariable modeling.

Results: Among 617 patients (median [IQR] age at diagnosis, 61 [50-71] years; 337 [62.9%] male), there was no association between indoor tanning exposure and TMB after adjustment for demographic, tumor, and dermatologic characteristics (yes vs no: log2 TMB [SE], 4.07 [0.44] vs 3.97 [0.45]; P = .39). However, there was a statistically significant association between higher TMB and older age at diagnosis, history of nonmelanoma skin cancer, and head and neck tumors relative to other primary sites. Average TMB was statistically significantly lower in patients with a history of abnormal nevi (yes vs no: log2 TMB [SE], 3.89 [0.44] vs 4.15 [0.44]; P = .01).

Conclusions and relevance: This cohort study suggests that indoor tanning exposure, while known to increase risk of melanoma, may not be meaningfully associated with melanoma TMB. Additional characteristics were associated with higher TMB and, thus, potentially improved immune checkpoint inhibitor response.

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黑色素瘤肿瘤突变负担与室内晒黑暴露。

重要性：相对于其他类型的癌症，紫外线诱变导致皮肤黑色素瘤更高的肿瘤突变负担（TMB）。TMB是晚期黑色素瘤的重要预后指标；较高的TMB与免疫检查点抑制的临床反应和生存率的提高有关。目的：评估皮肤黑色素瘤TMB与室内晒黑暴露以及其他人口统计学、皮肤病学和肿瘤特征之间的关系。设计、环境和参与者：这项回顾性队列研究于2013年至2022年在马萨诸塞州波士顿的丹娜-法伯癌症研究所（Dana-Farber Cancer Institute）进行。诊断为皮肤黑色素瘤的患者包括下一代测序数据和晒黑床暴露史。暴露：通过回顾性病历回顾收集室内晒黑暴露史、肿瘤特征、人口统计学和皮肤病史。主要结果和测量方法：采用治疗加权逆概率多变量模型对日光浴床使用与TMB的关联进行建模。结果：617例患者(诊断时中位[IQR]年龄61岁[50-71]岁；337例[62.9%]男性)，在调整人口统计学、肿瘤和皮肤特征后，室内晒黑暴露与TMB之间没有关联(是vs否：log2 TMB [SE]， 4.07 [0.44] vs 3.97 [0.45]；p = .39)。然而，与其他原发部位相比，较高的TMB与诊断年龄较大、非黑色素瘤皮肤癌病史以及头颈部肿瘤之间存在统计学上的显著关联。有异常痣史的患者平均TMB较低(有vs无：log2 TMB [SE]， 3.89 [0.44] vs 4.15 [0.44]；p = 0.01)。结论和相关性：这项队列研究表明，室内晒黑暴露虽然已知会增加黑色素瘤的风险，但可能与黑色素瘤TMB没有意义的关联。其他特征与较高的TMB相关，因此可能改善免疫检查点抑制剂反应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JAMA dermatology DERMATOLOGY-

CiteScore

14.10

自引率

5.50%

发文量

300

期刊介绍： JAMA Dermatology is an international peer-reviewed journal that has been in continuous publication since 1882. It began publication by the American Medical Association in 1920 as Archives of Dermatology and Syphilology. The journal publishes material that helps in the development and testing of the effectiveness of diagnosis and treatment in medical and surgical dermatology, pediatric and geriatric dermatology, and oncologic and aesthetic dermatologic surgery. JAMA Dermatology is a member of the JAMA Network, a consortium of peer-reviewed, general medical and specialty publications. It is published online weekly, every Wednesday, and in 12 print/online issues a year. The mission of the journal is to elevate the art and science of health and diseases of skin, hair, nails, and mucous membranes, and their treatment, with the aim of enabling dermatologists to deliver evidence-based, high-value medical and surgical dermatologic care. The journal publishes a broad range of innovative studies and trials that shift research and clinical practice paradigms, expand the understanding of the burden of dermatologic diseases and key outcomes, improve the practice of dermatology, and ensure equitable care to all patients. It also features research and opinion examining ethical, moral, socioeconomic, educational, and political issues relevant to dermatologists, aiming to enable ongoing improvement to the workforce, scope of practice, and the training of future dermatologists. JAMA Dermatology aims to be a leader in developing initiatives to improve diversity, equity, and inclusion within the specialty and within dermatology medical publishing.