Molecular Subtypes Based on PANoptosis Genes and Characteristics of Immune Infiltration in Cutaneous Melanoma.

Cutaneous melanoma (CM) remains the most life-threatening form of skin cancer. Further risk stratification and search for new prognostic targets for CM are of positive clinical significance. PANoptosis is defined as an inflammatory programmed cell death mediated by the PANoptosome complex and cannot be characterized by pyroptosis, apoptosis or necroptosis alone. Although PANoptosis is closely associated with many diseases including cancer, it has not been reported in CM. Combined with GTEx and TCGA database, we extracted 14 PANoptosis-related genes (PAGs). The molecular subtypes of CM were then analyzed by PAGs and their associations with the immune microenvironment and immunotherapy reactivity were analyzed. LASSO and univariate Cox analysis was performed on PAGs-related differentially expressed genes to establish PAGs characteristics that could effectively predict the prognosis of CM patients. Immune infiltration, tumor mutation burden analysis, immunotherapy response and drug sensitivity analysis were used to further analyze the causes of prognostic differences. Our study provides a new perspective on the role of PANoptosis in CM.

Development of anoikis-related long non-coding RNA signature associated with prognosis and immune landscape in cutaneous melanoma patients.

BACKGROUND: Anoikis is involved in many critical biological processes in tumors; however, function in CM is still unknown. In this study, the relevance between Anoikis-related lncRNAs (ARLs) and the clinicopathological characteristics of patients with CM was comprehensively assessed. METHODS: Through analysis of TCGA dataset, ARLs were identified by using TCGA dataset. Based on the ARLs, a risk model was established to anticipate the prognosis of patients with CM, besides, the prediction accuracy of the model was evaluated. The immune infiltration landscape of patients with CM was assessed comprehensively, and the correlation between ARLs and immunity was elucidated. Immunotherapy and drug sensitivity analyses were applied to analyze the treatment response in patients with CM with diverse risk scores. Different subgroups were distinguished among the patients using consensus cluster analysis. RESULTS: A risk model based on six ARLs was set up to obtain an accurate prediction of the prognosis of patients with CM. There were distinctions in the immune landscape among CM patients with diverse risk scores and subgroups. Six prognosis-related ARLs were highly correlated with the number of immune cells. Patients with CM with different risk scores have various sensitivities to immunotherapy and antitumor drug treatments. CONCLUSION: Our newly risk model associated with ARLs has considerable prognostic value for patients with CM. Not only has the risk model high prediction accuracy but it also indicates the immune status of CM patients, which will provide a new direction for the individualized therapy of patients with CM.

Retrospective Review of Efficacy and Safety of Anlotinib in Advanced Leiomyosarcoma: A Real-World Study.

Objective: Retrospective study on the safety and efficacy of anlotinib in the treatment of advanced leiomyosarcoma in real-world. Methods: Clinical data were collected from patients suffered from advanced leiomyosarcoma who received anlotinib treatment in Cancer Hospital of the University of Chinese Academy of Sciences from January 2018 to December 2020. Objective response rate (ORR) and disease control rate (DCR) were analyzed according to the RECIST 1.1 criteria. The progression free survival (PFS), overall survival (OS) and adverse reactions were recorded and calculated. Results: A total of 19 patients (14 female, 5 male) were enrolled, 3 (15.8%) achieved partial response (PR), 11 (57.9%) achieved stable disease (SD), with an ORR of 15.8%, a DCR of 73.7%, a median PFS of 4.1 months (95% CI: 3.0~5.2) and a median OS of 23.5 months (95% CI: 14.2~32.7). The majority of adverse events were grade 1/2, the most common grade 3/4 adverse events were hand-foot syndrome (12.5%), hypertension (5.3%) and oral ulcer (5.3%). Conclusion: Our results forecast that anlotinib is effective, safe and alternative in treatment of advanced leiomyosarcoma in real-world, combined with immunotherapy may become a potential treatment option. Further, more prospective randomized controlled trials are needed to confirm these findings.

Case report: complete remission with crizotinib in ROS1 fusion-positive sinonasal mucosal melanoma.

Introduction: Sinonasal mucosal melanoma (SNMM) originates from melanocytes. Currently, the main treatment methods, including surgery, radiotherapy and chemotherapy, have little effect on the recurrence and metastasis of SNMM. However, targeted therapy may be a breakthrough in treating SNMM. Methods: A SNMM patient with ROS1 fusion received 250mg Crizotinib capsule (2 times a day, 1 tablet each time) therapy. Results: The patient achieved partial remission after 4 months of treatment and complete remission after 8 months of treatment. Conclusion: Our findings suggest that crizotinib can be an option to improve overall survival and quality of life of patients with metastatic ROS1-fusion SNMM. We believe that our report will provide insights for the application of crizotini in the treatment of melanoma.

Next Generation Sequencing Reveals Pathogenic and Actionable Genetic Alterations of Soft Tissue Sarcoma in Chinese Patients: A Single Center Experience.

Background: Next generation sequencing (NGS) has systematically investigated the genomic landscape of soft tissue sarcoma (STS) in Western patients, but few reports have described the utility of NGS in identifying pathogenic and targetable mutations in Asian patients. Methods: We review our single center experience of identifying the genomic profile and feasible genetic mutations in 65 Chinese patients with STS by NGS. Results: On average, 3.35 mutations were identified per patient (range, 0-28), and at least one mutation could be detected in 95.4% (62/65) of patients. TP53, MDM2, CDK4, KDR, and NF1 were the most frequent mutation genes in Chinese STS patients. Actionable mutations were discovered in 36.9% (24/65) of patients, and clinical benefit was achieved in 4 patients treated with corresponding molecular targeted therapies. Conclusions: Our study describes the mutation profile of Chinese STS patients by a single center experience. Some patients have achieved improved clinical outcomes by adopting treatment based on the results of genetic testing. NGS may affect clinical decision-making as a routine clinical test for patients with STS.

PD-L1+ regulatory B cells act as a T cell suppressor in a PD-L1-dependent manner in melanoma patients with bone metastasis.

The five-year survival rate of melanoma worsens significantly with advancing tumor stage. We hypothesized that regulatory B cells (Breg) might have participated in the pathogenesis of melanoma. In this study, the PD-L1+ Breg cells were investigated. The expression of PD-L1 by circulating B cells was very low in healthy controls. In melanoma patients, on the other hand, the expression of PD-L1 by circulating B cells was significantly elevated in a manner that was positively associated with tumor stage, with the highest level in stage IV bone metastasis patients. Compared to total B cells, PD-L1+ B cells presented higher IgM and higher IgD expression, and were almost exclusively CD20+CD27-, suggesting that the PD-L1+ B cells exhibited a naive B cell-like phenotype. Healthy naive B cells, which presented little PD-L1, and stage I and stage II melanoma patient naive B cells, which presented detectable but low PD-L1, were unable to suppress T cell response. However, stage III and stage IV naive B cells, which presented moderate PD-L1, could significantly suppress T cell response in a PD-L1-dependent manner. We further found that the level of PD-L1+ B cells was significantly higher in bone metastasis than in the primary tumors. Overall, we demonstrated that PD-L1+ B cells were upregulated in advanced melanoma and were enriched in metastasis compared to primary tumors. Furthermore, PD-L1+ naive B cells could act as a T cell suppressor in a PD-L1-dependent manner.

Irradiation enhanced the effects of PD-1 blockade in brain metastatic osteosarcoma.

Brain metastasis of osteosarcoma are rare but carry a dismal prognosis. Despite the advances in both systemic immunotherapy and localized radiation, it is still difficult to treat brain metastasis, with less than 12 months of survival from the time of diagnosis for most patients. Currently, there is interest in combining strategies to take advantage of the potential synergy. In this study, the mouse model of metastatic osteosarcoma to brain was used to explore the ability of local radiation and anti-PD-1 blockade to induce beneficial anti-tumor immune responses against distant, unirradiated brain metastatic tumors. Immune markers from the peripheral blood and tumor tissue were analyzed by flow cytometry, real-time PCR and western blot. The combination treatment produced a stronger systemic anti-tumor response than either treatment alone, shown by the reduced tumor burden and larger numbers of cytotoxic CD8+ T cells in the unirradiated tumors, indicating an abscopal effect. These data suggested that combination treatment of irradiation with anti-PD-1 immunotherapy can induce abscopal anti-tumor responses and improve both local and distant control.

Who are at risk for thromboembolism after arthroplasty? A systematic review and meta-analysis.

BACKGROUND: Thromboembolism, including deep venous thrombosis and pulmonary embolism, is a grave threat to patients undergoing total joint replacement. Using a systematic review and meta-analysis we asked whether gene mutations or polymorphisms could be risk factors for thrombosis after arthroplasty. METHODS: We performed a comprehensive search of Medline, PubMed, Embase, Cochrane databases, China National Knowledge Infrastructure (CNKI), and Google Scholar, and identified 19 studies detailing genetic investigations of patients with thromboembolism following joint replacement. RESULTS: Our meta-analyses included 5149 patients who underwent arthroplasty surgery. Significant associations with venous thromboembolism were identified for factor G1691A (odds ratio (OR) 1.41, 95% confidence interval (CI) 1.03 - 1.94, p=0.03), prothrombin G20210A (OR 2.16, 95% CI, 1.27- 3.69, p=0.005), and MTHFR/C677T/TT (OR 2.36, 95% CI 1.03 - 5.42, p=0.04) in Caucasian populations. No significant gene mutation was identified in Asian populations. CONCLUSION: This study suggests a way to identify patients scheduled for arthroplasty who are at higher risk of thrombosis, enabling individualized treatment.