ABSTRACT
INTRODUCTION: Primary uveal melanoma is the most common intraocular malignancy in adults. Almost 50% of patients die from metastatic disease despite successful local treatment. The objective was to estimate the incidence of metastasis and survival in patients with primary uveal melanoma. The second objective was to determine the independent predictors of metastasis. METHODS: A retrospective, observational, analytical study was carried out using an ambidirectional cohort design in patients from Buenos Aires City between January 2003 to January 2020. Patients with uveal melanoma and potential clinical predictors of metastasis were identified. The density of incidence of metastasis and mortality were determined, and survival curves were analyzed (Kaplan Meir) A univariate and multivariate analysis using Cox proportional hazard models was performed. RESULTS: 143 patients (mean age 57 SD 16) were included. The median thickness was 6.2 mm SD 3.4 mm, the mean tumor diameter was 12.6 mm (SD 3.8). 69.9% of the patients underwent conservative treatment with brachytherapy while 25.9% underwent enucleation. 19.6% presented metastasis, the median time to the event was 26.5 months. The specific mortality due to melanoma was 17.5%. Diameter greater than 12 mm and extension were predictor variables of metastasis in a multivariable model. CONCLUSION: Although the median time to the event (metastasis) is 26.5 moths, it could occur many years after local oncological effective treatment. An early diagnosis would allow finding smaller tumors and would improve the prognosis.
Introducción: El melanoma uveal primario es el tumor intraocular maligno más frecuente del adulto. Cerca del 50% de los pacientes fallecen de enfermedad metastásica, a pesar de un tratamiento local exitoso. El objetivo primario fue estimar la incidencia de metástasis y sobrevida en los pacientes con melanoma uveal primario. Como objetivo secundario se planteó determinar los predictores independientes de metástasis. Métodos: Se realizó un estudio analítico observacional, retrospectivo mediante un diseño de cohorte ambidireccional entre 2003 y 2020 en CABA, en pacientes con melanoma uveal primario y los potenciales factores clínicos predictores de metástasis. Se determinó la densidad de incidencia de metástasis, la mortalidad, y se analizaron las curvas de sobrevida (Kaplan-Meier). Se realizó un análisis uni y multivariado utilizando el modelo de riesgos proporcionales de Cox. Resultados: De los 143 pacientes (edad promedio 57, DS 16), la mediana del espesor fue de 6. 2 mm DS 3.4, la media del diámetro tumoral fue de 12.6 mm (DS 3.8). Un 69.9% realizó tratamiento conservador con braquiterapia, un 25.9% enucleación. Un 19.6% presentaron metástasis (mediana de tiempo al evento: 26.5 meses). La mortalidad específica por melanoma fue de 17.5%. El diámetro mayor a 12 mm y la extensión fueron variables predictoras de metástasis en el modelo multivariado. Conclusión: Si bien la mediana del tiempo al evento metástasis fue de 26.5 meses, puede presentarse muchos años después de un tratamiento local oncológicamente eficaz. Un diagnóstico precoz permitiría pesquisar tumores más pequeños y mejoraría el pronóstico.
Subject(s)
Melanoma , Uveal Neoplasms , Humans , Melanoma/mortality , Melanoma/pathology , Melanoma/secondary , Uveal Neoplasms/mortality , Uveal Neoplasms/pathology , Male , Retrospective Studies , Female , Middle Aged , Incidence , Aged , Adult , Neoplasm Metastasis , Argentina/epidemiology , Brachytherapy , Proportional Hazards Models , Aged, 80 and over , Kaplan-Meier Estimate , Survival RateABSTRACT
Pediatric melanomas are rare and some of them may arise on giant congenital melanocytic nevi. The risk of developing melanoma on a medium-sized nevus is not clear but is thought to be very rare. Proliferative cellular nodules which mimic malignant melanoma may pose significant diagnostic challenges. We report the case of a 9-year-old patient who developed a melanoma on a medium-sized congenital melanocytic nevus on the tip of the nose, requiring a complex surgery with excellent aesthetic results.
Los melanomas en pediatría son raros y algunos de ellos pueden surgir sobre nevos melanocíticos congénitos gigantes. El riesgo de desarrollar melanoma en un nevo de tamaño mediano no está claro, pero se cree que es muy raro. Los nódulos proliferativos celulares, que imitan al melanoma, pueden plantear importantes desafíos diagnósticos. Presentamos el caso de una paciente de 9 años que desarrolló un melanoma sobre un nevo melanocítico congénito de tamaño mediano en la punta de la nariz, que requirió un procedimiento quirúrgico complejo con excelentes resultados estéticos.
Subject(s)
Melanoma , Nevus, Pigmented , Skin Neoplasms , Humans , Nevus, Pigmented/congenital , Nevus, Pigmented/pathology , Melanoma/pathology , Melanoma/surgery , Skin Neoplasms/congenital , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Child , Male , Nose Neoplasms/congenital , Nose Neoplasms/pathology , Nose Neoplasms/surgery , Nose Neoplasms/diagnostic imaging , FemaleABSTRACT
Genome instability relies on preserving the chromatin structure, with any histone imbalances threating DNA integrity. Histone synthesis occurs in the cytoplasm, followed by a maturation process before their nuclear translocation. This maturation involves protein folding and the establishment of post-translational modifications. Disruptions in this pathway hinder chromatin assembly and contribute to genome instability. JMJD1B, a histone demethylase, not only regulates gene expression but also ensures a proper supply of histones H3 and H4 for the chromatin assembly. Reduced JMJD1B levels lead to the cytoplasmic accumulation of histones, causing defects in the chromatin assembly and resulting in DNA damage. To investigate the role of JMJD1B in regulating genome stability and the malignancy of melanoma tumors, we used a JMJD1B/KDM3B knockout in B16F10 mouse melanoma cells to perform tumorigenic and genome instability assays. Additionally, we analyzed the transcriptomic data of human cutaneous melanoma tumors. Our results show the enhanced tumorigenic properties of JMJD1B knockout melanoma cells both in vitro and in vivo. The γH2AX staining, Micrococcal Nuclease sensitivity, and comet assays demonstrated increased DNA damage and genome instability. The JMJD1B expression in human melanoma tumors correlates with a lower mutational burden and fewer oncogenic driver mutations. Our findings highlight JMJD1B's role in maintaining genome integrity by ensuring a proper histone supply to the nucleus, expanding its function beyond gene expression regulation. JMJD1B emerges as a crucial player in preserving genome stability and the development of melanoma, with a potential role as a safeguard against oncogenic mutations.
Subject(s)
DNA Damage , Genomic Instability , Histones , Jumonji Domain-Containing Histone Demethylases , Melanoma , Skin Neoplasms , Animals , Humans , Mice , Cell Line, Tumor , DNA Damage/genetics , Gene Expression Regulation, Neoplastic , Histones/metabolism , Jumonji Domain-Containing Histone Demethylases/metabolism , Jumonji Domain-Containing Histone Demethylases/genetics , Melanoma/genetics , Melanoma/pathology , Melanoma/metabolism , Melanoma, Experimental/genetics , Melanoma, Experimental/pathology , Melanoma, Experimental/metabolism , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Skin Neoplasms/metabolismABSTRACT
CONTEXT: Melanoma is one of the cancers with the highest mortality rate for its ability to metastasize. Several targets have undergone investigation for the development of drugs against this pathology. One of the main targets is the kinase BRAF (RAF, rapidly accelerated fibrosarcoma). The most common mutation in melanoma is BRAFV600E and has been reported in 50-90% of patients with melanoma. Due to the relevance of the BRAFV600E mutation, inhibitors to this kinase have been developed, vemurafenib-OMe and dabrafenib. Ursolic acid (UA) is a pentacyclic triterpene with a privileged structure, the pentacycle scaffold, which allows to have a broad variety of biological activity; the most studied is its anticancer capacity. In this work, we reported the interaction profile of vemurafenib-OMe, dabrafenib, and UA, to define whether UA has binding capacity to BRAFWT, BRAFV600E, and BRAFV600K. Homology modeling of BRAFWT, V600E, and V600K; molecular docking; and molecular dynamics simulations were carried out and interactions and residues relevant to the binding of the inhibitors were obtained. We found that UA, like the inhibitors, presents hydrogen bond interactions, and hydrophobic interactions of van der Waals, and π-stacking with I463, Q530, C532, and F583. The ΔG of ursolic acid in complex with BRAFV600K (- 63.31 kcal/mol) is comparable to the ΔG of the selective inhibitor dabrafenib (- 63.32 kcal/mol) in complex to BRAFV600K and presents a ΔG like vemurafenib-OMe with BRAFWT and V600E. With this information, ursolic acid could be considered as a lead compound for design cycles and to optimize the binding profile and the selectivity towards mutations for the development of new selective inhibitors for BRAFV600E and V600K to new potential melanoma treatments. METHODS: The homology modeling calculations were executed on the public servers I-TASSER and ROBETTA, followed by molecular docking calculations using AutoGrid 4.2.6, AutoDockGPU 1.5.3, and AutoDockTools 1.5.6. Molecular dynamics and metadynamics simulations were performed in the Desmond module of the academic version of the Schrödinger-Maestro 2020-4 program, utilizing the OPLS-2005 force field. Ligand-protein interactions were evaluated using Schrödinger-Maestro program, LigPlot + , and PLIP (protein-ligand interaction profiler). Finally, all of the protein figures presented in this article were made in the PyMOL program.
Subject(s)
Melanoma , Molecular Docking Simulation , Molecular Dynamics Simulation , Proto-Oncogene Proteins B-raf , Triterpenes , Ursolic Acid , Triterpenes/chemistry , Triterpenes/pharmacology , Proto-Oncogene Proteins B-raf/chemistry , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Proto-Oncogene Proteins B-raf/metabolism , Proto-Oncogene Proteins B-raf/genetics , Humans , Melanoma/drug therapy , Melanoma/genetics , Imidazoles/chemistry , Imidazoles/pharmacology , Protein Binding , Vemurafenib/pharmacology , Vemurafenib/chemistry , Oximes/chemistry , Oximes/pharmacology , Mutation , Antineoplastic Agents/chemistry , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Protein Kinase Inhibitors/chemistry , Protein Kinase Inhibitors/pharmacology , Binding SitesABSTRACT
Oral mucosal melanomas (OMMs) are aggressive neoplasms commonly found in dogs but rare in humans. Utilizing whole exome sequencing (WES), which focuses on protein-coding regions to reveal mutation profiles, we conducted a comparative analysis of canine OMM and human melanomas. This study involved DNA extraction, exome enrichment, and sequencing from three canine OMM cell lines (CMGD-2, CMGD-5, TLM-1), five canine OMM frozen samples, a human OMM cell line (MEMO), and a human commercial skin melanoma cell line (SK-MEL-28). The sequencing and subsequent analysis of FASTQ files yielded final variant files, leading to the identification of mutations. Our findings revealed a total of 500 mutated genes in canine OMM, including significant ones such as EP300, FAT4, JAK3, LRP1B, NCOR1, and NOTCH1. Notably, 82 shared mutations were identified between human melanomas and canine OMM genomes. These mutations were categorized based on the gene functions. The identification of these mutations provides critical insights that can pave the way for the development of novel therapeutic strategies for both canine and human OMM, offering hope for more effective treatments in the future.
Subject(s)
Exome Sequencing , Melanoma , Mouth Mucosa , Mouth Neoplasms , Mutation , Dogs , Melanoma/genetics , Melanoma/veterinary , Melanoma/pathology , Humans , Animals , Mouth Neoplasms/genetics , Mouth Neoplasms/veterinary , Mouth Neoplasms/pathology , Mouth Mucosa/pathology , Mouth Mucosa/metabolism , Cell Line, Tumor , Dog Diseases/geneticsABSTRACT
Dacarbazine (DTIC) is the drug of choice for melanoma treatment, but its systemic administration is related to several adverse effects. Here, DTIC topical delivery stimulated by iontophoresis is proposed to overcome such drawbacks. Hence, this work analyzed the impact of anodal iontophoresis on DTIC cutaneous delivery to provide an innovative topical alternative for melanoma treatment. The electrical stability of the drug was evaluated prior to the iontophoretic experiments, which demonstrated the need to add an antioxidant to the drug formulation. DTIC cutaneous permeation was evaluated in vitro for 6 h using three current densities (0.10, 0.25, and 0.50 mA/cm2). In addition, the effect of DTIC against skin cancer cells (MeWo and WM164) was investigated for 72 h of exposure to the drug. Iontophoresis stimulated skin drug permeation compared to the passive control. However, the antioxidant presence reduced DTIC permeation under the lower currents of 0.10 and 0.25 mA/cm2, which was compensated by increasing the current density to 0.50 mA/cm2. At 0.50 mA/cm2, iontophoresis enhanced topical cutaneous drug permeation 7-fold (p < 0.05) compared to the passive control. DTIC showed a concentration-dependent antiproliferative effect on melanoma cell lines. Thus, iontophoresis intensifies DTIC skin penetration in concentrations that can reduce cell viability and induce cell death. In conclusion, DTIC cutaneous delivery mediated by iontophoresis is a promising approach for treating melanomas and other skin tumors.
Subject(s)
Administration, Cutaneous , Dacarbazine , Iontophoresis , Melanoma , Skin Absorption , Skin Neoplasms , Iontophoresis/methods , Melanoma/drug therapy , Humans , Skin Neoplasms/drug therapy , Cell Line, Tumor , Dacarbazine/administration & dosage , Dacarbazine/pharmacokinetics , Animals , Antineoplastic Agents, Alkylating/administration & dosage , Antineoplastic Agents, Alkylating/pharmacokinetics , Cell Survival/drug effects , Skin/metabolism , Antioxidants/administration & dosage , Antioxidants/pharmacokinetics , Antioxidants/pharmacology , Drug Delivery SystemsABSTRACT
Cutaneous melanoma is an aggressive type of skin cancer that is recognized for its high metastatic potential and the challenges it presents in its treatment. There has been increasing interest in plant extracts and their potential applications in melanoma. The present study aimed to investigate the content of individual phenolic compounds in araçá-boi extract, evaluate their antioxidant activity, and explore their effects on cell viability, migration properties, oxidative stress levels, and protein expression in the human metastatic melanoma cell line SK-MEL-28. HPLC-DAD analysis identified 11 phenolic compounds in the araçá-boi extract. Trans-cinnamic acid was the main phenolic compound identified; therefore, it was used alone to verify its contribution to antitumor activities. SK-MEL-28 melanoma cells were treated for 24 h with different concentrations of araçá-boi extract and trans-cinnamic acid (200, 400, 600, 800, and 1600 µg/mL). Both the araçá-boi extract and trans-cinnamic acid reduced cell viability, cell migration, and oxidative stress in melanoma cells. Additionally, they modulate proteins involved in apoptosis and inflammation. These findings suggest the therapeutic potential of araçá-boi extract and its phenolic compounds in the context of melanoma, especially in strategies focused on preventing metastasis. Additional studies, such as the analysis of specific signaling pathways, would be valuable in confirming and expanding these observations.
Subject(s)
Cell Movement , Cell Survival , Cinnamates , Melanoma , Phenols , Plant Extracts , Humans , Melanoma/drug therapy , Melanoma/pathology , Melanoma/metabolism , Cell Movement/drug effects , Plant Extracts/pharmacology , Cell Survival/drug effects , Cinnamates/pharmacology , Cell Line, Tumor , Phenols/pharmacology , Antioxidants/pharmacology , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Oxidative Stress/drug effects , Apoptosis/drug effects , Antineoplastic Agents, Phytogenic/pharmacologyABSTRACT
BACKGROUND: Tumour dormancy, a resistance mechanism employed by cancer cells, is a significant challenge in cancer treatment, contributing to minimal residual disease (MRD) and potential relapse. Despite its clinical importance, the mechanisms underlying tumour dormancy and MRD remain unclear. In this study, we employed two syngeneic murine models of myeloid leukemia and melanoma to investigate the genetic, epigenetic, transcriptomic and protein signatures associated with tumour dormancy. We used a multiomics approach to elucidate the molecular mechanisms driving MRD and identify potential therapeutic targets. RESULTS: We conducted an in-depth omics analysis encompassing whole-exome sequencing (WES), copy number variation (CNV) analysis, chromatin immunoprecipitation followed by sequencing (ChIP-seq), transcriptome and proteome investigations. WES analysis revealed a modest overlap of gene mutations between melanoma and leukemia dormancy models, with a significant number of mutated genes found exclusively in dormant cells. These exclusive genetic signatures suggest selective pressure during MRD, potentially conferring resistance to the microenvironment or therapies. CNV, histone marks and transcriptomic gene expression signatures combined with Gene Ontology (GO) enrichment analysis highlighted the potential functional roles of the mutated genes, providing insights into the pathways associated with MRD. In addition, we compared "murine MRD genes" profiles to the corresponding human disease through public datasets and highlighted common features according to disease progression. Proteomic analysis combined with multi-omics genetic investigations, revealed a dysregulated proteins signature in dormant cells with minimal genetic mechanism involvement. Pathway enrichment analysis revealed the metabolic, differentiation and cytoskeletal remodeling processes involved in MRD. Finally, we identified 11 common proteins differentially expressed in dormant cells from both pathologies. CONCLUSIONS: Our study underscores the complexity of tumour dormancy, implicating both genetic and nongenetic factors. By comparing genomic, transcriptomic, proteomic, and epigenomic datasets, our study provides a comprehensive understanding of the molecular landscape of minimal residual disease. These results provide a robust foundation for forthcoming investigations and offer potential avenues for the advancement of targeted MRD therapies in leukemia and melanoma patients, emphasizing the importance of considering both genetic and nongenetic factors in treatment strategies.
Subject(s)
Disease Models, Animal , Melanoma , Neoplasm, Residual , Animals , Melanoma/genetics , Melanoma/pathology , Mice , Leukemia/genetics , Leukemia/pathology , DNA Copy Number Variations , Exome Sequencing , Mice, Inbred C57BL , Proteomics , Transcriptome , Gene Expression Profiling , MultiomicsABSTRACT
BACKGROUND: Angiogenesis is a process that many tumors depend on for growth, development, and metastasis. Vascular endothelial growth factor (VEGF) is one of the major players in tumor angiogenesis in several tumor types, including melanoma. VEGF inhibition is achieved by bevacizumab, a humanized monoclonal antibody that binds with high affinity to VEGF and prevents its function. In order to successfully enable in vivo VEGF expression imaging in a murine melanoma model, we previously labeled bevacizumab with [99mTc]Tc. We observed that this was feasible, but it had prolonged blood circulation and delayed tumor uptake. OBJECTIVE: The aim of this study was to develop a radiolabeled Fab bevacizumab fragment, [99mTc]Tc-HYNICFab( bevacizumab), for non-invasive in vivo VEGF expression molecular imaging. METHODS: Flow cytometry was used to examine VEGF presence in the murine melanoma cell line (B16-F10). Bevacizumab was digested with papain for six hours at 37°C to produce Fab(bevacizumab), which was then conjugated to NHS-HYNIC-Tfa for radiolabeling with [99mTc]Tc. Stability and binding affinity assays were also evaluated. Biodistribution and single photon emission computed tomography/computed tomography (SPECT/CT) were performed at 1, 3, and 6 h (n = 4) after injection of [99mTc]Tc-HYNIC-Fab(Bevacizumab) in normal and B16-F10 tumor-bearing C57Bl/6J mice. RESULTS: Using flow cytometry, it was shown that the B16-F10 murine melanoma cell line has intracellular VEGF expression. Papain incubation resulted in the complete digestion of bevacizumab with good purity and homogeneity. The radiolabeling yield of [99mTc]Tc-HYNIC-Fab(bevacizumab) was 85.00 ± 6.06%, with a specific activity of 291.87 ± 18.84 MBq/mg (n=3), showing in vitro stability. Binding assays demonstrated significant intracellular in vitro VEGF expression. Fast blood clearance and high kidney and tumor uptake were observed in biodistribution and SPECT/CT studies. CONCLUSIONS: We present the development and evaluation of [99mTc]Tc-HYNIC-Fab(bevacizumab), a novel molecular VEGF expression imaging agent that may be used for precision medicine in melanoma and potentially in other VEGF-expressing tumors.
Subject(s)
Bevacizumab , Organotechnetium Compounds , Vascular Endothelial Growth Factor A , Animals , Bevacizumab/chemistry , Bevacizumab/pharmacology , Mice , Vascular Endothelial Growth Factor A/metabolism , Organotechnetium Compounds/chemistry , Molecular Imaging , Radiopharmaceuticals/chemistry , Radiopharmaceuticals/chemical synthesis , Mice, Inbred C57BL , Melanoma/diagnostic imaging , Melanoma/metabolism , Melanoma/drug therapy , Melanoma/pathology , Tissue Distribution , Technetium/chemistry , Molecular Structure , Humans , Cell Line, Tumor , Tomography, Emission-Computed, Single-Photon , Immunoglobulin Fab Fragments/chemistryABSTRACT
Patients with cutaneous malignancies and locoregional involvement represent a high-risk population for disease recurrence, even if they receive optimal surgery and adjuvant treatment. Here, we discuss how neoadjuvant therapy has the potential to offer significant advantages over adjuvant treatment, further improving outcomes in some patients with skin cancers, including melanoma, Merkel cell carcinoma, and cutaneous squamous-cell carcinoma. Both preclinical studies and in vivo trials have demonstrated that exposure to immunotherapy prior to surgical resection can trigger a broader and more robust immune response, resulting in increased tumor cell antigen presentation and improved targeting by immune cells, potentially resulting in superior outcomes. In addition, neoadjuvant approaches hold the possibility of providing a platform for evaluating pathological responses in the resected lesion, optimizing the prognosis and enabling personalized adaptive management, in addition to expedited drug development. However, more data are still needed to determine the ideal patient selection and the best treatment framework and to identify reliable biomarkers of treatment responses. Although there are ongoing questions regarding neoadjuvant treatment, current data support a paradigm shift toward considering neoadjuvant therapy as the standard approach for selecting patients with high-risk skin tumors.
Subject(s)
Neoadjuvant Therapy , Skin Neoplasms , Humans , Skin Neoplasms/drug therapy , Immunotherapy , Melanoma/drug therapy , Melanoma/therapy , Carcinoma, Merkel Cell/therapy , Carcinoma, Squamous Cell/therapySubject(s)
Melanoma , Osteopontin , Humans , Melanoma/genetics , Melanoma/diagnosis , Osteopontin/genetics , Osteopontin/metabolism , Prognosis , Gene Expression Regulation, Neoplastic , Biomarkers, Tumor/genetics , Biomarkers, Tumor/metabolism , Protein Isoforms/genetics , Protein Isoforms/metabolism , Skin Neoplasms/genetics , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Alternative Splicing , Female , MaleABSTRACT
The diagnosis of pigmented nail lesions is a concern for both general practitioners and dermatologists, due to the possibility of indicating nail melanoma. The origin of the dark pigmentation can be either melanocytic or non-melanocytic (fungi, bacteria, or blood), and clinical evaluation alone may not be sufficient for differentiation, requiring additional exams. Onychoscopy provides valuable information prior to biopsy. The causes of nail pigmentation will be described to aid in the differential diagnosis.
Subject(s)
Melanoma , Nail Diseases , Humans , Diagnosis, Differential , Nail Diseases/pathology , Nail Diseases/diagnosis , Melanoma/diagnosis , Melanoma/pathology , Skin Neoplasms/pathology , Skin Neoplasms/diagnosis , Dermoscopy , Pigmentation Disorders/pathology , Pigmentation Disorders/diagnosis , Nails/pathology , Nails/diagnostic imaging , BiopsyABSTRACT
Background: Anorectal melanoma (AM) is a rare and aggressive type of tumor, with varied and inconclusive scientific information. Its preoperative diagnosis is challenging due to its rarity and similarity to other anorectal conditions. It represents only 1.3% of melanomas and affects more women than men. Approximately 20-30% of AM cases are amelanotic, complicating endoscopic detection and leading to misdiagnoses. AM is often confused with hemorrhoids, polyps, and rectal cancer in two thirds of patients due to similar symptoms. The causes and risk factors of AM are not well understood, but they are suspected to differ from cutaneous and ocular melanomas. Diagnosis is performed through biopsy and immunohistochemical staining. Colonoscopy helps to characterize the lesions, and histological examination is crucial for definitive diagnosis. Clinical case: 50-year-old woman with rectal bleeding and proctalgia. AM was diagnosed through colonoscopy, and transanal resection with hemorrhoidectomy was performed. Conclusions: Management of AM is complicated by the lack of randomized trials. Resection surgery is the standard treatment, but there is no established protocol. Wide local excision may be an option for limited cases. Further research is needed to improve the management and treatment of AM. Early detection and complete surgical removal are crucial for enhancing survival in these patients.
Introducción: el melanoma anorrectal (MA) es un tipo raro y agresivo de tumor, cuya información científica es variada y poco concluyente. Su diagnóstico preoperatorio es un desafío debido a su rareza y a su similitud con otras afecciones anorrectales. Representa solo el 1.3% de los melanomas y afecta más a mujeres que a hombres. Aproximadamente el 20-30% de los casos de MA son amelanóticos, lo que complica su detección endoscópica y conduce a diagnósticos erróneos. El MA se confunde con hemorroides, pólipos y cáncer de recto en dos tercios de los pacientes debido a síntomas similares. Las causas y factores de riesgo del MA aún no se conocen bien, pero se sospecha que son diferentes de los melanomas cutáneos y oculares. El diagnóstico se realiza mediante biopsia y tinción inmunohistoquímica. La colonoscopía permite caracterizar las lesiones y el examen histológico es crucial para el diagnóstico definitivo. Caso clínico: mujer de 50 años con rectorragia y proctalgia. Se diagnosticó MA mediante colonoscopía y se realizó una resección transanal con hemorroidectomía. Conclusiones: el manejo del MA es complicado por la falta de ensayos aleatorizados. La cirugía de resección es el tratamiento habitual, pero no hay un protocolo establecido. La escisión local amplia puede ser una opción para casos limitados. Se necesita más investigación para mejorar el manejo y tratamiento del MA. La detección temprana y la extirpación quirúrgica completa son cruciales para mejorar la supervivencia en estos pacientes.
Subject(s)
Anus Neoplasms , Melanoma , Rectal Neoplasms , Humans , Middle Aged , Female , Rectal Neoplasms/diagnosis , Rectal Neoplasms/surgery , Rectal Neoplasms/pathology , Anus Neoplasms/diagnosis , Anus Neoplasms/pathology , Anus Neoplasms/surgery , Melanoma/diagnosis , Melanoma/pathology , Melanoma/surgery , Colonoscopy , HemorrhoidectomyABSTRACT
BACKGROUND: Metastatic melanoma stands out as the most lethal form of skin cancer because of its high propensity to spread and its remarkable resistance to treatment methods. METHODS: In this review article, we address the incidence of melanoma worldwide and its staging phases. We thoroughly investigate the different melanomas and their associated risk factors. In addition, we underscore the principal therapeutic goals and pharmacological methods that are currently used in the treatment of melanoma. RESULTS: The implementation of targeted therapies has contributed to improving the approach to patients. However, because of the emergence of resistance early in treatment, overall survival and progression-free periods continue to be limited. CONCLUSIONS: We provide new insights into plant serine protease inhibitor therapeutics, supporting high-throughput drug screening soon, and seeking a complementary approach to explain crucial mechanisms associated with melanoma.
Subject(s)
Melanoma, Cutaneous Malignant , Melanoma , Serine Proteinase Inhibitors , Skin Neoplasms , Melanoma/drug therapy , Melanoma/pathology , Melanoma/metabolism , Humans , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Serine Proteinase Inhibitors/therapeutic use , Serine Proteinase Inhibitors/pharmacology , Serine Proteinase Inhibitors/chemistry , Biotechnology/methodsABSTRACT
Despite the promising potential of Solanum plant glycoalkaloids in combating skin cancer, their clinical trials have been halted due to dose-dependent toxicity and poor water solubility. In this study, we present a rational approach to address these limitations and ensure colloidal stability of the nanoformulation over time by designing solid lipid-polymer hybrid nanoparticles (SLPH). Leveraging the biocompatible and cationic properties of polyaspartamides, we employed a new polyaspartamide derivative (P1) as a raw material for this class of nanostructures. Subsequently, we prepared SLPH through a one-step process involving hot-melt emulsification followed by ultrasonication. The physicochemical properties of the SLPH were thoroughly characterized using dynamic light scattering (DLS), ζ-potential analysis, nanoparticle tracking analysis (NTA), differential scanning calorimetry (DSC), Fourier-transform infrared spectroscopy (FT-IR), and transmission electron microscopy (TEM). The optimized formulation exhibited long-term stability over six months under low temperatures, maintaining a particle size around 200â¯nm, a polydispersity index (PdI) lower than 0.2, and a ζ-potential between +35-40â¯mV. Furthermore, we evaluated the cytotoxic effect of the SLPH against human cutaneous melanoma cells (SK-MEL-28) compared to human foreskin fibroblast cells (HFF-1). Encapsulation of glycoalkaloids into the nanoparticles (SLPH-GE) resulted in a two-fold greater selective cytotoxic profile for melanoma cells than glycoalkaloids-free (GE). The nanoparticles disrupted the stratum corneum barrier with a penetration depth of approximately 77 µm. These findings underscore the potential of the developed nanosystem as an effective glycoalkaloid carrier with suitable colloidal and biological properties for further studies in topical treatment strategies for cutaneous melanoma.
Subject(s)
Lipids , Melanoma , Nanoparticles , Polymers , Humans , Nanoparticles/chemistry , Lipids/chemistry , Melanoma/drug therapy , Melanoma/pathology , Polymers/chemistry , Polymers/pharmacology , Cell Survival/drug effects , Drug Carriers/chemistry , Particle Size , Alkaloids/chemistry , Alkaloids/pharmacology , Cell Line, Tumor , Skin Neoplasms/drug therapy , Skin Neoplasms/pathology , Antineoplastic Agents/pharmacology , Antineoplastic Agents/chemistry , Administration, Topical , Cell Proliferation/drug effects , Drug Screening Assays, Antitumor , Surface PropertiesABSTRACT
Melanoma, a malignant tumor of melanocytes, poses a significant clinical challenge due to its aggressive nature and high potential for metastasis. The advent of targeted therapy has revolutionized the treatment landscape of melanoma, particularly for tumors harboring specific genetic alterations such as BRAF V600E mutations. Despite the initial success of targeted agents, resistance inevitably arises, underscoring the need for novel therapeutic strategies. This review explores the latest advances in targeted therapy for melanoma, focusing on new molecular targets, combination therapies, and strategies to overcome resistance.
Subject(s)
Melanoma , Molecular Targeted Therapy , Proto-Oncogene Proteins B-raf , Humans , Melanoma/drug therapy , Melanoma/therapy , Melanoma/genetics , Melanoma/pathology , Melanoma/metabolism , Molecular Targeted Therapy/methods , Proto-Oncogene Proteins B-raf/genetics , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Drug Resistance, Neoplasm , Mutation , Antineoplastic Agents/therapeutic useABSTRACT
The lack of effective treatment options for an increasing number of cancer cases highlights the need for new anticancer therapeutic strategies. Immunotherapy mediated by Salmonella enterica Typhimurium is a promising anticancer treatment. Candidate strains for anticancer therapy must be attenuated while retaining their antitumor activity. Here, we investigated the attenuation and antitumor efficacy of two S. enterica Typhimurium mutants, ΔtolRA and ΔihfABpmi, in a murine melanoma model. Results showed high attenuation of ΔtolRA in the Galleria mellonella model, and invasion and survival in tumor cells. However, it showed weak antitumor effects in vitro and in vivo. Contrastingly, lower attenuation of the attenuated ΔihfABpmi strain resulted in regression of tumor mass in all mice, approximately 6 days after the first treatment. The therapeutic response induced by ΔihfABpmi was accompanied with macrophage accumulation of antitumor phenotype (M1) and significant increase in the mRNAs of proinflammatory mediators (TNF-α, IL-6, and iNOS) and an apoptosis inducer (Bax). Our findings indicate that the attenuated ΔihfABpmi exerts its antitumor activity by inducing macrophage infiltration or reprogramming the immunosuppressed tumor microenvironment to an activated state, suggesting that attenuated S. enterica Typhimurium strains based on nucleoid-associated protein genes deletion could be immunotherapeutic against cancer.
Subject(s)
Salmonella typhimurium , Animals , Salmonella typhimurium/immunology , Salmonella typhimurium/genetics , Mice , Mice, Inbred C57BL , Melanoma/immunology , Melanoma/genetics , Melanoma/pathology , Immunotherapy/methods , Macrophages/immunology , Macrophages/metabolism , Cell Line, Tumor , Mutation , Female , Melanoma, Experimental/immunology , Melanoma, Experimental/pathology , Melanoma, Experimental/therapy , Disease Models, AnimalABSTRACT
In this work, a polyhedral silsesquioxane (POSS) was used as an engineered drug delivery system for two oxindolimine-copper(II) anticancer complexes, [Cu(isaepy)]+ and [Cu(isapn)]+. The interest in hybrid POSS comes from the necessity of developing materials that can act as adjuvants to improve the cytotoxicity of non-soluble metallodrugs. Functionalization of POSS with a triazole ligand (POSS-atzac) permitted the anchorage of such copper complexes, producing hybrid materials with efficient cytotoxic effects. Structural and morphological characterizations of these copper-POSS systems were performed by using different techniques (IR, NMR, thermogravimetric analysis). A combination of continuous-wave (CW) and pulsed EPR (HYSCORE) spectroscopies conducted at the X-band have enabled the complete characterization of the coordination environment of the copper ion in the POSS-atzac matrix. Additionally, the cytotoxic effects of the loaded materials, [Cu(isapn)]@POSS-atzac and [Cu(isaepy)]@POSS-atzac, were assessed toward melanomas (SK-MEL), in comparison to non-tumorigenic cells (fibroblast P4). Evaluation of their nuclease activity or ability to facilitate cleavage of DNA indicated concentrations as low as 0.6 µg mL-1, while complete DNA fragmentation was observed at 25 µg mL-1. By using adequate scavengers, investigations on active intermediates responsible for their cytotoxicity were performed, both in the absence and in the presence of ascorbate as a reducing agent. Based on the observed selective cytotoxicity of these materials toward melanomas, investigations on the reactivity of these complexes and corresponding POSS-materials with melanin, a molecule that contributes to melanoma resistance to chemotherapy, were carried out. Results indicated the main role of the binuclear copper species, formed at the surface of the silica matrix, in the observed reactivity and selectivity of these copper-POSS systems.
Subject(s)
Antineoplastic Agents , Coordination Complexes , Copper , Melanoma , Organosilicon Compounds , Copper/chemistry , Copper/pharmacology , Antineoplastic Agents/pharmacology , Antineoplastic Agents/chemistry , Humans , Melanoma/drug therapy , Melanoma/pathology , Organosilicon Compounds/chemistry , Organosilicon Compounds/pharmacology , Coordination Complexes/chemistry , Coordination Complexes/pharmacology , Coordination Complexes/chemical synthesis , Cell Line, Tumor , Drug Delivery Systems , Cell Survival/drug effects , Drug Carriers/chemistry , Drug Screening Assays, AntitumorABSTRACT
BACKGROUND: Mucosa melanoma is a rare condition with aggressive behavior and a less favorable prognosis compared to cutaneous melanoma. The objective of this study was to estimate the overall survival and clinical outcomes of patients diagnosed with mucosal melanoma in a Colombian hospital. METHODS: A retrospective cohort study was conducted at Fundación Valle del Lili, a single center located in Cali, Colombia. Patients aged ≥ 18 years, both sexes, diagnosed with mucosal melanoma by histopathology study were included between 2010-2019. Patients who received extra-institutional treatment or whose vital status was unknown during follow-up were excluded. Demographic, clinical and laboratory data were obtained from medical records and laboratory and pathology databases. A descriptive analysis was performed. Survival analysis was conducted using the Kaplan-Meier method. RESULTS: A total of 23 patients were included. Median age was 63 years old (IQR: 57-68) and 52.2% were woman. Clinical stage was 34.8% early, 26.1% locally advanced and 39.1% metastatic. The main primary locations were nasopharynx (30.4%), genitals (26.1%), rectum (21.7%), oral cavity (13%) and paranasal sinuses (8.7%). The majority received surgery (30.4%) and immunotherapy (26.1%) as first line treatment. Overall survival at one year was 80.8%, at three years 44.3%, and at five years 36.9%. CONCLUSION: Mucosal melanoma is a rare, aggressive disease with adverse oncological outcomes due to late diagnosis and limited treatment options. This study provides real-world data in a single-center of Colombia.