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Sinonasal mucosal melanoma: Molecular profile and therapeutic implications from a series of 32 cases
Ist Teil von
Head & neck, 2013-08, Vol.35 (8), p.1066-1077
Ort / Verlag
Hoboken: Wiley Subscription Services, Inc., A Wiley Company
Erscheinungsjahr
2013
Quelle
Wiley Online Library - AutoHoldings Journals
Beschreibungen/Notizen
Background
Primary sinonasal mucosal melanomas are aggressive tumors with a poor clinical control by current treatments, raising the urgent need of novel strategies.
Methods
By fluorescence in situ hybridization (FISH), direct sequencing, and immunohistochemistry, we investigate the spectrum of molecular abnormalities in a cohort of 32 cases of primary sinonasal mucosal melanomas.
Results
We found that all primary sinonasal mucosal melanomas lack BRAF V600E mutation; in addition, they are characterized by somatic mutations of NRAS (22%) and KIT (12.5%), together with amplification of RREB1 (100%) and loss of MYB (76%). The large majority of cases showed KIT protein expression (96.9%). Among tumor suppressor genes, primary sinonasal mucosal melanomas showed loss of PTEN (48.1%) and p16/INK4a (55.2%). All tested cases showed expression of pAkt and pErk, suggesting a combined activation of PI3K/Akt and RAS‐mitogen‐activated protein kinase (MAPK) pathways.
Conclusions
This molecular fingerprint strongly argues against the clinical efficacy of BRAF‐inhibitors, but could candidate primary sinonasal mucosal melanomas to therapeutic strategies targeting RAS and KIT mutations or inhibiting PI3K‐Akt‐mTOR pathway. Head Neck, 2013