Recently, Medical Xpress reported on a study which found that damage caused by the sun predisposed children and adolescents to melanoma. The study also found that some melanomas found in adolescent patients would respond to the same treatments being used by adult patients. The study was conducted by St. Jude Children’s Research Hospital–Washington University Pediatric Cancer Genome Project. The findings come from the most comprehensive analysis of genetic changes responsible for melanoma in children. Melanoma is the most common skin cancer in children and adolescents.
Co-corresponding author, Dr. Alberto Pappo, says that the study shows that treatments being used for adults should be able to work for adolescents as well, and that these treatments need to be more readily available to them. He also reminds us that this study highlights the importance of sun protection during childhood. The earlier it becomes a habit, the better.
Researchers also identified distinct genetic alterations associated with other pediatric melanoma subtypes, including those associated with large congenital nevi (CNM) and spitzoid tumors. The alterations include a mutation that might help identify spitzoid patients who would benefit from aggressive therapy as well as those who could be cured with less intensive treatment.
Until this study, the genetics of pediatric melanoma have been a bit of a mystery. Co-corresponding author Armita Bahrami, M.D., points out that this study establishes molecular signatures for all three subtypes of the cancer. These signatures help with diagnosis and treatment.
It is estimated that 425 people 19 and younger develop melanoma each year, and while that number may seem low, the incidence has continued to rise at about 2% each year. The majority of pediatric melanoma patients are between the ages of 15 and 19. Within the 75% of patients whose melanoma has not spread, survival rates exceed 90%.
This study included 23 melanoma patients ranging in age from 9 months to 19 years old. Researchers used whole genome sequencing and other techniques to compare the normal and tumor genomes of patients with three different types of melanoma for clues about the genetic alterations that underlie their disease. The genome is the blueprint for life that is encoded in the DNA found in almost every cell.The group included 15 patients with conventional melanoma. Unlike many pediatric cancers, their tumors included numerous genetic alterations, more than any of the childhood cancers studied so far by the Pediatric Cancer Genome Project. More than 90 percent of the tumors had genetic changes consistent with damage caused by ultraviolet light. More than 60 percent of the tumors had mutations in the BRAF oncogene, the PTEN tumor suppressor gene or the promoter region of a gene called TERT. The same alterations are found in melanoma in adults and promoted the unchecked cell division and other changes that are hallmarks of cancer.
Differing from conventional melanoma, the three patients who had CNM subtype also had mutations in the NRAS oncogene with no defects in PTEN. These patients all passed from their disease. This contrasts with the death of only one of the patients with spitzoid melanoma. It is important to point out, too, that the one patient who died was the only one with an advanced stage of the disease.
We at MoleSafe find this to be an incredibly important study. It highlights the importance of sun safety from the start.
What do YOU think? Let us know below!