Introduction
Multiple primary melanomas (MPM) occur up to 8% of patients with cutaneous malignant melanoma (CMM). They are often sporadic harbouring several somatic mutations, but also familial cases harbouring a
CDKN2A
germline mutation have been describe in Caucasian populations. The aim of this study was to investigate the incidence, the distribution patterns and the impact of known and unknown germline and somatic mutations in patients with MPM from Italy.
Materials and methods
One-hundred and two MPM patients were enrolled for germline mutation analysis, and five patients with at least four MPMs were identified for somatic mutation analysis. The demographic, pathologic and clinical features were retrieved from medical records. Molecular analysis for both germline and somatic mutations was performed in genomic DNA from peripheral blood and tissue samples, respectively, through a next generation sequencing approach, using a specific multiple-gene panel constructed by the Italian Melanoma Intergroup for somatic analysis and a commercial cancer hotspot panel for somatic analysis.
Results
CDKN2A
mutations were detected in 6/16 (37.5%) and 3/86 (3.5%) MPM cases with and without family history for melanoma, respectively. Furthermore, multiple
MC1R
and, to a lesser extent,
ATM
variants have been identified.
BAP1
variants were found only in MPM patients from southern Italy. The most frequent somatic variants were the pathogenic
BRAF
V600E
and
TP53
, followed by
KIT, PIK3CA
,
KDR
, and
NRAS
. Single
APC, ERBB4, MET, JAK3
and other variants with unknown function were also detected.
Conclusions
CDNK2A
mutation is the most relevant susceptibility mutation in Italian patients with MPM, especially those with a family history for CMM. The prevalence of this mutation and other sequence variants identified in this study varies among specific sub-populations. Furthermore, some heterogeneity in driver somatic mutations between sporadic MPMs has been observed, as well as in a number of associated sequence variants the clinical impact of which needs to be further elucidated.
Electronic supplementary material
The online version of this article (10.1186/s12885-019-5984-7) contains supplementary material, which is available to authorized users.