Assessment of Trends in Second Primary Cancers in Patients With Metastatic Melanoma From 2005 to 2016

Deng, Weiye; Wang, Yifan; Liu, Xiangyu; Liu, Jieqiong; Wang, Liang; Yang, Zhaogang; Yang, Mingming; An, Yi; Tang, Chad; Sanford, Nina N.; Kim, Betty Y.S.; Jiang, Wen

doi:10.1001/jamanetworkopen.2020.28627

Cited by 25 publications

(22 citation statements)

References 27 publications

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“…In comparison, population‐based genetic testing among breast cancer survivors identified PVs in 5.0% of case patients and 1.63% of controls, 38 and in a universal genetic testing model for patients with cancer, 8.1% (242 of 2984) were identified as harboring a PV in 1 of the 21 genes ( ATM , BARD1 , BRCA1 , BRCA2 , BRIP1 , CDH1 , CHEK2 , EPCAM , MLH1 , MSH2 , MSH6 , biallelic MUTYH , NBN , NF1 , PALB2 , PMS2 , PTEN , RAD51C , RAD51D , STK11 , and TP53 ) 19 . Identifying patients with germline PVs is crucial to their care, including cancer treatment and cancer surveillance for a subsequent cancer diagnosis 39 . Emerging data suggest that patients with a subsequent cancer diagnosis have worse outcomes than patients with an initial cancer diagnosis among most cancer types 40 .…”

Section: Discussionmentioning

confidence: 99%

Prevalence and spectrum of pathogenic variants among patients with multiple primary cancers evaluated by clinical characteristics

Bychkovsky

Yussuf

et al. 2021

Cancer

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Background Multiple primary cancers (MPCs) are a hallmark of cancer predisposition syndromes. Here the frequency of germline pathogenic variants (PVs) among patients with MPCs is reported. Methods Patients with MPCs who underwent multigene panel testing from March 2012 to December 2016 were studied. Eligible patients had an analysis of 21 genes: ATM, BARD1, BRCA1, BRCA2, BRIP1, CDH1, CHEK2, EPCAM, MLH1, MSH2, MSH6, MUTYH, NBN, NF1, PALB2, PMS2, PTEN, RAD51C, RAD51D, STK11, and TP53. The frequencies of PVs by sex, number of cancers, and age at diagnosis were compared with 2‐sided χ2 tests or Fisher exact tests when the number was <10. Results Among the 9714 patients analyzed, most were female (91.1%) and White (71.0%); the median age at testing was 63 years, and the median ages at first and second cancer diagnoses were 49 and 58 years, respectively. Overall, 1320 (13.6%) had PVs. The prevalence of PVs increased with the number of primary cancers (PCs): 13.1% with 2 PCs, 15.9% with 3 PCs, and 18.0% with ≥4 PCs (P = .00056). Differences in the prevalence of PVs by age at diagnosis were significant: 14.7% with 2 PCs at an age < 50 years, 15.8% with 1 PC at an age < 50 years, and 12.0% with all PCs at an age ≥ 50 years (P = 2.07E–05). PVs by the age at second cancer diagnosis were also significant: 14.7% at an age < 50 years, 13.9% at an age of 50 to 69 years, and 11.4% at an age ≥ 70 years (P for trend = .005). Conclusions Among patients with MPCs, there is a high frequency of germline PVs, with a higher frequency found among patients with a higher number of PCs. These findings suggest that genetic testing should be considered even among patients who are older at the diagnosis of an additional primary malignancy.

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Section: Discussionmentioning

confidence: 99%

Prevalence and spectrum of pathogenic variants among patients with multiple primary cancers evaluated by clinical characteristics

Bychkovsky

Yussuf

et al. 2021

Cancer

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“…However, the effect of ICIs on second primary tumors is not yet clear. Heudel et al concluded that ICIs could reduce the incidence of second primary tumors, 6,7 while Deng et al found an increased overall risk of second primary cancer after the introduction of ICIs to the treatment of melanoma 8 . In theory, the immune effect activated by ICIs is systemic and should be able to produce an offensive effect against all types of tumors.…”

Section: Discussionmentioning

confidence: 99%

“…Heudel et al concluded that ICIs could reduce the incidence of second primary tumors, 6 , 7 while Deng et al found an increased overall risk of second primary cancer after the introduction of ICIs to the treatment of melanoma. 8 In theory, the immune effect activated by ICIs is systemic and should be able to produce an offensive effect against all types of tumors. However, patients who benefit from ICIs tend to have higher TMB, implying a higher frequency of genetic mutations than normal.…”

Section: Discussionmentioning

confidence: 99%

Second primary tumor after immune checkpoint inhibitor therapy: A case report

Miao

et al. 2022

Thoracic Cancer

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Immune checkpoint inhibitors (ICIs) are used to treat many types of cancers. However, the effect of ICIs on second primary tumors is still unclear. Some studied have concluded that ICIs could reduce the incidence of second primary tumors, while others found an increased overall risk of second primary cancer after the introduction of ICIs to the treatment of melanoma. Here, we report the case of a patient with advanced non-small cell lung cancer (NSCLC) who was treated with ICIs in combination with antiangiogenic drugs, and subsequently developed a second primary tumor in the context of a favorable curative effect of the primary lung cancer. From this case, we know that good efficacy of ICIs for a primary tumor does not mean that a second primary tumor will never develop, which reminds clinicians to consider the possibility of a second primary tumor rather than treating it directly as disease progression.K E Y W O R D S case report, immune checkpoint inhibitor, non-small cell lung cancer, second primary tumor

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“…In a study by Heudel et al, patients treated with ICI for a first primary cancer had reduced risk of MPM, compared to those treated with chemotherapy [ 26 ]. In contrast, a SEER-based study comparing melanoma patients from the pre- and post-ICI eras (2005-2010 and 2011-2016, respectively), found that patients from the later period had more MPM [ 27 ]; however, the authors did not report whether patients received ICI or not (PD-1 inhibitors were approved in 2014), but rather looked at differences by date of treatment alone.…”

Section: Discussionmentioning

confidence: 99%

A Case Series of Multiple Primary Malignancies Among Patients With Advanced Melanoma

Ebia

Capone

Ricker

et al. 2021

Cureus

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Multiple primary malignancies (MPM) are described as two or more primary tumors within the same individual. The impact of MPM on the tumor microenvironment among patients with melanoma is poorly understood. Here, we describe this unique group of patients who have both advanced melanoma and at least one other primary malignancy and report their survival outcomes. In this study, patients with advanced melanoma and a second primary malignancy were identified. Medical records were reviewed for cancer treatment history. Kaplan-Meier methods were used to derive survival curves and estimate overall survival (OS), and log-rank tests were used to compare OS. Among 11 MPM patients, the most common nonmelanoma cancers were breast (n = 3) and thyroid (n = 3). Median OS was 153.5 months for all patients. Median OS for synchronous MPM (sMPM) and metachronous MPM (mMPM) were 83.1 and 196.7 months, respectively (p = 0.10). Median OS was not reached when melanoma was diagnosed first, and 153.5 months when diagnosed second (p = 0.45). For six patients receiving immunotherapy for melanoma, there was a 100% complete response rate. In conclusion, patients with melanoma are at risk of secondary malignancies, including breast and thyroid cancer. The timing of secondary malignancies may impact prognosis. Further study of the impact of immunotherapy on MPM is warranted.

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Assessment of Trends in Second Primary Cancers in Patients With Metastatic Melanoma From 2005 to 2016

Cited by 25 publications

References 27 publications

Prevalence and spectrum of pathogenic variants among patients with multiple primary cancers evaluated by clinical characteristics

Prevalence and spectrum of pathogenic variants among patients with multiple primary cancers evaluated by clinical characteristics

Second primary tumor after immune checkpoint inhibitor therapy: A case report

A Case Series of Multiple Primary Malignancies Among Patients With Advanced Melanoma

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