Genome-wide association study to reveal novel germline markers of melanoma survival.

Authors

null

Vylyny Chat

New York University Medical Center, Manhattan, NY

Vylyny Chat , Robert Ferguson , Leah Morales , Una Moran , Min Jae Kim , Matija Snuderl , Iman Osman , Jeffrey S. Weber , Tomas Kirchhoff

Organizations

New York University Medical Center, Manhattan, NY, New York University, New York, NY, The Ronald O. Perelman Department of Dermatology, New York University School of Medicine, New York, NY, NYU Grossman School of Medicine, New York, NY, Massachusetts General Hospital, Boston, MA, Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY, New York University School of Medicine, New York, NY

Research Funding

U.S. National Institutes of Health
U.S. National Institutes of Health

Background: Cutaneous melanoma (CM) is the most invasive form of skin cancer accounting for ̃80% of all skin cancer related deaths. While tumor staging (based on recent AJCC classification) is routinely used in prognostic assessment, a large fraction of the outcomes is not explained by AJCC staging system. This urges for the discovery of a more personalized prognostic surrogates. Growing evidence highlights the role of germline genetics in CM progression; yet, to date no systematic prognostic germline study has been conducted in melanoma. We performed the first genome-wide association analysis (GWAS) to identify germline variants associated with melanoma survival. Methods: A cases/case GWAS was performed using the Infinium global screening array (GSA v3.0) to genotype 1,117 stage 0-III melanoma patients with no history of immunotherapy treatments ascertained at New York University Langone Health (NYULH). We randomly divided the study cohort into a discovery (N=630) and a validation (N=487) sets and tested the association of > 5 million imputed germline variants with melanoma overall survival (OS) by fitting Cox-proportional hazard ratio (HR) regression in an additive genetic model adjusting for sex, age at diagnosis, AJCC 8th staging, tumor anatomic sites, and top 3 principal components. Results: We found 151 independent variants associated with melanoma OS (p< 5×10−5) in the discovery cohort. Two of these associations validated in the independent replication set (Bonferroni threshold for 151 tests: p < 0.003) with enhanced clinical and statistical significance in the pooled meta-analysis: rs4128212 [HR =2.47(1.75-3.48); p=2.2× 10−7], and rs13212644 [HR =2.59 (1.72-3.88); p=4.2× 10−6]. We further tested the combined effect of these two variants and found the presence of at least one risk allele of the variants associated with a substantially increased risk of death, surpassing GWAS level of significance (HR=3.74 (2.43-5.74); p=1.5×10−9). Conclusions: We present the results of first GWAS testing an association of germline variation with melanoma OS. Stemming from a unique patient population with extensive clinical follow-up data, we identified two prognostic germline loci with large HR effect size >2.5 that were independently validated. The observed association is independent of established histopathologic markers. While rs4128212 was mapped to a putative cancer prognostic gene locus (PLPP4: phospholipid phosphatase 4), rs13212644 was an eQTL (expression quantitative trait loci) for GCLC (Glutamate-Cysteine Ligase Catalytic Subunit), a key regulator in glutathione synthesis previously linked with favorable melanoma survival. The significantly enhanced combined effect of these two loci (HR >3.5; p<5×10−9) indicates a great promise for their clinical utility as independent personalized predictive markers of melanoma progression.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Local-Regional Disease

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 9581)

DOI

10.1200/JCO.2021.39.15_suppl.9581

Abstract #

9581

Poster Bd #

Online Only

Abstract Disclosures

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