Outlier response to anti-PD1 in uveal melanoma reveals germline MBD4 mutations in hypermutated tumors.

Outlier response to anti-PD1 in uveal melanoma reveals germline MBD4 mutations in hypermutated tumors.
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DOI:
10.1038/s41467-018-04322-5
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发表时间:
2018-05-14
影响因子:
16.6
通讯作者:
Stern MH
Stern MH
中科院分区:
综合性期刊1区
文献类型:
--
作者:
Rodrigues M;Mobuchon L;Houy A;Fiévet A;Gardrat S;Barnhill RL;Popova T;Servois V;Rampanou A;Mouton A;Dayot S;Raynal V;Galut M;Putterman M;Tick S;Cassoux N;Roman-Roman S;Bidard FC;Lantz O;Mariani P;Piperno-Neumann S;Stern MH

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Metastatic uveal melanoma is a deadly disease with no proven standard of care. Here we present a metastatic uveal melanoma patient with an exceptional high sensitivity to a PD-1 inhibitor associated with outlier CpG>TpG mutation burden, MBD4 germline deleterious mutation, and somatic MBD4 inactivation in the tumor. We identify additional tumors in The Cancer Genome Atlas (TCGA) cohorts with similar hypermutator profiles in patients carrying germline deleterious MBD4 mutations and somatic loss of heterozygosity. This MBD4-related hypermutator phenotype may explain unexpected responses to immune checkpoint inhibitors. Hypermutated tumors respond more favorably to checkpoint inhibitor-based immune therapy. Here, the authors describe a new hypermutated phenotype due to germline mutations and subsequent somatic loss of heterozygosity of MBD4, and a dramatic response to the PD-1 inhibitor pembrolizumab in a patient with a MBD4-inactivated hypermutated uveal melanoma.
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