Integration of Clinical and Molecular Biomarkers for Melanoma Survival

项目摘要/概要 我们聚集了12个机构，以促进更好地了解生物学， 以及它如何影响个体的生存。我们的假设是原发性黑色素瘤 允许在AJCC TNM分期对黑色素瘤进行分层的分子和临床特征 IIA/IIB/IIC/IIIA/IIIB，其中几乎没有有效的辅助治疗，分为预后良好的患者和 预后不佳。目前，在这些阶段诊断出的个人死亡率在18- 19岁之间。 IIA/IIB/IIC期为47%，IIIA/IIIB期为32-78%。改善临床护理的能力， 这些患者的患者结局可能通过关注以下方面的识别和优先顺序来实现： 生物标志物-分子和临床-可能分流高风险患者的新的辅助治疗。 在这项研究中，我们将确定体细胞肿瘤突变，CNV，免疫谱，甲基化谱， 原发性黑色素瘤中与预后相关的microRNA/mRNA特征，最终目的是 将这些信息转化到诊所，以提供个性化的护理。目前，缺乏关于 研究流行病学/基因组因素和黑色素瘤生存率的黑色素瘤领域。为了识别，确认 并开发此类生物标志物，我们将9组AJCC TNM分期的黑色素瘤患者聚集在一起， IIA/IIB/IIC/IIIA/IIIB，包括1000人，其中500人死于2012年的疾病，500人死于2014年的疾病。 至少活了5年的人。患者将根据分期进行频率匹配。当我们整合来自 在多个平台上，我们将数据集随机分为训练集（660个肿瘤，一半是侵袭性的，一半是侵袭性的）。 非侵袭性）和验证组（340个肿瘤，一半侵袭性，一半非侵袭性）。显著 训练集中的结果将在验证集中复制。这些病人都接受过 标准护理手术本研究中的所有患者将具有足够的肿瘤组织、生殖系DNA和临床， 记录病理学和人口统计学信息。 我们的目标是确定与生存相关的预后生物标志物。目标是识别患者， 在发生转移之前进行更积极的治疗是相关的，这将使 对他们的生存有区别。我们的中心假设是，黑色素瘤的预后在很大程度上是在早期决定的。 肿瘤发生与DNA和RNA标志物，结合临床病理和蛋白质 原发性黑色素瘤的特征将为病理学特征以外的结果预测增加信息 用于AJCC肿瘤分期。我们正在采取综合办法，利用和组织 每个项目都产生大量的信息。这些信息将提供给临床医生， 其他调查人员尽快。

Program Project Abstract/Summary We have brought together 12 institutions in order to promote a better understanding of the biology of melanoma and how that affects an individual’s survival. Our hypothesis is that primary melanomas will have molecular and clinical features that will allow the stratification of melanoma tumors at AJCC TNM Stages IIA/IIB/IIC/IIIA/IIIB, where there is little effective adjuvant therapy, into those with a good prognosis and those with poor prognosis. The current mortality rate for individuals diagnosed at these stages ranges between 18- 47% for Stages IIA/IIB/IIC and 32-78% for Stage IIIA/IIIB patients. The ability to improve clinical care and patient outcomes for these patients might be achieved by focusing on the identification and prioritization of biomarkers – both molecular and clinical – that might triage high risk patients for new adjuvant therapies. In this study, we will identify somatic tumor mutations, CNVs, an immune profile, methylation profiles, and microRNA/mRNA signatures in primary melanoma that are associated with prognosis, with the ultimate intent of translating this information into the clinic to personalize care. Currently, there is a dearth of studies in the melanoma field looking at epidemiologic/genomic factors and melanoma survival. In order to identify, confirm and develop such biomarkers, we have brought together 9 cohorts of melanoma patients at AJCC TNM stages IIA/IIB/IIC/IIIA/IIIB, comprising 1000 individuals, 500 of whom have died from their disease as of 2012 and 500 whom have lived at least 5 years. Patients will be frequency matched for stage. As we integrate data from multiple platforms, we will randomly divide the dataset into a training set (660 tumors, half aggressive and half non-aggressive) and a validation set (340 tumors, half aggressive and half non-aggressive). Significant findings in the training set will be replicated in the validation set. These patients have all been treated using standard-of-care surgery. All patients in this study will have adequate tumor tissue, germline DNA and clinical, pathologic and demographic information recorded. Our objective is to identify prognostic biomarkers associated with survival. The goal is to identify patients for whom more aggressive therapy prior to developing metastases would be relevant, that is would make a difference to their survival. Our central hypothesis is that melanoma prognosis is largely determined early in tumor development and that DNA and RNA markers, combined with clinicopathologic and protein characteristics in primary melanoma will add information to outcome prediction beyond the pathologic features used in AJCC tumor staging. We are taking an integrative approach to take advantage of and organize the large amount of information generated from each project. Such information will be available to clinicians and other investigators as soon as possible.