Purpose: Assess for an association of wait times to melanoma treatment with overall survival. Methods: Retrospective review of Ontario patients with melanoma, with descriptive and survival analyses. Results: Median wait times were 43 days (interquartile range (IQR), 24-64) for wide local excision (WLE), 59 days (IQR, 41-81) for sentinel lymph node biopsy (SNB), 63 days (IQR, 43-91) for lymph node dissection (LND), 124 days (IQR, 96-150) for medical therapy, and 130 days (IQR, 89.5-157.5) for radiation therapy. In multivariate analysis, wait times to treatment were not associated with overall survival for WLE (hazard ratio (HR), 0.97; 95% confidence interval (CI), 0.87-1.08; p=0.62), SNB (HR, 0.89; 95% CI, 0.74-1.07; p=0.21), LND (HR, 0.99; 95% CI, 0.89-1.11; p=0.92), medical therapy (HR, 0.94; 95% CI, 0.80-1.10; p=0.41) or radiation therapy (HR, 0.80; 95% CI, 0.61-1.03; p=0.08). Conclusion: Overall survival for patients with melanoma was not associated with wait times to surgical, medical or radiation therapy.

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro de Ciências da Saúde, Programa de Pós-Graduação em Farmácia, Florianópolis, 2016. / Made available in DSpace on 2016-09-20T04:10:56Z (GMT). No. of bitstreams: 1 341096.pdf: 2936966 bytes, checksum: 935577bec836eb461f4854e3cc51d7e7 (MD5) Previous issue date: 2016 / Inúmeros estudos demonstram que a inflamação em indivíduos obesos está fortemente associada com um maior risco de desenvolvimento e progressão tumoral. O fator de necrose tumoral alfa (TNF-a) é uma das citocinas responsáveis pela iniciação e progressão de tumores, como também a amiloide sérica A (SAA), proteína produzida pelo fígado e pelo tecido adiposo em condições de inflamação. Além disso, ligantes do receptor de fator de crescimento epidermal (EGFR), como o EGF, demonstraram efeitos no favorecimento da proliferação celular e metástase. Neste sentido, analisamos se o soro de pacientes obesos e meio de cultura suplementado com citocinas poderiam criar um microambiente favorável ao crescimento tumoral com células de melanoma, além de verificar alterações na expressão gênica relacionada à progressão tumoral (B-RAF e N-RAS). Realizamos o ensaio clonogênico, o ensaio de migração 2D e ciclo celular em três linhagens de melanoma, SK-mel-19, SK-mel-28 e SK-mel-147. Uma delas, a SK-mel-28, demonstrou uma resposta mais intensa em relação à migração e capacidade clonogênica quando tratada com TNF-a e EGF. Deste modo, as células com mutação em B-RAF (SK-mel-28) foram tratadas com soro de 10 pacientes com IMC acima de 30 kg/m2, e 6 indivíduos com IMC abaixo de 25kg/m2, TNF-a (25 e 50 pg/mL), EGF (100 ng/mL), IL-1ß (10 pg/mL), IL-6 (10 pg/mL), MCP-1 (25 pg/mL) e SAA (75 ng/mL) a fim de avaliar os efeitos de componentes inflamatórios na migração pelo ensaio de migração 2D, e na expressão de B-RAF e N-RAS por PCR em tempo real. Também analisamos estes tratamentos na co-cultura de SK-mel-28 e mononucleares isolados do sangue periférico (PBMC). Foi observado um aumento na capacidade migratória das células de melanoma quando tratadas com soro dos obesos, rico em SAA (soros com concentração de SAA 50 vezes maior do valor de referência), além do tratamento com TNF-a. O soro dos obesos aumentou a expressão de N-RAS nas células de melanoma, fato também observado após tratamento com IL-6. As citocinas IL-1ß e IL-6 ampliaram a expressão de B-RAF. No ensaio clonogênico, os tratamentos com EGF e TNF-a aumentaram a capacidade clonogênica. Além disso, na co-cultura de melanoma com mononucleares, as células foram capazes de liberar citocinas no sobrenadante após tratamento com proteínas inflamatórias. Os resultados demonstraram uma associação entre as citocinas envolvidas em situação de obesidade (TNF-a, EGF, IL-1ß, IL-6, MCP-1 e SAA) e progressão tumoral, e sugerem que as citocinas pró-inflamatórias podem servir como alvo secundário no tratamento do melanoma. É necessário um aperfeiçoamento no entendimento dos efeitos das citocinas nas células de melanoma a fim de desenvolver novas abordagens terapêuticas para o tratamento do câncer.<br> / Abstract : It has been shown that low-grade inflammation on obese patients is strongly associated with an increased risk of cancer development and tumor progression. Tumor necrosis factor-a (TNF-a) is one of the cytokines that are responsible for both initiation and progression of tumors, as well as serum amyloid A (SAA), a cytokine produced by both liver and adipose tissue in inflammatory conditions. In addition, epidermal growth factor receptor (EGFR) ligands, such as EGF, have also demonstrated effect on fostering cell proliferation, tumor resistance and metastasis. Therefore, we examined whether serum from obese patients and cytokine-supplemented medium could create a growth-enhancing microenvironment in melanoma cells and gene expression alterations regarding tumor progression in melanoma (B-RAF and N-RAS). We performed clonogenic assay, scratch assay and cell cycle analysis in three different melanoma cell lines. One of them (SK-mel-28) demonstrated a major improvement regarding migration and clonogenicity when treated with TNF-a and EGF. Therefore, B-RAF mutated melanoma cells (SK-mel-28) were treated with serum from 10 patients with BMI > 30 kg/m2, and 6 individuals with BMI < 25 kg/m2, TNF-a (25 and 50 pg/mL), EGF (100 ng/mL), IL-1ß (10 pg/mL), IL-6 (10 pg/mL), MCP-1 (25 pg/mL) and SAA (75 ng/mL) in order to evaluate the effect of these cytokines on 2D cell migration, along with B-RAF and N-RAS gene expression by real-time PCR. We also analyzed these treatments in co-culture of SK-mel-28 and peripheral blood mononuclear cells (PBMC). An improve in melanoma cell migration was observed on cells treated with SAA-rich serum of obese patients (sera with a 50-fold increment of SAA above reference value), along with TNF-a?treated cells. Likewise, SAA-rich serum increased N-RAS gene expression in melanoma cells, fact observed with treatment with IL-6 as well. Cytokines such as IL-1ß and IL-6 increased the expression of B-RAF. In clonogenic assay, treatment with EGF increased the colony-forming potential, as well as TNF-a. Furthermore, when in co-culture of melanoma with PBMC, cells were able to release cytokines in supernatant after treatment with inflammatory proteins. The results demonstrated an association between cytokines involved in obesity (TNF-a, EGF, IL-1ß, IL-6, MCP-1 and SAA) and tumor progression, moreover, these cytokines may be target for melanoma treatment. The improvement in the understanding of the effects of cytokines in tumor cells is important in order to pave the way for new therapeutic approaches for cancer treatment.

The metastatic process requires that tumour cells are capable of traversing various micro-environmental barriers, such as the basement membrane. There are various proteolytic mechanisms which could contribute to the process, plasminogen activation by tissue plasminogen activator (tPA) and urokinase plasminogen activator (uPA) is one such mechanism. Extensive reports in the literature (reviewed in the introduction) indicate that most tumour cells synthesize uPA and that it is this enzyme, particularly when receptor-bound, which plays a role in invasion. UCT-Mel 3 is a human malignant melanoma cell line which was established in our laboratory, and has been shown to be highly metastatic in the nude mouse. This cell line is typical of many melanomas in that it synthesizes only tPA and not uPA. In part 1 of this thesis I further investigated the plasminogen activator production by these cells (at the level of mRNA as well as activity) as well as expression of plasminogen activator inhibitor PAl-1 and receptors for tPA and uPA (uPAR). UCT-Mel 3 cells expressed uPAR although uPA was not detected. I also examined cells cultured from two metastatic deposits. Interestingly, the metastatic cells produced PAl-1 which was undetected in the parent cells. After confirming that UCT-Mel 3 do not express detectable levels of uPA, I attempted (in part 2) to determine whether tPA could play a comparable role to that of uPA in the invasive process. My strategy was to inhibit the expression of tPA via two different methods, namely the use of antisense RNA and ribozyme. I then hoped to isolate clones producing no tPA, which would have been injected into nude mice in order to assay for metastasis. Unfortunately, neither of these methods proved to be successful in abrogating tPA expression. I was thus unable to achieve the ultimate aim of the project. However, during the course of the study a number of unforeseen problems arose. Firstly, the clonal variation within the cell population, and secondly, my inability to obtain antisense transfectants. I have speculated that a possible reason for the latter may be that the cells are in fact unable to grow in the absence of tPA.

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Excerpt: Approximately 1 week after having been shot in the left eye with a foam dart from a toy gun, a 37-year-old woman presented to an optometrist due to persistent pain in the eye.

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Cutaneous melanoma is associated with significant morbidity and mortality representing the most significant cutaneous malignancy. As it is known that early diagnosis and treatment are the most efficient approaches to cure cutaneous melanoma, an improved understanding of the molecular pathogenesis of melanoma and exploration of more reliable molecular biomarkers are particularly essential. Two different types of molecular biomarker for melanoma have been investigated in this thesis. microRNAs (miRNAs) are single-stranded RNA molecules of 20-23 nucleotides in length that are found in both animal and plant cells. miRNAs are involved in the RNA interference (RNAi) machinery to regulate gene expression posttranscriptionally. miRNAs have important roles in cancer: by controlling the expression level of their target genes they can affect cell signalling pathways and have been shown to have both prognostic and therapeutic potential. Importantly for melanoma research, reproducible miRNA expression profiles from formalin-fixed paraffin-embedded (FFPE) tissues can be obtained that are comparable to those from fresh-frozen samples. The aims of the miRNA project were: first, to identify a melanoma-specific miRNA expression profile; secondly, to investigate roles of some of the melanoma-specific miRNAs identified in melanomagenesis. Using miRNA microarray on FFPE samples, I obtained a melanoma-specific miRNA expression profile. 9 of these differentially expressed miRNAs between benign naevi and melanomas (7 downregulated, 2 upregulated in malignancies) were verified by qRT-PCR and the functions of four of these miRNAs were studied. Ectopic overexpression of miR- 200c and miR-205 in A375 melanoma cells inhibited colony forming ability in methylcellulose, an in vitro surrogate assay for tumourigenicity. Moreover, elevation of miR-200c resulted in increased expression levels of E-cadherin through negative regulation of the zinc finger E-box-binding homeobox 2 (ZEB2) gene. Ectopic overexpression of miR-211 in A375 melanoma cells repressed both colony formation in methylcellulose and migratory ability in matrigel, an in vitro surrogate assay for invasiveness. These findings indicate that miR-200c, miR-205 and miR-211 act as tumour suppressors in melanomagenesis. The second biomarker investigated, mutated BRAF, has been seen in 50-70% of spontaneous cutaneous melanoma. The commonest mutation in melanoma is a glutamic acid for valine substitution at position 600 (V600E). Oncogenic BRAF controls many aspects of melanoma cell biology. The aim of this part of the work was: firstly, to study BRAF V600E mutation status in our melanoma tissue microarray (TMA) panel; secondly, to correlate this mutation to various clinicopathological features and evaluate its prognostic value through statistical analyses. BRAF V600E mutations were seen in 20% of the primary and 69% of the metastatic melanomas, respectively. More BRAF V600E mutations were seen in males relative to females. The mutation was also related to cell pigmentation, but not to age, ulceration or solar elastosis. Melanoma patients with the BRAF V600E mutation relapse earlier than patients without this mutation. However, no significant association between the BRAF V600E mutation and overall survival and melanoma specific survival was found.

Thesis (Ph.D.)--University of Alberta, 2010. / A thesis submitted to the Faculty of Graduate Studies and Research in partial fulfillment of the requirements for the degree of Doctor of Philosophy, Medical Sciences - Medical Genetics. Title from pdf file main screen (viewed on March 19, 2010). Includes bibliographical references.