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Using T-cell repertoire profiles as predictor in a primary mucosal melanoma

Chang, Che-Mai and Liao, Yu-Ming and Lan, Gong-Yau and Chang, Wei-Chiao and Yen, Yun (2020) Using T-cell repertoire profiles as predictor in a primary mucosal melanoma. Clinical and Translational Medicine, 10 (4). Art. No. e136. ISSN 2001-1326.

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Dear Editor, Primary mucosal melanoma is a rare subtype of melanoma that carries poor prognosis. Traditional treatment options of mucosal melanoma are surgery, radiation, and chemotherapy; but the overall survival remains low.1 Cytotoxic T‐lymphocyte associated protein 4 (CLTA‐4) and programmed cell death protein 1 (PD‐1), both inhibitory immune checkpoints commonly seen on activated T cells, have been found to be promising targets for treatment of advanced cancers.2 However, the efficacy and response to immunotherapy in mucosal melanoma remains unknown. Herein, we report a case involving a patient, who was a 70‐year‐old male and referred to Taipei Medical University Hospital with confirmed diagnosis of mucosa melanoma over hard plate of mouth. The patient was admitted and subjected to anti‐PD‐1 immunotherapy (pembrolizumab 200 mg every 3 weeks) (Figure 1A). Serial imaging of primary malignant melanoma of the hard palate showed that the tumor size gradually decreased after treatment with pembrolizumab, suggesting partial response/stable disease secondary to continuous immunotherapy (Figure 1B). However, after seventh cycle of treatment, magnetic resonance imaging (MRI) revealed enlarged previous known metastatic lesions and new tumor nodules in brain (Figure 1B). The patient received stereotactic radiation therapy before treatment cycle 14 (Figure 1A). Although the primary metastatic brain lesions were smaller and stationary after radiotherapy, the following brain MRI displayed several hyperdensity masses in the right frontal lobe with perifocal edema and mild mass effect (Figure 1B). Subsequently, patient suffered from infection and respiratory distress and died 2 months after 17th cycle of pembrolizumab therapy.

Item Type:Article
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Chang, Che-Mai0000-0002-0353-9744
Yen, Yun0000-0003-0815-412X
Additional Information:© 2020 The Authors. Clinical and Translational Medicine published by John Wiley & Sons Australia, Ltd on behalf of Shanghai Institute of Clinical Bioinformatics. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. Issue Online: 20 August 2020; Version of Record online: 11 August 2020; Manuscript accepted: 11 July 2020; Manuscript revised: 11 July 2020; Manuscript received: 13 June 2020. We are grateful to Dr San‐Chi Chen for reading the paper, Yu‐Wen Hsu for sample management, and Prof Yusuke Nakamura for providing technical supports in T‐cell receptor sequencing. This work was supported by the grants from Ministry of Science and Technology, Taiwan (MOST‐108‐2321‐B‐038‐003 and MOST‐105‐2628‐B‐038‐001‐MY4), Taipei Medical University (106‐5807‐001‐400), and Health and Welfare Surcharge of Tobacco Products Grant (MOHW109‐TDU‐B‐212‐134014 and MOHW109‐TDU‐B‐212‐134020). This work was financially supported by the “TMU Research Center of Cancer Translational Medicine” from The Featured Areas Research Center Program within the framework of the Higher Education Sprout Project by the Ministry of Education (MOE) in Taiwan. The authors declare no potential conflict of interest. Ethical Approval: The study was conducted with approval from the Taipei Medical University Joint Institutional Review Board (TMUJIRB) [IRB number: N201904029].
Funding AgencyGrant Number
Ministry of Science and Technology (Taipei)MOST‐108‐2321‐B‐038‐003
Ministry of Science and Technology (Taipei)MOST‐105‐2628‐B‐038‐001‐MY4
Taipei Medical University106‐5807‐001‐400
Ministry of Health and Welfare (Taipei)MOHW109‐TDU‐B‐212‐134014
Ministry of Health and Welfare (Taipei)MOHW109‐TDU‐B‐212‐134020
Ministry of Education (Taipei)UNSPECIFIED
Issue or Number:4
Record Number:CaltechAUTHORS:20200818-151255515
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Official Citation:Chang, C.‐M., Liao, Y.‐M., Lan, G.‐Y., Chang, W.‐C. and Yen, Y. (2020), Using T‐cell repertoire profiles as predictor in a primary mucosal melanoma. Clin. Transl. Med., 10: e136. doi:10.1002/ctm2.136
Usage Policy:No commercial reproduction, distribution, display or performance rights in this work are provided.
ID Code:105012
Deposited By: George Porter
Deposited On:19 Aug 2020 14:06
Last Modified:27 Aug 2020 18:12

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