Open AccessMolecular analysis of primary melanoma T cells identifies patients at risk for metastatic recurrence
Author(s) -
W. Pruessmann,
Julie Rytlewski,
James S. Wilmott,
Martín C. Mihm,
Grace H. Attrill,
Beatrice DyringAndersen,
Paul Fields,
Qimin Zhan,
Andrew J. Colebatch,
Peter M. Ferguson,
John F. Thompson,
Klaus Kallenbach,
Erik Yusko,
Rachael A. Clark,
Harlan Robins,
Richard A. Scolyer,
Thomas S. Kupper
Publication year - 2020
Publication title -
nature cancer
Language(s) - English
Resource type - Journals
ISSN - 2662-1347
DOI - 10.1038/s43018-019-0019-5
Subject(s) - melanoma , primary tumor , oncology , medicine , metastatic melanoma , cancer research , cell , disease , beta (programming language) , pathology , metastasis , cancer , biology , genetics , computer science , programming language
Primary melanomas >1 mm thickness are potentially curable by resection, but can recur metastatically. We assessed the prognostic value of T cell fraction (TCFr) and repertoire T cell clonality, measured by high-throughput-sequencing of the T cell receptor beta chain (TRB) in T2-T4 primary melanomas (n=199). TCFr accurately predicted progression-free survival (PFS) and was independent of thickness, ulceration, mitotic rate, or age. TCFr was second only to tumor thickness in its predictive value, using a gradient boosted model. For accurate PFS prediction, adding TCFr to tumor thickness was superior to adding any other histopathological variable. Furthermore, a TCFr >20% was protective regardless of tumor ulceration status, mitotic rate or presence of nodal disease. TCFr is a quantitative molecular assessment that predicts metastatic recurrence in primary melanoma patients whose disease has been resected surgically. This study suggests that a successful T cell-mediated antitumor response can be present in primary melanomas.