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Analysis of the Circulating Metabolome of Patients with Cutaneous, Mucosal and Uveal Melanoma Reveals Distinct Metabolic Profiles with Implications for Response to Immunotherapy
Indexado
WoS WOS:001035119400001
Scopus SCOPUS_ID:85170582406
DOI 10.3390/CANCERS15143708
Año 2023
Tipo artículo de investigación

Citas Totales

Autores Afiliación Chile

Instituciones Chile

% Participación
Internacional

Autores
Afiliación Extranjera

Instituciones
Extranjeras


Abstract



Simple Summary Advanced melanoma is an aggressive cancer with a historical 12-month median survival after the diagnosis. This scenario has greatly changed since the advent of immunotherapy. Unfortunately, half of patients do not respond to this treatment and rare types of melanomas such as mucosal and uveal are known for their poorer outcomes compared to cutaneous melanoma. We investigated the serum metabolome of patients with these three melanomas subtypes, aiming to identify metabolic profiles that correlate with response to immunotherapy. Our results indicate that mucosal and uveal melanomas have a very distinct profile of circulating metabolites compared to cutaneous melanomas, mainly in the kynurenine pathway. Uveal melanoma, the most resistant subtype, also exhibits higher levels of sphingolipids and spermine. The later was associated with a poor survival in patients treated with immunotherapy. These results contribute to the growing evidence about tumoral resistance mechanisms to immunotherapy, with potential implication for future targeted therapies. Cutaneous melanoma (CM) patients respond better to immune checkpoint inhibitors (ICI) than mucosal and uveal melanoma patients (MM/UM). Aiming to explore these differences and understand the distinct response to ICI, we evaluated the serum metabolome of advanced CM, MM, and UM patients. Levels of 115 metabolites were analyzed in samples collected before ICI, using a targeted metabolomics platform. In our analysis, molecules involved in the tryptophan-kynurenine axis distinguished UM/MM from CM. UM/MM patients had higher levels of 3-hydroxykynurenine (3-HKyn), whilst patients with CM were found to have higher levels of kynurenic acid (KA). The KA/3-HKyn ratio was significantly higher in CM versus the other subtypes. UM, the most ICI-resistant subtype, was also associated with higher levels of sphingomyelin-d18:1/22:1 and the polyamine spermine (SPM). Overall survival was prolonged in a cohort of CM patients with lower SPM levels, suggesting there are also conserved metabolic factors promoting ICI resistance across melanoma subtypes. Our study revealed a distinct metabolomic profile between the most resistant melanoma subtypes, UM and MM, compared to CM. Alterations within the kynurenine pathway, polyamine metabolism, and sphingolipid metabolic pathway may contribute to the poor response to ICI. Understanding the different metabolomic profiles introduces opportunities for novel therapies with potential synergic activity to ICI, to improve responses of UM/MM.

Revista



Revista ISSN
Cancers 2072-6694

Métricas Externas



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Disciplinas de Investigación



WOS
Oncology
Scopus
Sin Disciplinas
SciELO
Sin Disciplinas

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Publicaciones WoS (Ediciones: ISSHP, ISTP, AHCI, SSCI, SCI), Scopus, SciELO Chile.

Colaboración Institucional



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Autores - Afiliación



Ord. Autor Género Institución - País
1 Vilbert, Maysa Mujer Univ Hlth Network - Canadá
UNIV TORONTO - Canadá
Princess Margaret Cancer Centre - Canadá
University of Toronto - Canadá
University of Toronto Faculty of Medicine - Canadá
2 Koch, Erica C. Mujer Univ Hlth Network - Canadá
UNIV TORONTO - Canadá
Pontificia Universidad Católica de Chile - Chile
Princess Margaret Cancer Centre - Canadá
University of Toronto - Canadá
University of Toronto Faculty of Medicine - Canadá
3 Rose, April A. N. Mujer MCGILL UNIV - Canadá
Institut Lady Davis de Recherches Médicales - Canadá
4 Laister, Rob C. Hombre Univ Hlth Network - Canadá
Princess Margaret Cancer Centre - Canadá
University of Toronto - Canadá
5 Gray, Diana Mujer Univ Hlth Network - Canadá
Princess Margaret Cancer Centre - Canadá
University of Toronto - Canadá
6 Sotov, Valentin Hombre Univ Hlth Network - Canadá
Princess Margaret Cancer Centre - Canadá
University of Toronto - Canadá
7 Penny, Susanne Mujer CNR - Canadá
National Research Council Canada - Canadá
8 Spreafico, Anna Mujer Univ Hlth Network - Canadá
UNIV TORONTO - Canadá
Princess Margaret Cancer Centre - Canadá
University of Toronto - Canadá
University of Toronto Faculty of Medicine - Canadá
9 Marcela Pinto, Diana Mujer CNR - Canadá
National Research Council Canada - Canadá
10 Butler, Marcus O. Hombre Univ Hlth Network - Canadá
UNIV TORONTO - Canadá
Princess Margaret Cancer Centre - Canadá
University of Toronto - Canadá
University of Toronto Faculty of Medicine - Canadá
11 Saibil, Samuel D. Hombre Univ Hlth Network - Canadá
UNIV TORONTO - Canadá
Princess Margaret Cancer Centre - Canadá
University of Toronto - Canadá
University of Toronto Faculty of Medicine - Canadá

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Financiamiento



Fuente
Alamos Gold Inc.
Princess Margaret Cancer Centre

Muestra la fuente de financiamiento declarada en la publicación.

Agradecimientos



Agradecimiento
We thank the Alamos Gold inc. for supporting research and the Medical Oncology Fellowship at Princess Margaret Cancer Centre.

Muestra la fuente de financiamiento declarada en la publicación.