Prevalence of CDKN2A, CDK4, POT1, BAP1, MITF, ATM, and TERT Pathogenic Variants in a Single-Center Retrospective Series of Patients With Melanoma and Personal or Family History Suggestive of Genetic Predisposition

Giada Ferrara; Salvatore Paiella; Giulio Settanni; Melissa Frizziero; Paolo Rosina; Valeria Viassolo

doi:10.5826/dpc.1403a120

Prevalence of CDKN2A, CDK4, POT1, BAP1, MITF, ATM, and TERT Pathogenic Variants in a Single-Center Retrospective Series of Patients With Melanoma and Personal or Family History Suggestive of Genetic Predisposition

Authors

Giada Ferrara Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
Salvatore Paiella Pancreatic Surgery Unit, Pancreas Institute, University of Verona, Verona, Italy
Giulio Settanni Pathology Unit, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Italy
Melissa Frizziero Cancer Research UK Manchester Institute Cancer Biomarker Centre, Manchester, UK
Paolo Rosina Section of Dermatology and Venereology, Department of Medicine, University of Verona, Verona, Italy
Valeria Viassolo Medical Genetics, IRCCS Sacro Cuore Don Calabria Hospital, Negrar di Valpolicella, Italy

Keywords:

Melanoma, CDKN2A, MITF, genetic predisposition, pancreatic cancer

Abstract

Introduction: Approximately 20%-45% of familial melanoma (FM) cases are associated with genetic predisposition.

Objectives: This single-center retrospective study aimed to assess the frequency of pathogenic variants (PV) in the main melanoma-predisposing genes in patients with cutaneous melanoma and investigate the clinical predictors of genetic predisposition.

Methods: Patients included were those diagnosed with cutaneous melanoma at the Dermatology Unit of the University Hospital, Verona, Italy, from 2000 to 2022, presenting at least one of the following: multiple melanomas (≥3); personal/family history of pancreatic cancer (PC) (up to second-degree relatives); ≥2 first-degree relatives with melanoma; ≥1 first-degree relatives with early onset (<45 years) melanoma and tested for CDKN2A, CDK4, POT1, BAP1, MITF, ATM, and TERT.

Results: During the study period, 35 out of 1,320 patients (2.7%) underwent genetic testing. Four patients (11.4%) harbored a PV in a melanoma-predisposing gene, 3 in CDKN2A (8.6%), and 1 in MITF (2.9%). Variants currently classified as being of unknown clinical significance (VUS) were detected in CDKN2A (n=1), MITF (n=1), and ATM (n=2). Family history of PC and ≥5 melanomas, personal history of ≥50 nevi, and ≥4 melanomas were significantly associated with PV in tested genes (P<0.05).

Conclusions: The prevalence of PV in predisposing genes in FM was lower than previously reported in Italian registries. Possible reasons include deleterious variants in untested intermediate-/low-penetrance genes or yet-to-be-discovered high-penetrance genes and environmental risk factors. A family history of PC, a high number of nevi and melanomas predict a monogenic predisposition to melanoma.

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