Presence of Human Polyomavirus 6 in Mutation-Specific BRAF Inhibitor-Induced Epithelial Proliferations

Schrama, David and Groesser, Leopold and Ugurel, Selma and Hafner, Christian and Pastrana, Diana V. and Buck, Christopher B. and Cerroni, Lorenzo and Theiler, Anna and Becker, Juergen C. (2014) Presence of Human Polyomavirus 6 in Mutation-Specific BRAF Inhibitor-Induced Epithelial Proliferations. JAMA DERMATOLOGY, 150 (11). pp. 1180-1186. ISSN 2168-6068, 2168-6084

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Abstract

IMPORTANCE A frequent adverse effect of mutation-specific BRAF inhibitor therapy is the induction of epithelial proliferations including cutaneous squamous cell carcinomas. To date, the only factor identified contributing to their development is the activation of the mitogen-activated signal transduction cascade by mutations in the RAS genes. However, these mutations explain only 60% of the tumors; hence, it is important to identify what is causing the remaining tumors. OBJECTIVE To test for the presence of human papillomaviruses (HPVs) and the recently identified human polyomaviruses (HPyVs), Merkel cell polyomavirus (MCPyV), and trichodysplasia spinulosa-associated polyomavirus (TSPyV), as well as HPyV-6, HPyV-7, HPyV-9, and HPyV-10, in epithelial proliferations occurring after BRAF inhibitor therapy to determine whether these oncogenic viruses may contribute to BRAF inhibitor-induced skin tumors. DESIGN, SETTING, AND PARTICIPANTS Retrospective study at a university hospital in Austria of epithelial proliferations that developed in patients with melanoma after initiation of treatment with the BRAF inhibitor vemurafenib. Samples were analyzed for (1) presence of the most frequently observed RAS mutations by SNaPshot technology, (2) detection of the viruses by real-time polymerase chain reaction, and (3) presence of capsid proteins of the most abundantly detected virus by immunohistochemical analysis. MAIN OUTCOMES AND MEASURES RAS mutational status, as well as HPV and HPyV presence, in BRAF inhibitor-induced epithelial proliferations. RESULTS Eighteen biopsy samples from 6 patients were retrieved from our hospital's archive. We identified RAS mutations in 10 (62%) of the 16 samples with clear results. DNA of HPyV-9, HPyV-10, and TSPyV were virtually absent in the samples. MCPyV DNA was present in 13 of 18 samples, and HPV, HPyV-6, and HPyV-7 DNA were present in all samples. In general, the amount of DNA encoding the latter viruses was rather low, with the exception of HPyV-6 in several samples of 1 individual patient. Notably, the relevance of the presence of HPyV-6 in the epithelial proliferation was underlined by immunohistochemical detection of the core protein VP1 of HPyV-6. CONCLUSIONS AND RELEVANCE The presence of both high HPyV-6 DNA load and VP1 protein suggests that polyomaviruses may contribute to the epithelial proliferations observed in patients receiving BRAF inhibitor therapy, albeit the relative impact as compared with that of RAS mutations appears circumstantial.

Item Type: Article
Uncontrolled Keywords: MERKEL CELL POLYOMAVIRUS; SPINULOSA-ASSOCIATED POLYOMAVIRUS; METASTATIC MELANOMA; RAF INHIBITORS; HUMAN-PAPILLOMAVIRUS; CARCINOMA; DABRAFENIB; VEMURAFENIB; GROWTH; TUMORS;
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Dermatologie und Venerologie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 08 Aug 2019 08:29
Last Modified: 08 Aug 2019 08:29
URI: https://pred.uni-regensburg.de/id/eprint/9244

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