Abstract
Background: The prevalence of melanoma in Romanian patients is underestimated. There is a need to identify the BRAF V600E mutation to accurately treat patients with the newest approved BRAF inhibitor therapy. This is a pilot study in which we first aimed to choose the optimal DNA purification method from formalin fixation and paraffin embedding (FFPE) malignant melanoma skin samples to assess the BRAF mutation prevalence and correlate it with clinical pathological parameters. Methods: 30 FFPE samples were purified in parallel with two DNA extraction kits, a manual and a semi-automated kit. The extracted DNA in pure and optimum quantity was tested for the BRAF V600E mutation using the quantitative allele-specific amplification (quasa) method. quasa is a method for the sensitive detection of mutations that may be present in clinical samples at low levels. Results: The BRAF V600E mutation was detected in 60% (18/30) samples in patients with primary cutaneous melanoma of the skin. BRAFV600E mutation was equally distributed by gender and was associated with age >60, nodular melanoma, and trunk localization. Conclusions: The high prevalence of BRAF V600E mutations in our study group raises awareness for improvements to the national reporting system and initiation of the target therapy for patients with malignant melanoma of the skin.
Highlights
Melanoma is the most aggressive form of skin cancer that can arise from a preexisting nevus or on normal skin
We used the BRAF V600E mutation detection kit by quantitative allele-specific amplification kit/Primer Design and MX3005P Stratagene thermocycler. quasa is a method for the sensitive detection of mutations that may be present in clinical samples at low levels [11]
The semi-automated kit was the optimum solution for DNA extraction from our selected formalin fixation and paraffin embedding (FFPE) skin samples, as the semi-automated kit had all the advantages of automatization; the most important feature for our samples was the isolation of very pure nucleic acids in adjustable elution volumes
Summary
Melanoma is the most aggressive form of skin cancer that can arise from a preexisting nevus or on normal skin. According to GLOBOCAN 2020, the estimated crude incidence rates in 2020 of melanoma of skin, for both genders, ages 0–74 in Romania was 7.2, while Nordic countries were registered as having higher values: Denmark with 41.9, The Netherlands with 40.6 and Norway with 36.7 [3]. There is a need to identify the BRAF V600E mutation to accurately treat patients with the newest approved BRAF inhibitor therapy This is a pilot study in which we first aimed to choose the optimal DNA purification method from formalin fixation and paraffin embedding (FFPE) malignant melanoma skin samples to assess the BRAF mutation prevalence and correlate it with clinical pathological parameters. Conclusions: The high prevalence of BRAF V600E mutations in our study group raises awareness for improvements to the national reporting system and initiation of the target therapy for patients with malignant melanoma of the skin
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