4.6 Review

TERT promoter mutations and melanoma survival: A comprehensive literature review and meta-analysis

Journal

CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY
Volume 160, Issue -, Pages -

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.critrevonc.2021.103288

Keywords

Melanoma; Survival; Telomerase reverse transcriptase gene promoter; Review; Meta-analysis

Funding

  1. Italian Ministry of Health with Ricerca Corrente
  2. 5x1000 funds

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Somatic mutations of the TERT gene promoter are associated with worse overall survival in melanoma patients, especially in non-acral cutaneous melanomas. Limited evidence suggests a detrimental effect of TERT mutations on various survival measures.
We conducted a systematic review and meta-analysis of the association between somatic mutations of the TERT gene promoter and melanoma survival. Data from nineteen independent studies (>2,500 melanoma overall) were pooled using random effects meta-analysis models. TERT-mutated melanoma patients had a significantly worse overall survival (OS) (summary hazard ratio 1.43, 95 % confidence intervals (CI) 1.05-1.95) compared to wild-type ones. The association became stronger when combining risk estimates for overall and melanomaspecific survival (MSS) (1.52, 95 % CI 1.14-2.02), and when restricting the analysis to studies mostly based on invasive non-acral cutaneous melanomas (1.77, 95 % CI 1.00-3.15). Limited, yet suggestive evidence of a detrimental effect of TERT promoter mutations on melanoma prognosis emerged also for other survival measures (e.g. disease-free and distant metastasis-free survival). We found suggestive evidence of a detrimental effect of TERT mutations on melanoma patients' survival.

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