Journal
NATURE CANCER
Volume 1, Issue 2, Pages 197-+Publisher
NATURE PORTFOLIO
DOI: 10.1038/s43018-019-0019-5
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Funding
- National Institutes of Health [R01 AI127654, R01 CA203721]
- German Research Foundation [PR 1621/1-1]
- Novo Nordisk Foundation
- Lundbeck Foundation
- National Cancer Institute Cancer Center [NIH 5 P30 CA06516]
- Australian National Health and Medical Research Council Fellowships
- Medical Foundation of the University of Sydney
- University of Sydney
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Primary melanomas >1 mm thickness are potentially curable by resection, but can recur metastatically. We assessed the prognostic value of the T-cell fraction (TCFr) and repertoire T-cell clonality, measured by high-throughput sequencing of the T-cell receptor beta-chain in T2-T4 primary melanomas (n = 199). TCFr accurately predicted progression-free survival and was independent of thickness, ulceration, mitotic rate and age. TCFr was second only to tumor thickness in its predictive value, using a gradient-boosted model. For accurate progression-free survival prediction, adding TCFr to tumor thickness was superior to adding any other histopathological variable. Furthermore, a TCFr >20% was protective regardless of tumor ulceration status, mitotic rate or presence of nodal disease. TCFr is a quantitative molecular assessment that predicts metastatic recurrence in primary melanoma patients whose disease has been resected surgically. The present study suggests that a successful T-cell-mediated, antitumour response can be present in primary melanomas.
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