Inherited genes play a bigger role in melanoma risk than previously thought
2 minutes read
- Up to one in seven melanoma patients has a genetic predisposition to the disease, suggesting that family history may be a more significant risk factor than sun exposure in some cases.
When it comes to skin cancer, most people think of warnings about sunburn and tanning beds. The ideas of “cancer genes” or inherited risk are reserved for diseases such as breast cancer or colon cancer. A new study challenges this status quo by showing that genetics plays a bigger role in melanoma risk than previously recognised.
Doctors rarely order genetic tests to assess risk factors in patients with a family history of melanoma because, according to earlier, limited studies, only 2-2.5% of all cases are genetic. For the same reason, insurance companies rarely cover these tests outside the most extreme situations. In medicine, genetic testing is generally not offered for cancers that fall below a 5% threshold.
A study by researchers and clinicians led by Dr. Joshua Arbesman of Cleveland Clinic and Dr. Pauline Funchain of Stanford Medicine (formerly of Cleveland Clinic) suggests that melanoma exceeds this threshold. Their results, published in the Journal of the American Academy of Dermatology, report that up to 15% (1 in 7) of patients diagnosed with melanoma by Cleveland Clinic physicians between 2017 and 2020 carried mutations in cancer susceptibility genes. The research team, which includes Ying Ni, PhD, and Claudia Marcela Diaz, PhD, of the Center for Immunotherapy and Precision Immuno-Oncology, analysed international patient databases and found similar results.
“Hereditary cancers can wreak havoc on families and leave devastation in their wake. Genetic testing allows us to identify, screen and even proactively treat these families to equip them with the tools they need to receive the best possible care,” says Dr. Arbesman. “I would encourage doctors and insurance companies to broaden their criteria for offering genetic testing to individuals with a family history of melanoma, because hereditary predisposition is not as rare as we thought.”
Dr. Arbesman, who runs a lab in Cancer Biology at Cleveland Clinic’s Lerner Research Institute, also says their findings support an increasingly popular view among cancer biologists: there are risk factors beyond sun exposure that can influence a person’s chances of developing melanoma.
“Not all of my patients had inherited mutations that made them more susceptible to the sun,” he says. “There is clearly something else going on here and more research is needed.”
Dr. Arbesman and his team are studying many of the genes that appeared in their patients’ genetic tests to learn more about how melanoma develops and how it can be treated. For example, he is working to determine whether some patients and families with inherited mutations may benefit more from immunotherapy than those without inherited mutations. His lab is also working to determine how other patients’ genes contributed to the development and severity of their melanoma.