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Prognostic value of PRAME expression in uveal melanoma: a meta-analysis
Manuel Perez-Perez1,2, Carmen García de Sola-Llamas3, Gonzalo Mariscal4
1Anatomía Patológica, Hospital Universitario Quirónsalud Sevilla, Seville, Spain mpperez1992@gmail.com.
Introduction:
Overexpression of Preferentially Expressed Melanoma Antigen (PRAME) is associated with melanoma progression. In the case of uveal melanoma (UM), PRAME expression was identified as conferring a metastatic risk.
Aim:
This study aimed to review the available evidence regarding the prognostic value of PRAME expression in UM.
Methods:
This study adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included cohort studies and randomised clinical trials. The methodological quality of the studies was assessed by the Methodological Index for Non-Randomised Studies (MINORS). The meta-analysis was performed using Review Manager V.5.4. Heterogeneity was checked with the I2 test. If there was no heterogeneity, a fixed-effects model was adopted.
Results:
Nine studies were included. The PRAME+ group showed significant differences in the development of metastases OR (M-H, Fixed, 95% CI): 3.46 (2.84, 4.22). The PRAME+ group had a significantly shorter time to metastasis MD (IV, Random, 95% CI): -28.31 (-55.41, -1.22) and a significantly lower percentage metastasis-free survival at 5-year follow-up MD (IV, Fixed, 95% CI): -21.67 (-25.74,-17.61). PRAME expression was an independent marker for the development of metastatic disease at any follow-up HR (IV, Fixed, 95% CI): 2.00 (1.60, 2.49). In addition, PRAME+tumours were significantly larger than PRAME-tumours MD (IV, Random, 95% CI): 0.22 (0.01, 0.42).
Conclusions:
PRAME is a good prognostic marker in UM. We believe that further studies are needed to determine the most cost-effective method for reporting PRAME overexpression.
Insights
Preferentially Expressed Melanoma Antigen (PRAME) overexpression is a significant indicator of metastatic risk in uveal melanoma (UM). PRAME positivity is linked to increased metastasis development and poorer survival outcomes in UM patients.
Area of Science:
- Ophthalmology
- Oncology
- Genetics
Background:
- Preferentially Expressed Melanoma Antigen (PRAME) overexpression is linked to melanoma progression.
- PRAME expression in uveal melanoma (UM) indicates a higher risk of metastasis.
Purpose of the Study:
- To systematically review and synthesize evidence on the prognostic value of PRAME expression in uveal melanoma.
- To assess the association between PRAME expression and metastatic risk in UM patients.
Main Methods:
- Systematic review and meta-analysis adhering to PRISMA guidelines.
- Inclusion of cohort studies and randomized clinical trials.
- Methodological quality assessed using MINORS; meta-analysis performed using Review Manager V.5.4.
Main Results:
- Nine studies were included in the meta-analysis.
- PRAME-positive UM showed significantly higher odds of developing metastases (OR: 3.46).
- PRAME positivity correlated with shorter time to metastasis, lower metastasis-free survival, and was an independent predictor of metastatic disease.
Conclusions:
- PRAME serves as a valuable prognostic marker in uveal melanoma.
- Further research is recommended to establish cost-effective methods for reporting PRAME overexpression.
