26901 The genetics of early-stage melanoma in a veteran population

Military personnel are at increased risk for melanoma compared with the general population. To improve understanding of the genetic signature of early-stage melanomas in veterans, mutation profiling using next-generation sequencing (NGS) was performed on melanoma tissue samples from patients at the Iowa City VAMC and analyzed for hotspot mutations. Genetic analysis identified BRAF (36%), TP53 (26%), NRAS (19%), CDKN2A (11%), KIT (8%), and BAP1 (7%) mutations with the highest prevalence. Although common variants in BRAF were detected at lower rates than what is reported for the general population, 55% of cases showed activating mutations in the RAS/RAF pathways. Variants in TP53 and KIT were detected at higher rates than in the general population. Patients with prior history of melanoma were at significantly higher odds of having TP53 mutation (OR = 2.67, P = .04). This finding suggests that TP53 may indicate alternative exposures in the military population and may be used to help identify veterans at particularly increased risk of recurrence. In conclusion, this study provides new information regarding both genetics of melanoma in a veteran population and early-stage tumors. Ultimately, these findings should influence how we educate, screen, and treat melanoma in veterans and active military personnel and pave the way for continued research to identify exposures and risk factors unique to this population.