{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T14:36:24Z","timestamp":1788878184824,"version":"build-2803163510"},"reference-count":14,"publisher":"American Medical Association (AMA)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Dermatol"],"published-print":{"date-parts":[[2025,2,1]]},"abstract":"<jats:sec id=\"ab-dbr240021-4\"><jats:title>Importance<\/jats:title><jats:p>UV-induced mutagenesis leads to a higher tumor mutational burden (TMB) in cutaneous melanoma relative to other cancer types. TMB is an important prognostic marker in advanced melanoma; higher TMB is associated with greater clinical response to immune checkpoint inhibition and improved survival.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240021-5\"><jats:title>Objective<\/jats:title><jats:p>To evaluate the association between cutaneous melanoma TMB and indoor tanning exposure, as well as other demographic, dermatologic, and tumor characteristics.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240021-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This retrospective cohort study took place at Dana-Farber Cancer Institute, a tertiary-care cancer treatment center in Boston, Massachusetts, between 2013 and 2022. Patients with a diagnosis of cutaneous melanoma for whom next-generation sequencing data and tanning bed exposure history were available were included.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240021-7\"><jats:title>Exposures<\/jats:title><jats:p>Indoor tanning exposure history, tumor characteristics, demographics, and dermatologic history were collected via retrospective medical record review.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240021-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>The association of tanning bed use with TMB was modeled using inverse probability of treatment weighted, multivariable modeling.<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240021-9\"><jats:title>Results<\/jats:title><jats:p>Among 617 patients (median [IQR] age at diagnosis, 61 [50-71] years; 337 [62.9%] male), there was no association between indoor tanning exposure and TMB after adjustment for demographic, tumor, and dermatologic characteristics (yes vs no: log<jats:sub>2<\/jats:sub> TMB [SE], 4.07 [0.44] vs 3.97 [0.45]; <jats:italic>P<\/jats:italic>\u2009=\u2009.39). However, there was a statistically significant association between higher TMB and older age at diagnosis, history of nonmelanoma skin cancer, and head and neck tumors relative to other primary sites. Average TMB was statistically significantly lower in patients with a history of abnormal nevi (yes vs no: log<jats:sub>2<\/jats:sub> TMB [SE], 3.89 [0.44] vs 4.15 [0.44]; <jats:italic>P<\/jats:italic>\u2009=\u2009.01).<\/jats:p><\/jats:sec><jats:sec id=\"ab-dbr240021-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>This cohort study suggests that indoor tanning exposure, while known to increase risk of melanoma, may not be meaningfully associated with melanoma TMB. Additional characteristics were associated with higher TMB and, thus, potentially improved immune checkpoint inhibitor response.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamadermatol.2024.4819","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T20:31:27Z","timestamp":1733949087000},"page":"198","source":"Crossref","is-referenced-by-count":7,"title":["Melanoma Tumor Mutational Burden and Indoor Tanning Exposure"],"prefix":"10.1001","volume":"161","author":[{"given":"Grace B.","family":"Hanrahan","sequence":"first","affiliation":[{"name":"Center for Melanoma Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"University of Massachusetts T.H. Chan School of Medicine, Worcester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anita","family":"Giobbie-Hurder","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Data Science, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair","family":"Allais","sequence":"additional","affiliation":[{"name":"Melanoma and Skin Cancer Center, Inova Schar Cancer Institute, Fairfax, Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jayne","family":"Vogelzang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Dana-Farber Cancer Institute, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Fay","sequence":"additional","affiliation":[{"name":"Center for Melanoma Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"University of Massachusetts T.H. Chan School of Medicine, Worcester"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hillary C.","family":"Tsibris","sequence":"additional","affiliation":[{"name":"Center for Melanoma Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts"},{"name":"Department of Dermatology, Brigham and Women\u2019s Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"12","key":"dbr240021r1","doi-asserted-by":"publisher","first-page":"2041","DOI":"10.3390\/cancers11122041","article-title":"A review of key biological and molecular events underpinning transformation of melanocytes to primary and metastatic melanoma.","volume":"11","author":"Jackett","year":"2019","journal-title":"Cancers (Basel)"},{"issue":"4","key":"dbr240021r2","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1093\/annonc\/mdz034","article-title":"Sex-based differences of the tumor mutational burden and 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