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Thus, we performed RNA sequencing on 88 resected MBMs and 42 patient-matched extracranial metastases; tumors with sufficient tissue also underwent whole-exome sequencing, T-cell receptor sequencing, and IHC. MBMs demonstrated heterogeneity of immune infiltrates that correlated with prior radiation and post-craniotomy survival. Comparison with patient-matched extracranial metastases identified significant immunosuppression and enrichment of oxidative phosphorylation (OXPHOS) in MBMs. Gene-expression analysis of intracranial and subcutaneous xenografts, and a spontaneous MBM model, confirmed increased OXPHOS gene expression in MBMs, which was also detected by direct metabolite profiling and [U-13C]-glucose tracing in vivo. IACS-010759, an OXPHOS inhibitor currently in early-phase clinical trials, improved survival of mice bearing MAPK inhibitor\u2013resistant intracranial melanoma xenografts and inhibited MBM formation in the spontaneous MBM model. The results provide new insights into the pathogenesis and therapeutic resistance of MBMs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance:<\/jats:title>\n                    <jats:p>Improving our understanding of the pathogenesis of MBMs will facilitate the rational development and prioritization of new therapeutic strategies. This study reports the most comprehensive molecular profiling of patient-matched MBMs and extracranial metastases to date. The data provide new insights into MBM biology and therapeutic resistance.<\/jats:p>\n                    <jats:p>See related commentary by Egelston and Margolin, p. 581.<\/jats:p>\n                    <jats:p>This article is highlighted in the In This Issue feature, p. 565<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1158\/2159-8290.cd-18-1489","type":"journal-article","created":{"date-parts":[[2019,2,20]],"date-time":"2019-02-20T08:26:07Z","timestamp":1550651167000},"page":"628-645","update-policy":"https:\/\/doi.org\/10.1158\/crossmark_policy","source":"Crossref","is-referenced-by-count":319,"title":["Molecular Profiling Reveals Unique Immune and Metabolic Features of Melanoma Brain Metastases"],"prefix":"10.1158","volume":"9","author":[{"given":"Grant M.","family":"Fischer","sequence":"first","affiliation":[{"name":"1Department of Cancer Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas."},{"name":"2Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas."},{"name":"3Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Jalali","sequence":"additional","affiliation":[{"name":"4Department of Neurosurgery, Baylor College of Medicine, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Kircher","sequence":"additional","affiliation":[{"name":"5Department of Oncological Sciences, University of Utah Health Sciences Center, Salt Lake City, Utah."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8052-2420","authenticated-orcid":false,"given":"Won-Chul","family":"Lee","sequence":"additional","affiliation":[{"name":"6Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2393-2172","authenticated-orcid":false,"given":"Jennifer L.","family":"McQuade","sequence":"additional","affiliation":[{"name":"2Department of Melanoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"Haydu","sequence":"additional","affiliation":[{"name":"7Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aron Y.","family":"Joon","sequence":"additional","affiliation":[{"name":"8Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4510-0382","authenticated-orcid":false,"given":"Alexandre","family":"Reuben","sequence":"additional","affiliation":[{"name":"9Department of Thoracic\/Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana P.","family":"de Macedo","sequence":"additional","affiliation":[{"name":"10Department of Pathology, A.C. 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L.","family":"Carapeto","sequence":"additional","affiliation":[{"name":"3Department of Translational Molecular Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chendong","family":"Yang","sequence":"additional","affiliation":[{"name":"11Children's Medical Research Institute, The University of Texas Southwestern Medical Center, Dallas, Texas."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuj","family":"Srivastava","sequence":"additional","affiliation":[{"name":"12Department of Computational Sciences, The Jackson Lab for Genomic Medicine, Farmington, Connecticut."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandrashekar R.","family":"Ambati","sequence":"additional","affiliation":[{"name":"13Department of Molecular and Cell Biology, Baylor College of Medicine, Houston, Texas."},{"name":"14Advanced Technology Core, Alkek Center for Molecular Discovery, Dan L. 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