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arXiv · 2608.21448

DNA Methylation Profiling in Melanoma: From Lesion Classification to Therapeutic Stratification

Jana T. Winterstein·Lukas Heinlein·Günter Raddatz·Carina Nogueira Garcia·Sarah Haggenmüller·Christoph Wies·Lucas Schneider·Annemarie Hoffsommer·Tim J. Zeuner·Friedegund Meier·Sarah Hobelsberger·Frank F. Gellrich·Mildred Sergon·Axel Hauschild·Lucie Heinzerling·Justin G. Schlager·Kamran Ghoreschi·Max Schlaak·Franz J. Hilke·Carola Berking·Markus V. Heppt·Michael Erdmann·Sebastian Haferkamp·Konstantin Drexler·Dirk Schadendorf·Wiebke Sondermann·Matthias Goebeler·Bastian Schilling·Daniel B. Lipka·Stefan Fröhling·Felix Sahm·Jakob N. Kather·Yuri Tolkach·Jochen S. Utikal·Benjamin Izar·Yevgeniy R. Semenov·Titus J. Brinker
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Abstract

DNA methylation provides a stable record of cellular identity, capturing epigenetic programs that distinguish specialized cell states despite a shared genome. Because malignant transformation and tumour progression are accompanied by extensive epigenetic remodeling, we hypothesized that the methylome of melanocytic lesions contains biologically and clinically relevant information for both diagnosis and disease progression. In a cohort of 1,001 tissue samples prospectively collected across eight German university hospitals profiled using Illumina Infinium MethylationEPIC arrays, we compared machine-learning models based on selected Cytosine phosphate Guanine (CpG) methylation sites with models incorporating biology-guided features, including epigenetic age acceleration, cell type composition and copy-number variation burden. In an external test set, the best diagnostic classifier was CpG-based and distinguished melanocytic nevi, noninvasive melanoma and invasive melanoma with a macro-averaged area under the receiver operating characteristic curve of 0.919 (95% CI: 0.878 to 0.952). Notably, across CpGs most strongly hyper- and hypomethylated between NV and IM, NIM showed an intermediate methylation profile, providing a molecular correlate of its diagnostic complexity. The best model for clinically relevant treatment group prediction, with AJCC stages grouped according to guideline-based management recommendations, relied on biology-guided features and achieved a macro-averaged mean absolute error of 0.627 (95% CI: 0.477 to 0.808). Together, these findings demonstrate that methylation-based models can capture both diagnostic identity and clinically relevant disease stratification, supporting DNA methylation as a promising biomarker for further validation and potential clinical translation.

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Jana T. Winterstein, Lukas Heinlein, Günter Raddatz, Carina Nogueira Garcia, Sarah Haggenmüller, Christoph Wies, Lucas Schneider, Annemarie Hoffsommer, Tim J. Zeuner, Friedegund Meier, Sarah Hobelsberger, Frank F. Gellrich, Mildred Sergon, Axel Hauschild, Lucie Heinzerling, Justin G. Schlager, Kamran Ghoreschi, Max Schlaak, Franz J. Hilke, Carola Berking, Markus V. Heppt, Michael Erdmann, Sebastian Haferkamp, Konstantin Drexler, Dirk Schadendorf, Wiebke Sondermann, Matthias Goebeler, Bastian Schilling, Daniel B. Lipka, Stefan Fröhling, Felix Sahm, Jakob N. Kather, Yuri Tolkach, Jochen S. Utikal, Benjamin Izar, Yevgeniy R. Semenov, Titus J. Brinker. 2026-08-19. DNA Methylation Profiling in Melanoma: From Lesion Classification to Therapeutic Stratification. https://arxiv.org/abs/2608.21448

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