Follow-up in melanoma patients

Rutkowski, Piotr; Ługowska, Iwona

doi:10.1007/s12254-014-0151-y

Cited by 12 publications

(13 citation statements)

References 29 publications

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“…Similarly, 10-year survival rates decrease from 88% for stage IIIA to 69% for stage IIIC melanoma 4 . Recurrence of stage III melanoma is moderate-to-high with 5-year recurrence-free survival ranging from 50–63% for stage IIIA and 11–12% for stage IIIC melanoma 5 . Survival rates for stage III melanoma are significantly lower compared with those diagnosed with early stage melanoma, demonstrating a need for effective treatments in those diagnosed with high-risk melanoma.…”

Section: Introductionmentioning

confidence: 99%

An indirect treatment comparison of the efficacy of pembrolizumab versus competing regimens for the adjuvant treatment of stage III melanoma

Lorenzi¹,

Arndorfer²,

Aguiar-Ibáñez

et al. 2019

Journal of Drug Assessment

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Objective: To determine the efficacy of pembrolizumab relative to other treatments used in stage III melanoma by conducting a systematic literature review (SLR) and network meta-analysis (NMA). Methods: A SLR was conducted to identify randomized clinical trials (RCTs) evaluating approved adjuvant treatments including interferon-containing regimens, BRAF-inhibitors, and PD-L1 inhibitors in stage III melanoma patients. Relative treatment effects for recurrence-free survival (RFS) were synthesized with Bayesian NMA models that allowed for hazard ratios (HRs) to vary over time. Results: Included studies formed a connected network of evidence composed of eight trials. In high-risk stage III patients, the HR for pembrolizumab vs observation decreased significantly over time with the superiority of pembrolizumab over observation becoming statistically meaningful before 3 months. By 9 months, the HR for pembrolizumab vs observation was statistically significantly lower than the HR for most other treatments vs observation, with the exception of ipilimumab and biochemotherapy due to overlapping 95% credible intervals. In BRAF + patients, pembrolizumab was statistically significantly better than observation after 3 months. The HR for both BRAF-inhibitors vs observation increased significantly over time and pembrolizumab was statistically superior to both BRAF-inhibitors after 15 months. Conclusions: Pembrolizumab results in statistically significantly improved RFS compared to all competing regimens after 9 months, except ipilimumab and biochemotherapy, for the adjuvant treatment of stage III melanoma. However, point estimate HRs vs observation for pembrolizumab are much lower than those for ipilimumab. In BRAF + patients, the advantage of pembrolizumab versus competing interventions increases over time with respect to RFS.

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Section: Introductionmentioning

confidence: 99%

An indirect treatment comparison of the efficacy of pembrolizumab versus competing regimens for the adjuvant treatment of stage III melanoma

Lorenzi¹,

Arndorfer²,

Aguiar-Ibáñez

et al. 2019

Journal of Drug Assessment

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“…Indeed, early and precise prognostic markers are urgently needed for melanoma due to its strong metastatic capacity, particularly given the low survival rate of metastatic patients and the 5-year relapse free rate of 56%, even when melanoma is detected at early stages (stage II) 1,28 . Highest recurrence rate is observed within 2-3 years after surgical treatment while recurrence probability decreases to less than 5% in patients with treated stage I-III melanomas and 5 years of disease-free follow-up 29 . According to these figures, intense medical monitoring should be implemented in the first 2-3 years after treatment, even for stage II cases, representing an important medical and economic burden.…”

Section: Discussionmentioning

confidence: 96%

A new clinical tool to predict outcome in early-stage melanoma patients

Mancuso¹,

Lage²,

Rasero

et al. 2019

Preprint

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Short title: Prognostic serum signature in early-stage melanomaWe have developed a prognostic equation that considers the serum IL-4, GM-CSF and DCD levels, along with the Breslow thickness to accurately classify melanoma outcome in patients. In this sense, a rigorous follow-up is recommended for early-stage melanoma patients with a high Breslow thickness, high serum IL-4 levels and low GM-CSF and DCD levels at the time of diagnosis, given the elevated risk for these patients to develop metastasis during follow-up.3 AbstractAround 25% of early-stage melanoma patients eventually develop metastasis. Thus, we set out to define serological biomarkers that could be used along with clinical and histopathological features of the disease to predict these events. We previously demonstrated that in stage II melanoma patients, serum levels of dermcidin (DCD) were associated with metastatic progression. Based on the relevance of the immune response on the cancer progression and the recent association of DCD with local and systemic immune response against cancer cells, serum DCD was analyzed in a new cohort of patients along with IL-4, IL-6, IL-10, IL-17A, IFN TGF and GM-CSF. We included 448 melanoma patients, 323 of whom were diagnosed as stages I-II according to AJCC. Levels of selected cytokines were determined by ELISA and Luminex and obtained data were analyzed employing Machine Learning and Kaplan-Meier techniques to define an algorithm capable of accurately classifying early-stage melanoma patients with a high and low risk of developing metastasis. The results show that in early-stage melanoma patients, serum levels of the cytokines IL-4, GM-CSF and DCD together with the Breslow thickness are those that best predict melanoma metastasis. Moreover, resulting algorithm represents a new tool to discriminate subjects with good prognosis from those with high risk for a future metastasis.

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“…Moreover, risk of recurrence for early-stage (stage I-II) melanomas must also be considered with 5-year probability values ranging from 8.8% to 74.5% depending on the substage (Bajaj et al, 2020). According to Rutkowski and Lugowska (2014), highest recurrence rate is observed within 2-3 years after surgical treatment while recurrence probability decreases to < 5% in patients with treated stage I-III melanomas and 5 years of disease-free follow-up. In a cohort similar to ours, median time until recurrence was set at 1.7 years although with clear differences among tumors with different Breslow thickness (Lyth, 2018).…”

Section: Discussionmentioning

confidence: 99%

Serum markers improve current prediction of metastasis development in early‐stage melanoma patients: a machine learning‐based study

et al. 2020

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Metastasis development represents an important threat for melanoma patients, even when diagnosed at early stages and upon removal of the primary tumor. In this scenario, determination of prognostic biomarkers would be of great interest. Serum contains information about the general status of the organism and therefore represents a valuable source for biomarkers. Thus, we aimed to define serological biomarkers that could be used along with clinical and histopathological features of the disease to predict metastatic events on the early‐stage population of patients. We previously demonstrated that in stage II melanoma patients, serum levels of dermcidin (DCD) were associated with metastatic progression. Based on the relevance of the immune response on the cancer progression and the recent association of DCD with local and systemic immune response against cancer cells, serum DCD was analyzed in a new cohort of patients along with interleukin 4 (IL‐4), IL‐6, IL‐10, IL‐17A, interferon γ (IFN‐γ), transforming growth factor‐β (TGF‐ β), and granulocyte–macrophage colony‐stimulating factor (GM‐CSF). We initially recruited 448 melanoma patients, 323 of whom were diagnosed as stages I‐II according to AJCC. Levels of selected cytokines were determined by ELISA and Luminex, and obtained data were analyzed employing machine learning and Kaplan–Meier techniques to define an algorithm capable of accurately classifying early‐stage melanoma patients with a high and low risk of developing metastasis. The results show that in early‐stage melanoma patients, serum levels of the cytokines IL‐4, GM‐CSF, and DCD together with the Breslow thickness are those that best predict melanoma metastasis. Moreover, resulting algorithm represents a new tool to discriminate subjects with good prognosis from those with high risk for a future metastasis.

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Follow-up in melanoma patients

Cited by 12 publications

References 29 publications

An indirect treatment comparison of the efficacy of pembrolizumab versus competing regimens for the adjuvant treatment of stage III melanoma

An indirect treatment comparison of the efficacy of pembrolizumab versus competing regimens for the adjuvant treatment of stage III melanoma

A new clinical tool to predict outcome in early-stage melanoma patients

Serum markers improve current prediction of metastasis development in early‐stage melanoma patients: a machine learning‐based study

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