Τίτλος:
Prognostic significance of autoimmunity during treatment of melanoma
with interferon
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
BACKGROUND:
Immunotherapy for advanced melanoma induces serologic and clinical
manifestations of autoimmunity. We assessed the prognostic significance
of autoimmunity in patients with stage IIB, IIC, or III melanoma who
were treated with high-dose adjuvant interferon alfa-2b.
METHODS:
We enrolled 200 patients in a substudy of a larger, ongoing randomized
trial. Blood was obtained before the initiation of intravenous
interferon therapy, after 1 month of therapy, and at 3, 6, 9, and 12
months. Serum was tested for antithyroid, antinuclear, anti-DNA, and
anticardiolipin autoantibodies, and patients were examined for vitiligo.
RESULTS:
The median duration of follow-up was 45.6 months. Relapse occurred in
115 patients, and 82 patients died. The median relapse-free survival was
28.0 months, and the median overall survival was 58.7 months.
Autoantibodies and clinical manifestations of autoimmunity were detected
in 52 patients (26 percent). The median relapse-free survival was 16.0
months among patients without autoimmunity (108 of 148 had a relapse)
and was not reached among patients with autoimmunity (7 of 52 had a
relapse). The median survival was 37.6 months among patients without
autoimmunity (80 of 148 died) and was not reached among patients with
autoimmunity (2 of 52 died). In univariate and multivariate regression
analyses, autoimmunity was an independent prognostic marker for improved
relapse-free survival and overall survival (P<0.001).
CONCLUSIONS:
The appearance of autoantibodies or clinical manifestations of
autoimmunity during treatment with interferon alfa-2b is associated with
statistically significant improvements in relapse-free survival and
overall survival in patients with melanoma.
Συγγραφείς:
Gogas, H
Ioannovich, J
Dafni, U
Stavropoulou-Giokas, C and
Frangia, K
Tsoutsos, D
Panagiotou, P
Polyzos, A and
Papadopoulos, O
Stratigos, A
Markopoulos, C
Bafaloukos, D
and Pectasides, D
Fountzilas, G
Kirkwood, JM
Περιοδικό:
The New England journal of medicine
Εκδότης:
MASSACHUSETTS MEDICAL SOC
DOI:
10.1056/NEJMoa053007
