June 9, 2009 Contrary to previous reports, the appearance of autoantibodies is not strongly associated with improved outcome in melanoma patients treated with interferon, according to a new study.
Results were published in the June 9 online issue of the Journal of the National Cancer Institute.
Adjuvant treatment of melanoma with interferon-α (IFN) has been shown to increase recurrence-free survival. In this study, Alexander M.M Eggermont, M.D., at Erasmus University MC in the Netherlands, and colleagues, looked at randomized controlled clinical trials in which patients with melanoma received or did not receive intermediate doses of IFN. Using statistical models accounting for guarantee-time bias--which is the additional time that patients with improved outcomes would have to become antibody-positive--they did not find a statistically significant association between autoantibodies after initiation of treatment and the length of time to recurrence.
Serum levels of antibodies were determined using enzyme-linked immunosorbent assays in over 500 patients in the European Organization for Research and Treatment of Cancer (EORTC18952) and Nordic IFN trials. Cox regression models were used to assess the association of seroconversion with recurrence-free survival.
When treated as a time-independent variable, appearance of autoantibodies was associated with improved relapse-free interval in both trials, but correction for guarantee-time bias found that the association was not statistically significant.
"The results of two similar randomized trials reported here do not suggest that the presence or appearance of autoantibodies is a strong prognostic factor in melanoma patients," the authors write. "The findings indicate that the assessment of autoimmune antibodies is not a useful tool in selecting patients who would benefit from treatment with intermediate doses of IFN-a2b."
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- Marna G. Bouwhuis, Stefan Suciu, Sandra Collette, Steinar Aamdal, Wim H. Kruit, Lars Bastholt, Ulrika Stierner, François Salès, Poulam Patel, Cornelis J. A. Punt, Micaela Hernberg, Alain Spatz, Timo L. M. ten Hagen, Johan Hansson, Alexander M. M. Eggermont, and for the EORTC Melanoma Group and the Nordic Melanoma Group. Autoimmune Antibodies and Recurrence-Free Interval in Melanoma Patients Treated With Adjuvant Interferon. Journal of the National Cancer Institute, 2009; DOI: 10.1093/jnci/djp132
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