Abusaif Sail, Jradi Zeinab, Held Laura, Pflugfelder Annette, Weide Benjamin, Meier Friedegund, Garbe Claus, Eigentler Thomas K
Department of Dermatology, Skin Cancer Program, Tübingen, Germany.
Melanoma Res. 2013 Oct;23(5):396-401. doi: 10.1097/CMR.0b013e3283650741.
Vemurafenib is a highly efficient BRAF inhibitor for metastatic melanoma patients carrying the V600 mutation: progression-free survival is prolonged to ∼ 6 months and 50-80% of the patients show objective tumor responses. S100B and lactate dehydrogenase (LDH) are established tumor markers in routine melanoma follow-up. This study evaluated their potential as response and progression markers during vemurafenib treatment. A cohort of 44 patients with stage IV melanoma disease who were treated with vemurafenib was retrospectively analyzed. Staging was performed every 6-8 weeks comprising computed tomography scans and measurement of LDH and S100B levels. Response Evaluation Criteria In Solid Tumors (RECIST) criteria were used for standardized radiological response evaluations. The correlation between response or progression and LDH and S100B levels was analyzed using accuracy tests, Spearman's rank correlation ρ, and polynominal regression analyses. There was a good correlation between S100B and LDH decline and a RECIST-confirmed response, especially when S100B and/or LDH were elevated at baseline (accuracy, 81.2% for S100B and 85.7% for LDH). However, the accuracy in case of RECIST-confirmed progression and S100B/LDH levels was low - 30.3% for S100B and 32.4% for LDH. Neither Spearman's rank correlation ρ nor polynomial regression analyses showed a correlation between the clinical course and S100B/LDH levels. Measurement of S100B and LDH levels during treatment with vemurafenib indicates an initial response; however, this does not seem to be sufficient in detecting tumor progression and is thus not an alternative to monitoring with imaging examinations.
维莫非尼是一种对携带V600突变的转移性黑色素瘤患者高效的BRAF抑制剂：无进展生存期延长至约6个月，50 - 80%的患者显示出客观的肿瘤反应。S100B和乳酸脱氢酶（LDH）是黑色素瘤常规随访中已确立的肿瘤标志物。本研究评估了它们在维莫非尼治疗期间作为反应和进展标志物的潜力。对44例接受维莫非尼治疗的IV期黑色素瘤患者队列进行了回顾性分析。每6 - 8周进行分期，包括计算机断层扫描以及LDH和S100B水平的测定。实体瘤疗效评价标准（RECIST）用于标准化的放射学反应评估。使用准确性检验、Spearman等级相关系数ρ和多项式回归分析来分析反应或进展与LDH和S100B水平之间的相关性。S100B和LDH下降与RECIST确认的反应之间存在良好的相关性，特别是当S100B和/或LDH在基线时升高时（准确性，S100B为81.2%，LDH为85.7%）。然而，RECIST确认进展时S100B/LDH水平的准确性较低 - S100B为30.3%，LDH为32.4%。Spearman等级相关系数ρ和多项式回归分析均未显示临床病程与S100B/LDH水平之间存在相关性。在维莫非尼治疗期间测量S100B和LDH水平可表明初始反应；然而，这在检测肿瘤进展方面似乎并不充分，因此不能替代影像学检查进行监测。
