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MIA 和 S100 血清肿瘤标志物与监测转移性黑色素瘤患者 BRAF 抑制剂治疗的相关性。

Relevance of MIA and S100 serum tumor markers to monitor BRAF inhibitor therapy in metastatic melanoma patients.

机构信息

Department of Medical Oncology, University Clinic of Navarra, Spain.

Laboratory of Biochemistry, University Clinic of Navarra, Spain.

出版信息

Clin Chim Acta. 2014 Feb 15;429:168-74. doi: 10.1016/j.cca.2013.11.034. Epub 2013 Dec 9.

Abstract

BRAF V600 mutation has been reported in more than 50% of melanoma cases and its presence predicts clinical activity of BRAF inhibitors (iBRAF). We evaluated the role of MIA, S100 and LDH to monitor iBRAF efficiency in advanced melanoma patients presenting BRAF V600 mutations. This was a prospective study of melanoma patients harboring the BRAF V600 mutation and treated with iBRAF within a clinical trial (dabrafenib) or as part of an expanded access program (vemurafenib). MIA, S100 and LDH were analyzed in serum at baseline, and every 4-6 weeks during treatment. Eighteen patients with melanoma stages IIIc-IV were enrolled with 88.8% of response rate to iBRAF. Baseline concentrations of all the tumor markers correlated with tumor burden. MIA and S100 concentrations decreased significantly one month after the beginning of treatment and, upon progression, their concentrations increased significantly above the minimum levels previously achieved. MIA levels lower than 9 μg/L one month after the beginning of treatment and S100 concentrations lower than 0.1 μg/L at the moment of best response were associated with improved progression-free survival. In conclusion, MIA and S100 are useful to monitor response in melanoma patients treated with iBRAF.

摘要

BRAF V600 突变在超过 50%的黑色素瘤病例中被报道,其存在预测了 BRAF 抑制剂(iBRAF)的临床活性。我们评估了 MIA、S100 和 LDH 在携带 BRAF V600 突变的晚期黑色素瘤患者中监测 iBRAF 疗效的作用。这是一项前瞻性研究,纳入了在临床试验(dabrafenib)或扩大准入计划(vemurafenib)中接受 iBRAF 治疗的携带 BRAF V600 突变的黑色素瘤患者。在基线时和治疗期间每 4-6 周分析血清中的 MIA、S100 和 LDH。共纳入 18 例 IIIc-IV 期黑色素瘤患者,iBRAF 的反应率为 88.8%。所有肿瘤标志物的基线浓度与肿瘤负荷相关。治疗开始一个月后,MIA 和 S100 浓度显著下降,疾病进展时,其浓度显著高于之前达到的最低水平。治疗开始一个月后 MIA 水平低于 9μg/L 且最佳反应时 S100 浓度低于 0.1μg/L 与无进展生存期改善相关。总之,MIA 和 S100 可用于监测接受 iBRAF 治疗的黑色素瘤患者的反应。

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