Pachmann Katharina, Willecke-Hochmuth Regina, Schneider Katrin, Kaatz Martin
Labor Dr Pachmann, Bayreuth.
Klinik für Hautkrankheiten, Universitätsklinikum, Jena, Germany.
Melanoma Res. 2018 Feb;28(1):37-43. doi: 10.1097/CMR.0000000000000407.
Although immune therapies with checkpoint inhibitors have gained increasing attention in advanced and metastatic melanoma, interferon-α remains a standard therapy for nonmetastatic malignant melanoma with risk factors. Interferons can successfully prevent relapse; however, the response rate is still not as high as would be desired. Prognostic tools to predict the response are required, which could lead to more individualized treatment regimens. In numerous studies over the past decade, circulating epithelial tumor cells (CETCs) have been shown to be a promising biomarker for estimating the risk of metastatic relapse, and we sought to determine whether they can also be used for this purpose in malignant melanoma. To establish a prognostic tool for patients with melanoma, we quantified CETCs over the course of interferon treatment in 49 patients. Patients were categorized into two groups according to the behavior of their circulating tumor cells during the interferon treatment: those with increasing and those with decreasing numbers of circulating tumor cells. Patients with increasing numbers of circulating tumor cells had a significantly higher risk of relapse. Kaplan-Meier survival analysis showed a significant difference between patients with increasing CETC numbers (mean survival time: 2.6 years) and patients with decreasing or stable CETC numbers (mean survival time: 12.6 years) (P=0.001). Quantification of CETCs could prove to be a prognostic marker for patients with melanoma receiving interferon immunotherapy. Further studies should determine whether these results are applicable to other immunotherapies, for example, immune checkpoint inhibition.
尽管免疫检查点抑制剂免疫疗法在晚期和转移性黑色素瘤中越来越受到关注，但干扰素-α仍然是伴有危险因素的非转移性恶性黑色素瘤的标准疗法。干扰素能够成功预防复发；然而，其缓解率仍未达到理想高度。需要能够预测缓解情况的预后工具，这可能会带来更具个体化的治疗方案。在过去十年的众多研究中，循环上皮肿瘤细胞（CETCs）已被证明是一种用于评估转移性复发风险的有前景的生物标志物，我们试图确定它们是否也可用于恶性黑色素瘤。为了建立黑色素瘤患者的预后工具，我们对49例患者在干扰素治疗过程中对循环上皮肿瘤细胞进行了定量分析。根据患者在干扰素治疗期间循环肿瘤细胞的变化情况将患者分为两组：循环肿瘤细胞数量增加的患者和循环肿瘤细胞数量减少的患者。循环肿瘤细胞数量增加的患者复发风险显著更高。Kaplan-Meier生存分析显示，循环上皮肿瘤细胞数量增加的患者（平均生存时间：2.6年）与循环上皮肿瘤细胞数量减少或稳定的患者（平均生存时间：12.6年）之间存在显著差异（P = 0.001）。循环上皮肿瘤细胞的定量分析可能成为接受干扰素免疫治疗的黑色素瘤患者的预后标志物。进一步的研究应确定这些结果是否适用于其他免疫疗法，例如免疫检查点抑制疗法。
