Janka Eszter Anna, Szabó Imre Lőrinc, Kollár Sándor, Toka-Farkas Tünde, Ványai Beatrix, Várvölgyi Tünde, Kapitány Anikó, Shabu Hibah, Szegedi Andrea, Emri Gabriella
Department of Dermatology, MTA Centre of Excellence, Faculty of Medicine, University of Debrecen, 4032 Debrecen, Hungary.
HUN-REN-UD Allergology Research Group, University of Debrecen, 4032 Debrecen, Hungary.
Cancers (Basel). 2024 Aug 27;16(17):2981. doi: 10.3390/cancers16172981.
Prognostic studies can provide important information about disease biology and improve the use of biomarkers to optimize treatment decisions.
A total of 199 patients with advanced melanoma treated with BRAF + MEK inhibitors were included in our single-center retrospective study. We analyzed the risk of progression and death using multivariate Cox proportional hazard models. The predictive effect of prognostic factors on progression-free survival (PFS) was evaluated in ROC analysis.
We found that primary tumor localization, Clark level, pT category, baseline M stage and baseline serum S100B are independent and significant prognostic factors for PFS. The discriminative power of the combination of these factors was excellent for predicting 18 month PFS (AUC 0.822 [95% CI 0.727; 0.916], < 0.001). Primary tumor localization on the extremities, Clark level V, baseline M1c stage or M1d stage, and elevated baseline serum S100B and LDH levels were independently and significantly associated with unfavorable overall survival (OS).
Baseline M stage and serum S100B appear to be independent prognostic factors for both PFS and OS in melanoma patients treated with BRAF + MEK inhibitors. We newly identified significant and independent prognostic effects of primary tumor localization and Clark level on survival that warrant further investigation.
预后研究可以提供有关疾病生物学的重要信息，并改善生物标志物的应用以优化治疗决策。
我们的单中心回顾性研究纳入了199例接受BRAF+MEK抑制剂治疗的晚期黑色素瘤患者。我们使用多变量Cox比例风险模型分析了进展和死亡风险。在ROC分析中评估了预后因素对无进展生存期（PFS）的预测效果。
我们发现原发肿瘤定位、Clark分级、pT类别、基线M分期和基线血清S100B是PFS的独立且显著的预后因素。这些因素组合的判别能力在预测18个月PFS方面表现出色（AUC 0.822 [95%CI 0.727; 0.916]，<0.001）。四肢的原发肿瘤定位、Clark分级V级、基线M1c期或M1d期，以及基线血清S100B和乳酸脱氢酶（LDH）水平升高与不良总生存期（OS）独立且显著相关。
基线M分期和血清S100B似乎是接受BRAF+MEK抑制剂治疗的黑色素瘤患者PFS和OS的独立预后因素。我们新发现了原发肿瘤定位和Clark分级对生存有显著且独立的预后影响，值得进一步研究。
