Autoantibodies of Little Prognostic Value in Melanoma
Analysis of pegylated interferon alfa-2b-treated patients shows no link with improved outcome
THURSDAY, April 15 (HealthDay News) -- In melanoma patients who are treated with adjuvant pegylated interferon alfa-2b, the appearance of autoimmune antibodies is not a prognostic or predictive factor for improved outcome, according to research published online April 12 in the Journal of Clinical Oncology.
Marna G. Bouwhuis, M.D., of the Erasmus University Medical Center in Rotterdam, Netherlands, and colleagues evaluated data from the European Organisation for Research and Treatment of Cancer 18991 trial, which compared long-term administration of pegylated interferon alfa-2b with observation, and used enzyme-linked immunosorbent assays to identify anticardiolipin, antithyroglobulin, and antinuclear antibodies in 296 patients who were followed for up to five years. The prognostic impact of autoantibodies on recurrence-free survival was assessed via: a model that considered autoantibody appearance as a time-independent variable (model 1); a model that considered a patient to be autoantibody positive from the first positive test (model 2); and a model in which the most recent autoantibody test was used to define the status of the patient (model 3).
In the 220 patients who were autoantibody negative at baseline, the researchers found that the rate of autoantibody occurrence was higher in the pegylated interferon alfa-2b group than in the observation group (52 versus 18 percent). Although model 1 showed that autoantibody appearance was of prognostic importance (hazard ratio 0.56), when guarantee-time bias was taken into account with model 2 or model 3, there was no significant effect.
"The results reported here suggest that determination of autoantibodies is not useful in selecting patients who will benefit from treatment with pegylated interferon alfa-2b," the authors conclude.
Several authors disclosed financial relationships with Schering-Plough.