Most of the mortality from melanoma comes from metastasis.
Current monitoring requires costly imaging methods.
PHILADELPHIA - Scientists at Yale University have identified a set of plasma biomarkers that could reasonably predict the risk of metastasis among patients with melanoma, according to findings published in Clinical Cancer Research, a journal of the American Association for Cancer Research.
"The rate at which melanoma is increasing is dramatic, and there is a huge number of patients under surveillance," said Harriet Kluger, M.D., associate professor of medicine at Yale University School of Medicine. "Our current method of surveillance includes periodic imaging, which creates huge societal costs."
Melanoma is the fifth most common cancer in men and the seventh most common cancer in women. It is estimated that 68,130 people in the United States were diagnosed in 2010, and 8,700 died. With proper screening, melanoma can often be caught early enough to be removed with surgery, and mortality typically comes when the cancer metastasizes. The risk of metastasis varies from less than 10 percent for those with stage 1A melanoma, to as high as 70 percent with stage 3C.
Patients with melanoma are typically subjected to a combination of imaging tests, blood tests and physical examinations, but there is no clear consensus on how often these tests should occur or how reliable they are.
Kluger and colleagues tested the plasma of 216 individuals, including 108 patients with metastatic melanoma and 108 patients with stage 1 or 2 disease. They identified seven plasma biomarkers: CEACAM, ICAM-1, osteopontin, MIA, GDF-15, TIMP-1 and S100B.
All of these biomarkers were higher in patients with metastatic melanoma than patients with early-stage disease. In fact, 76 percent of patients with early-stage disease had no elevations at all whereas 83 percent of metastatic patients had elevations of at least one marker. Researchers calculated that the area under the curve, a measure of the tests reliability, was 0.898. Area under the curve calculations rate from .5 to 1, with 1 being optimal and .5 being useless.
"This finding will need to be confirmed prospectively before it is used in the clinic, but it shows that such testing is possible," said Kluger.
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The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, the AACR is the worlds oldest and largest professional organization dedicated to advancing cancer research. The membership includes 33,000 basic, translational and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 90 other countries. The AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants, research fellowships and career development awards. The AACR Annual Meeting attracts more than 18,000 participants who share the latest discoveries and developments in the field. Special conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment and patient care. Including Cancer Discovery, the AACR publishes seven major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; Cancer Epidemiology, Biomarkers & Prevention; and Cancer Prevention Research. AACR journals represented 20 percent of the market share of total citations in 2009. The AACR also publishes CR, a magazine for cancer survivors and their families, patient advocates, physicians and scientists.