Sunday, August 28, 2016

Melanoma antigens in blood are prognostic of OS and correlated with response to ipi!

I've talked about biomarkers before.  Here's a post from earlier this year (with additional links within - including one to another study that found blood biomarkers associated with response to ipi):  Biomarkers - blood components, circulating tumor cells AND of the tumor itself 

A valid and specific blood draw that could help diagnose, determine the presence of a response to therapy, and be used as follow-up (instead of scans!) would be sooooooooooo  awesome!!!!  Now there's this:

Melanoma antigens are biomarkers for ipilimumab response.  Arenberger, Fialova, Gkalpakiotis, et al.  J Eur Acad Dermatol Venereol. 2016 Aug 24. 

Novel immunotherapy modalities significantly improve survival of patients with metastatic melanoma. However, CTLA-4-blocking monoclonal antibody ipilimumab is effective only in a small proportion of patients. Biomarkers for prediction of treatment response are indispensably needed.

To determine the utility of multimarker detection of circulating melanoma cells as prognostic and pharmacodynamic biomarker in patients with metastatic melanoma treated with ipilimumab.

Patients (n=62) with metastatic melanoma in unresectable stage III or metastatic stage IV treated with ipilimumab were recruited prospectively. The values of 4 melanoma markers on circulating cells Melan-A, gp100, MAGE-3 and MIA prior to the treatment and within the therapy were compared to the data collected at baseline - after the melanoma surgery.

The immunotherapy pretreatment marker level was found to be prognostic of overall survival, lower levels were linked to longer survival time. Moreover, longitudinal follow-up of melanoma markers in patients treated with ipilimumab correlates with therapy response. A decline of marker levels by greater than 30% at week 6 (in 83% of the responding subjects) to week 9 (in all responders) of ipilimumab administration was associated with response to therapy. Elevation of the tumor markers during the treatment precedes clinical progression and gives an early warning of treatment failure. 

Melanoma circulating cells hold potential as predictive and pharmacodynamic biomarker of immunotherapy.

Come on researchers.  Let's make this happen!  Soon!!! - c


  1. celeste, this is really good info. i tried to ask about bio markers and gene markers for stage IIIb and was told they are of no use for stage III, does that seem right? we are deciding if we should start IPI 3mg for stage IIIb and want to know if any type of marker would help inform our decision. any advice would be helpful please.

  2. No, it doesn't really make sense. In the end I think these sorts of tests will be important for checking all folks at all stages for progression, status, and response to therapy. At the moment, I am not sure that any of the tests have gained FDA approval. Additionally, I fear they haven't been tried in many Stage III folks. Once they have even gained approval, we'll have to fight to get insurance to cover them and docs to order and believe in them. I think we will get there. But, at the moment, I am not sure there is anything available to help you (or any of us) in a consistent, available, understandable way today. On the other hand, if you can get 3mg ipi for Stage III (instead of the 10mg dose) you may have a doc that is giving you a really good deal. Good luck.