Abstract
e21573 Background: The prognostic role of eosinophils is still unclear with a trend towards longer survival for melanoma patients with eosinophilia at any point in their course of disease. However, eosinophil count at initial diagnosis of metastatic disease does not predict survival. Since eosinophil cationic protein (ECP) might mediate anticancer effects, such as tissue remodeling and cytotoxic activity, this marker was investigated as early prognostic marker preceding eosinophilia. Methods: Serum of 56 melanoma patients was collected at the time of diagnosis of metastatic disease. ECP levels as measured by ELISA were correlated with overall survival (OS) in patients before systemic therapy with immunotherapy or chemotherapy. Statistical analyses were performed using the Log–Rank (Mantel–Cox) test and Gehan-Breslow-Wilcoxon test. Results: The median OS for patients with high serum ECP above 10 ng/ml was 13 months, compared to 32 months for patients with ECP below this threshold (p = 0.0001). This striking survival difference was observed independently of the consecutive therapy. ECP levels were not correlated with LDH levels. Conclusions: ECP is a novel prognostic serum marker for predicting the outcome of melanoma patients which is independent of LDH and easy to perform in clinical practice. The negative prognostic value of high ECP level is unanticipated.
Highlights
The role of eosinophils in cancer is not yet completely understood, but patients with eosinophilia show a trend towards longer survival in several types of cancer, including melanoma
Patients with low eosinophil cationic protein (ECP) at initial diagnosis of metastatic disease had a longer survival in comparison with patients with high ECP
This study suggests that ECP represents an independent novel prognostic biomarker in patients with metastatic melanoma
Summary
The role of eosinophils in cancer is not yet completely understood, but patients with eosinophilia show a trend towards longer survival in several types of cancer, including melanoma. Eosinophil count at initial diagnosis of metastatic melanoma does not predict survival. Eosinophil count has already been shown to be a predictive biomarker for therapy with immune checkpoint inhibitors in melanoma [14]. Baseline frequencies as well as an increase of the number of eosinophils between the first and the second infusion of the anti-CTLA-4 antibody ipilimumab correlate with a better overall survival (OS) [14,15,16]. Regarding therapy with anti-PD-1 antibodies, eosinophil count at baseline correlated with OS of melanoma patients [14, 17]. In Krückel et al BMC Cancer (2019) 19:207 most cases patients only developed eosinophilia during the course of metastatic disease, eosinophil count at initial diagnosis of metastatic disease did not predict survival [9, 18]
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