The prevalence and prognostic significance of autoantibodies detected in patients with high risk melanoma receiving adjuvant therapy with high-dose interferon

Abstract

7519 Background: Immunotherapies that have shown a benefit in advanced melanoma have been shown to induce the collateral appearance of autoimmune responses as thyroid autoantibodies and depigmentation. The purpose of this study was to assess the prevalence of autoantibodies in the serum of stage IIB and III melanoma patients on high dose adjuvant interferon and the appearance of vitiligo, and address their prognostic significance. Patients and Methods: Two hundred patients were included in the study. Peripheral blood was obtained prior to initiation of adjuvant interferon at completion of 1 month of intravenous interferon and at three monthly intervals. Serum samples were tested for antithyroid, antinuclear, anti-DNA, anticardiolipin antibodies by enzyme linked immunosorbant assay (ELISA). Patients were examined for the appearance of vitiligo. Results: The patients were followed for a median time of 36 months. Autoantibodies were detected in fifty two (26%) of 200 patients. 111 patients have relapsed and 78 have died. The median time to progression was 24 months and the median survival was 43.9 months. The median time to progression for the patients who tested negative for autoantibodies was 14.8 months and has not been reached yet for the 52 patients who developed autoantibodies (105 vs 6 p<0.0001). The median survival was 30.7 months for those who were negative and has not been reached yet for the other group (76 vs 2 p<0.001). In multivariante analysis the presence of autoimmunity was an independent favorable prognostic marker. Conclusion: The detection of autoantibodies and appearance of vitiligo was associated with a lower risk of relapse, longer disease free and overall survival. The induction of autoimmunity may be a surrogate marker for monitoring the efficacy of adjuvant treatment with interferon in stage IIB and III melanoma patients. No significant financial relationships to disclose.