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[Cancer Research 60, 2253-2257, April 15, 2000]
© 2000 American Association for Cancer Research

Molecular Biology and Genetics

Molecular Markers in Blood as Surrogate Prognostic Indicators of Melanoma Recurrence1

Dave S. B. Hoon2, Peter Bostick, Christine Kuo, Tetsuro Okamoto, He-Jing Wang, Robert Elashoff and Donald L. Morton

Department of Molecular Oncology [D. S. B. H., P. B., C. K., T. O.], Division of Biostatistics [H-J. W., R. E.], and John Wayne Cancer Clinic [D. L. M.], John Wayne Cancer Institute, Saint John’s Health Center, Santa Monica, California 90404, and Department of Biomathematics, University of California at Los Angeles School of Medicine, Los Angeles, California 90024 [H-J. W., R. E.]

Improvement is needed in the ability to evaluate the prognosis of melanoma patients who are clinically disease-free but likely to develop recurrent metastatic disease. The detection of circulating melanoma cells in blood is a potential surrogate marker of subclinical residual disease. We assessed the prognostic clinical utility of a multimarker melanoma reverse transcriptase-PCR (RT-PCR) assay using blood of 46 patients who were clinically disease-free. All patients were followed up for more than 4 years for disease recurrence. There was a significant correlation between number of RT-PCR markers present in blood and American Joint Committee on Cancer stage (P = 0.009). The number of RT-PCR markers detected in blood was an independent prediction factor of disease recurrence in a Cox proportional hazard model (P = 0.02). A risk factor model using American Joint Committee on Cancer stage and number of positive RT-PCR markers significantly predicted disease recurrence in 2, 3, and 4 years of follow-up. These studies demonstrate that molecular detection of circulating melanoma cells may be of significant prognostic value in determining early disease recurrence and may be useful for stratifying patients for adjuvant therapy.




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