This study demonstrates the limitations of FDG-PET scanning in staging patients with primary melanoma. SNB is the only reliable method for identifying micrometastatic disease in the regional draining node.
Melanoma, a potentially lethal skin cancer, is widely thought to be immunogenic
in nature. While there has been much focus on T cell-mediated immune responses,
limited knowledge exists on the role of mature B cells. We describe an approach,
including a cell-based ELISA, to evaluate mature IgG antibody responses to
melanoma from human peripheral blood B cells. We observed a significant increase
in antibody responses from melanoma patients (n = 10) to
primary and metastatic melanoma cells compared to healthy volunteers
(n = 10) (P<0.0001). Interestingly, we
detected a significant reduction in antibody responses to melanoma with
advancing disease stage in our patient cohort (n = 21)
(P<0.0001). Overall, 28% of
melanoma patient-derived B cell cultures (n = 1,800)
compared to 2% of cultures from healthy controls
(n = 600) produced antibodies that recognized melanoma
cells. Lastly, a patient-derived melanoma-specific monoclonal antibody was
selected for further study. This antibody effectively killed melanoma cells
in vitro via antibody-mediated cellular cytotoxicity. These
data demonstrate the presence of a mature systemic B cell response in melanoma
patients, which is reduced with disease progression, adding to previous reports
of tumor-reactive antibodies in patient sera, and suggesting the merit of future
work to elucidate the clinical relevance of activating humoral immune responses
to cancer.
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