Prognostic Significance of Autoimmunity during Treatment of Melanoma with Interferon

Abstract

The appearance of autoantibodies or clinical manifestations of autoimmunity during treatment with interferon alfa-2b is associated with statistically significant improvements in relapse-free survival and overall survival in patients with melanoma.

The Society for Immunotherapy of Cancer consensus statement on tumour immunotherapy for the treatment of cutaneous melanoma

“…[47][48][49][50][51][52][53][54][55][56][57][58] These effects can range from asymptomatic vitiligo or autoimmune thyroiditis, to symptomatic skin, gastro intestinal, hepatic and endocrine immunerelated toxic effects, as seen with ipilimumab. [47][48][49][50][51][52][53][54][55][56][57][58] The development of autoimmunity might be associated with clinical response, as a report demonstrated an association between autoimmune thyroid dysfunction and improved relapse-free and overall survival in patients with melanoma who were treated with adjuvant interferon-α2b or IL-2. 58,59 Although the panel recognizes published guidelines for the treatment of patients with interferon-α2b, 32 IL-2 60 and ipilimumab, 10 four special-issue topics were identified where there are not significant level A or level B data to guide clinical recom mendations.…”

“…[47][48][49][50][51][52][53][54][55][56][57][58] The development of autoimmunity might be associated with clinical response, as a report demonstrated an association between autoimmune thyroid dysfunction and improved relapse-free and overall survival in patients with melanoma who were treated with adjuvant interferon-α2b or IL-2. 58,59 Although the panel recognizes published guidelines for the treatment of patients with interferon-α2b, 32 IL-2 60 and ipilimumab, 10 four special-issue topics were identified where there are not significant level A or level B data to guide clinical recom mendations. These issues include the manage ment of interferon-related depression, frequency of clinical labora tory monitoring and imaging during treatment and how to determine when to stop therapy (Box 2).…”

Therapeutic implications of autoimmune vitiligo T cells

“…In fact, stress protein/ tumor antigen fusion proteins are currently in clinical trials for the treatment of human tumors, including melanoma. Interestingly, it has been shown that vitiligo development in melanoma patients is an indicator of effective immunity against the tumor, and vitiligo in melanoma patients is considered a positive prognostic factor [21]. It is therefore of great importance to analyze the similarities and discrepancies among effective immunity to melanocytic cells in autoimmune vitiligo, and the lack thereof in patients with malignant melanoma [22].…”

Controversies on autoimmunity and prognosis in cancer

“…The appearance of autoantibodies or clinical manifestations of autoimmunity during treatment with high-dose adjuvant interferon alfa-2b was associated with statistically significant improvements in relapse-free survival and overall survival (Gogas et al, 2006). By contrast, the early presence of autoantibodies in the serum has been described to correlate with an unfavourable prognosis (de Visser et al, 2006).…”

“…While it could be possible to use autoimmune responses as surrogate markers to evaluate new treatments (Gogas et al, 2006), it might be highlighted that individuals with progressive tumours could produce a higher antigen load, therefore triggering greater antibody deposition (de Visser et al, 2006).…”