Last Updated: 2003-03-31 9:40:46 -0400 (Reuters Health)
NEW YORK (Reuters Health) - In patients with malignant melanoma, testing for circulating cancer cells does not improve the predictive value of disease staging, according to a report published in the March 1st issue of the Journal of Clinical Oncology.
"At present, an independent prognostic role for the detection of circulating melanoma cells (CMCs) is yet to be defined, and therefore, its general use is not warranted," Dr. Janice P. Dutcher, from New York Medical College in Valhalla, notes in an accompanying editorial.
The findings are based on a study of 200 patients with stage I to IV melanoma whose blood samples were tested for CMCs. The cells were identified by using reverse transcriptase-polymerase chair reaction (RT-PCR) to detect three markers: tyrosinase, p97, and MelanA/MART1.
During the 1-year study period, 32% of patients experienced disease progression, study author Dr. Paolo A. Ascierto, from the National Cancer Institute in Naples, Italy, and colleagues note. The median progression-free survival period for the entire group was 52 months.
On univariate analysis, the presence of CMCs and the various markers, alone or in combination, was predictive of prognosis. However, on multivariate analysis, the authors found that such testing did not add to the prognostic information provided by disease stage.
Although the findings suggest limited prognostic value for CMC testing, detection of such cells could, perhaps, be useful in guiding therapy. "Studies of CMCs, prospectively correlated with response to treatment in either the adjuvant or advanced setting, are of interest," Dr. Dutcher notes.
J Clin Oncol 2003;21:767-773.