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Elevated C-reactive protein predicts poorer outcomes in melanoma
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Higher blood levels of C-reactive protein were associated with poorer OS and melanoma-specific survival in patients with invasive melanoma, according to study results.
“The relationship between changes in [C-reactive protein] and melanoma disease progression within the same patient has not been investigated,” Shenying Fang, MD, PhD, of the department of surgical oncology at The University of Texas MD Anderson Cancer Center, and colleagues wrote. “The primary aim of this study was to investigate whether increased levels of [C-reactive protein] in plasma are associated with disease stage, recurrence, or survival in patients with melanoma.”
Fang and colleagues obtained peripheral blood samples from 3,189 non-Hispanic white patients between March 1998 and August 2009. Samples from 1,144 (587 initial and 557 confirmatory) of these patients with invasive melanoma were evaluable for C-reactive protein (CRP) determination.
Median follow-up from blood draw to patient death or censoring was 6.23 years for all patients.
Study results showed that elevated CRP was associated with poorer OS in the initial, confirmatory and combined data sets. In the combined data set, CRP levels contributed to overall risk of death by a factor of 1.44 (95% CI, 1.3-1.59) per unit increase of logarithmic CRP.
After multivariable adjustment, increased CRP continued to be associated with poorer OS in the individual and combined data sets.
Researchers observed a stronger association between CRP and melanoma-specific survival (HR = 1.51, 95% CI, 1.36-1.68) compared with the relationship between CRP and OS.
CRP levels of at least 10 mg/L vs. CRP levels less than 10 mg/L conferred poorer OS in patients with any-stage, stage I/II or stage III/IV disease and poorer DFS in those with stage I/II disease.
One hundred fifteen patients underwent sequential blood draws to evaluate the relationship between change in disease status and change in CRP level. Researchers noted an increased CRP level was significantly associated with response to treatment (P ˂ .001), disease progression (P ˂ .001), increase in cancer stage (P = .006) and increase in the number of metastases (two levels, P = .001; three levels, P = .004).
“CRP is an independent prognostic marker in patients with melanoma,” Fang and colleagues wrote. “CRP measurement should be considered for incorporation into prospective studies of outcome in patients with melanoma and clinical trials of systemic therapies for those with melanoma.” – by Lauren Frisby
Disclosure: Fang reports no relevant financial disclosures. Other researchers report consultant/advisory, speakers bureau, leadership and employment roles with; honoraria and travel accommodations from; and royalties on patents licensed to Amgen, Castle Biosciences, Delcath, Forward Health Group, Genentech, GlaxoSmithKline, Mercator Therapeutics, Merck, Navidea and NeoStem.
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