ELEVATED CRP AS PROGNOSTIC FACTOR IN MELANOMA

In a study reported in the Journal of Clinical Oncology, Fang et al found that an elevated C-reactive protein level was associated with poorer overall and melanoma-specific survival in patients with melanoma and that sequential increases in C-reactive protein were associated with an increased risk of disease progression.

Study Details

The study involved C-reactive protein measurements in two independent sets of plasma samples from a total of 1,144 patients with melanoma of any stage (587 in initial and 557 in confirmatory data sets). In total, 34% had stage III or IV disease at blood draw, and 11% had a C-reactive protein level ≥ 10 mg/L.

Poorer Outcome

In the combined data set, an elevated C-reactive protein level was associated with poorer overall survival (hazard ratio [HR] = 1.44 per unit increase of logarithmic C-reactive protein, P < .001) and melanoma-specific survival (HR = 1.51 per unit increase of logarithmic C-reactive protein, P < .001), with significance persisting on multivariate analysis. On multivariate analysis, compared with a C-reactive protein level < 10 mg/L, C-reactive protein ≥ 10 mg/L was associated with significantly reduced overall survival in patients with any-stage disease (HR = 2.62, P < .001), stage I or II disease (HR  = 3.70, P = .0110), and stage III or IV disease (HR  = 3.30, P < .001) and significantly reduced melanoma-specific survival in those with any stage disease (HR = 2.67, P < .001) and stage III or IV disease (HR = 3.42, P < .001).

Among 115 patients with sequential blood draws, there was a significant association of an increased C-reactive protein level with increased risk of disease progression (P < .001).

The investigators concluded: “[C-reactive protein] is an independent prognostic marker in patients with melanoma. [C-reactive protein] 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.”

Jeffrey E. Lee, MD, of The University of Texas MD Anderson Cancer Center, is the corresponding author of the Journal of Clinical Oncology article.

The study was supported by the National Cancer Institute; Aim at Melanoma Foundation; and philanthropic contributions to The University of Texas MD Anderson Cancer Center Moon Shots Program, Miriam and Jim Mulva Research Fund, and Marit Peterson Fund for Melanoma Research. For full disclosures of the study authors, visit jco.ascopubs.org.