The incidence of cutaneous melanoma, especially thin (≤ 1.0 mm) melanomas, continues to increase worldwide. Breslow thickness, ulceration, and sentinel lymph node status, which are currently regarded as the most accurate prognostic markers for cutaneous melanoma, fail to identify patients at high risk of disseminating disease amongst those with thin melanomas. Thus, there is an urgent need to identify melanoma-specific prognostic biomarkers for the identification of patients with an increased risk of disease progression to ultimately increase patient survival.
The utilisation of autoantibodies as melanoma-associated biomarkers is a promising avenue towards personalised medicine. Autoantibodies reflect a biologically amplified, stable signature of the anti-tumour immune response that is produced often prior to the clinical detection of other tumour markers and prior to the first clinically detectable signs of cancer recurrence.
In this retrospective study, clinical data will be extracted from the population- based Western Australia Cancer Registry, regarding the survival outcomes of 104 early stage (in situ - stage II) melanoma patients. The potential of autoantibodies to predict the risk for progression will be evaluated by analysing the autoantibody profiles exhibited at the time of diagnosis relative to their present disease status (median follow-up of 3.83 years). Sera (n=104) were screened against a high-throughput microarray platform containing 1627 functional proteins.
The selection of three prognostic autoantibodies will be based on the identification as a top marker by iPathwayGuide, a gene and protein expression analysis tool, fold change >2 (high risk versus low risk), p<0.05, AUC > 0.7 and literature relation to melanoma. An in-house immunoassay will be developed to measure IgG autoantibody levels using the Bio-Plex® immunoassay platform.
The measurement of a prognostic biomarker via routine and minimally invasive venipuncture could be a powerful tool for clinicians to determine which patients require frequent monitoring to prevent the recurrence and spread of the cancer, thereby increasing patient survival.