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. 2012 Feb;19(2):620-6.
doi: 10.1245/s10434-011-2027-2. Epub 2011 Aug 23.

Use of S-100B to evaluate therapy effects during bevacizumab induction treatment in AJCC stage III melanoma

S Kruijff  1 , E Bastiaannet, A H Brouwers, W B Nagengast, M J Speijers, A J H Suurmeijer, G A Hospers, H J Hoekstra
Affiliations

Use of S-100B to evaluate therapy effects during bevacizumab induction treatment in AJCC stage III melanoma

S Kruijff et al. Ann Surg Oncol. 2012 Feb.

Abstract

Aim: To investigate the feasibility of using bevacizumab to improve the survival of American Joint Committee on Cancer (AJCC) stage III melanoma patients, we investigated how a single bevacizumab treatment affected nodal disease and a panel of biomarkers in clinically fluorodeoxyglucose positron emission tomography (FDG-PET)/computed tomography (CT)-staged, stage III melanoma patients, prior to therapeutic lymph node dissection (TLND).

Methods: Four weeks before TLND, nine patients (median age 50, range 28.8-62.1 years; two male, seven female) with palpable lymph node metastases received 7.5 mg/kg bevacizumab. Before and after this treatment, all patients were assessed by measurements of the maximum standardized uptake value (SUVmax) by FDG-PET scan, and serum S-100B and lactate dehydrogenase (LDH). After TLND, the dissection specimen was analyzed for number of removed lymph nodes, number of metastatic lymph nodes, and tumor necrosis.

Results: Median follow-up was 15.5 (2.2-32.9) months. Histopathological analysis revealed tumor necrosis in six patients, of whom five had an S-100B decline and one had an unchanged S-100B level after bevacizumab. The other three patients showed an S-100B increase and no necrosis. Tumor necrosis was correlated with S-100B decrease (P = 0.048). No association was found between necrosis and the markers SUVmax and LDH. No wound healing disturbances were encountered.

Conclusion: Tumor necrosis in dissection specimens was associated with declining S-100B levels, while elevated S-100B was only found in cases with no necrosis. Bevacizumab might be useful in treating AJCC stage III melanoma patients prior to TLND, and S100-B appears to be a useful marker for assessment of treatment effects.

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Figures

Fig. 1
Fig. 1
S-100B before and after bevacizumab
Fig. 2
Fig. 2
Patient (61 years, female), melanoma lower extremities (Breslow 2.1 mm, ulceration). Inguinal lymph nodes metastases with a SUVmax of 9.2 first scan and 10.5 second scan
See this image and copyright information in PMC

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