A diagnostic autoantibody signature for primary cutaneous melanoma

The cover for issue 55 of Oncotarget features Figure 4, "(A) Regression tree diagram of the best combination of the identified autoantibody biomarkers. (B) Cumulative sensitivity and specificity of the 10 AAb biomarker panel. (C) ROC curve and AUC of the biomarker combination in cohort 1," by Zaenker, et al.

To improve early stage melanoma detection, the development of a highly sensitive diagnostic test is of utmost importance. This melanoma autoantibody signature may prove valuable for the development of a diagnostic blood test for routine population screening that, when used in conjunction with current melanoma diagnostic techniques, could improve the early diagnosis of this malignancy and ultimately decrease the mortality rate of patients.

Dr. Pauline Zaenker from the School of Medical and Health Sciences, Edith Cowan University, Joondalup, Perth, WA, Australia said "The incidence of cutaneous melanoma, the most aggressive and treatment resistant type of skin cancer, continues to increase and New Zealand followed by Australia have the highest incidence rates."

Figure 4: (A) Regression tree diagram of the best combination of the identified autoantibody biomarkers. (B) Cumulative sensitivity and specificity of the 10 AAb biomarker panel. (C) ROC curve and AUC of the biomarker combination in cohort 1.

Detecting the primary melanoma tumours at an early stage results in a 5-year survival rate as high as 99%, whereas 5-year survival for late stage patients is only 15-20%, indicating the importance of the timely diagnosis of this malignancy. Moreover, it is questionable whether these methods are suitable for the screening of people at risk of melanoma development, such as patients with a substantial number of moles on their body, those with a family history, cases of occult melanoma, or those with very thin and unpigmented primary lesions.

To date, many blood-based biomarkers have been proposed for melanoma prognosis, indication of recurrence, and assessment of treatment response, including micro RNAs, circulating tumour cells and circulating tumour DNA. While the mechanisms involved in the production of AAbs in cancer patients, remain speculative, AAbs are well known to be sensitive biomarkers in the detection and surveillance of many types of tumours. Here the research team utilized the Immunome Protein Array containing 1627 proteins, developed by Oxford Gene Technology, Oxfordshire, United Kingdom, to screen sera from a total of 124 early stage melanoma patients and 121 healthy volunteers.

The research team concluded, "since it is known that autoantigens that are modified before or during the course of tumour formation and progression in cancer, can stimulate the immune response in patients when they are released from tumour cells and that immune responses have been observed to be responsible for tumour growth promotion, but also prevention in a process called immunoediting, the fact that some of the top 139 biomarker associated signaling pathways are involved in the immune response, is consistent with the immunoediting theory and leads to the proposal that the identified AAb biomarkers may be utilized in future therapeutic interventions to treat or monitor advanced melanoma and aid in the early diagnosis and surveillance of patients with melanoma."

Full text - https://doi.org/10.18632/oncotarget.25669

Correspondence to - Pauline Zaenker - paulinez@our.ecu.edu.au

Keywords - melanoma, diagnosis, autoantibody, microarray, biomarker