Research Article

Eosinophilic count as a biomarker for prognosis of melanoma patients and its importance in the response to immunotherapy

Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany

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Waltraud Leisgang

Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany

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Gerold Schuler

Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany

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Lucie Heinzerling

*Author for correspondence:

E-mail Address: lucie.heinzerling@uk-erlangen.de

Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany

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Published Online:27 Jan 2017https://doi.org/10.2217/imt-2016-0138

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Abstract

Aim: The prognostic role of eosinophils in cancer has been controversial. Some entities such as gastrointestinal cancers show a better survival, while others such as Hodgkin's lymphoma a worse survival in patients with eosinophilia. Patients who exhibited an increase in eosinophils upon therapy with ipilimumab or pembrolizumab were shown to survive longer. We wanted to investigate whether eosinophilia is a prognostic marker in metastatic melanoma. Methods: In total, 173 patients with metastatic melanoma from our data base (median age 60 years; n = 86 with immunotherapy, n = 87 without immunotherapy) were analyzed for eosinophil counts and survival over the course of 12 years. Eosinophilic count was detected by peripheral blood smear. The ethical committee had approved this retrospective study. Results: Melanoma patients with eosinophilia at any point in their course of disease show a trend toward longer survival independently of their therapy. There is a statistically significant difference for the patients who survive at least 12 months (p < 0.005). In patients with checkpoint inhibitor therapy, survival was significantly prolonged in every patient with eosinophilia (p < 0.05). Furthermore, 69% of the patients treated with immunotherapy experienced at least once an eosinophilia of 5% or greater compared with 46% in the immunotherapy naive-group; for an eosinophilia of 10% values were 30 and 9%, respectively. Interestingly, in patients with more than 20% eosinophils (n = 7) survival was prolonged with a median of 35 months (range 19–60 months) as compared with 16 months (range 1–117 months). Conclusion: Eosinophilia is a prognostic marker in patients with metastatic melanoma.

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References

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Vol. 9, No. 2

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Published online 27 January 2017

Published in print February 2017

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Acknowledgements

A Moreira performed the present work in fulfillment of the requirements of the Friedrich-Alexander-University Erlangen- Nuremberg (FAU) for obtaining the degree ‘Dr. med’.. The authors thank T Eigentler and M Ronicke for assistance in the statistical analysis.

Funding statement

This study is an academic study without any external funding.

Data availability

The authors confirm that all data underlying the findings are fully available without restriction. All relevant data are within the paper and its Supporting Information files.

Ethical conduct of research

The authors state that they have obtained appropriate institutional review board approval or have followed the principles outlined in the Declaration of Helsinki for all human or animal experimental investigations. In addition, for investigations involving human subjects, informed consent has been obtained from the participants involved.

Financial & competing interests disclosure

L Heinzerling has been consultant for BMS, MSD, Amgen, Roche, Novartis, GSK. The institution performs trials financed by MSD, BMS, Amgen, Novartis, GSK and Roche. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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