The value of cysteinyldopa in the follow-up of disseminated malignant melanoma.
In a series of 92 patients with malignant melanoma, clinical stage III or IV, both 5-S-cysteinyldopa (5SCD) and 6-hydroxy-5-methoxyindole-2-carboxylic acid (6H5MI2C) were measured in urine during chemotherapy. A total of 434 urine specimens were analysed. The sensitivity of 5SCD for the detection of stage III-IV melanoma was 83%, while the corresponding sensitivity of 6H5MI2C was 52%. Fifty per cent of patients with one metastatic site had increased 5SCD excretion, while all patients with four or more metastatic sites had increased excretion. A significant correlation was found between 5SCD decrease and clinical regression (P<0.001) and between 5SCD increase and clinical progression (P<0.001). Corresponding correlations were not found for 6H5MI2C. Increments in 5SCD excretion (median 269 micromol/mol creatinine) were seen for 83% of the occasions when clinical progression was recorded, and decrements in 5SCD excretion (median 145 micromol/mol creatinine) were seen for 85% of the occasions when clinical regression was seen. During clinical 'stable disease' increases in 5SCD excretion were seen in 59% and decreases in 41%. The median value of 5SCD changes for stable disease was 7.0 micromol/mol creatinine, indicating a chemical marker stability in many cases. We recommend the use of 5SCD in urine as a valuable, reliable and simple biochemical marker to use in the clinical follow-up of melanoma patients with advanced disease.
Kärnell
R
R
Department of General Oncology Radiumhemmet, Karolinska Hospital, Stockholm, Sweden.
Kågedal
B
B
Lindholm
C
C
Nilsson
B
B
Arstrand
K
K
Ringborg
U
U
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000652:urine*; D003548:Cysteinyldopa / Q000652:urine*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007211:Indoles / Q000652:urine; D008297:Male; D008545:Melanoma / Q000188:drug therapy / Q000556:secondary / Q000652:urine*; D008875:Middle Aged; D012878:Skin Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000652:urine*
D014408:Biomarkers, Tumor; D007211:Indoles; D003548:Cysteinyldopa; C017408:6-hydroxy-5-methoxy-2-indolylcarboxylic acid