title: Use of S-100B to evaluate therapy effects during bevacizumab induction treatment in AJCC stage III melanoma.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Surgical Oncology, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. skruyff@hotmail.com
authors.forename: S
authors.initials: S
authors.lastname: Kruijff
authors.forename: E
authors.initials: E
authors.lastname: Bastiaannet
authors.forename: A H
authors.initials: AH
authors.lastname: Brouwers
authors.forename: W B
authors.initials: WB
authors.lastname: Nagengast
authors.forename: M J
authors.initials: MJ
authors.lastname: Speijers
authors.forename: A J H
authors.initials: AJ
authors.lastname: Suurmeijer
authors.forename: G A
authors.initials: GA
authors.lastname: Hospers
authors.forename: H J
authors.initials: HJ
authors.lastname: Hoekstra
mesh_terms: D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008297:Male; D008545:Melanoma / Q000097:blood* / Q000188:drug therapy* / Q000473:pathology; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D009414:Nerve Growth Factors / Q000097:blood*; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins / Q000097:blood*; D012878:Skin Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; D014408:Biomarkers, Tumor; D009414:Nerve Growth Factors; D019275:Radiopharmaceuticals; D064568:S100 Calcium Binding Protein beta Subunit; D009418:S100 Proteins; D019788:Fluorodeoxyglucose F18; D000068258:Bevacizumab