title: Metastatic melanoma: spontaneous occurrence of auto antibodies is a good prognosis factor in a prospective cohort.
abstract: BACKGROUND
  Melanoma is an immunogenic tumour type frequently associated with spontaneous auto-immune manifestations such as spontaneous regression, vitiligo-like reactions or auto-immune retinopathy, which seem to be associated with better prognosis.
  
  
  OBJECTIVE
  The aim of this prospective study was to evaluate the correlation between spontaneous autoimmunity and survival in patients with stage IV melanoma.
  
  
  METHODS
  From 2007 to 2008, 103 patients were studied with antithyroid and antinuclear auto antibody assays performed every 6 months. Any detectable occurrence of a spontaneous self antibody (SpSA) at the upper detection limit, at least for one assay, was considered to be a biological marker of autoimmunity.
  
  
  RESULTS
  Univariate and multivariate analyses confirmed significantly longer survival in the absence of known primary melanoma (P = 0.044) and in the presence of marker of biologic autoimmunity, independently of previous immunotherapy (P = 0.045).
  
  
  CONCLUSIONS
  This prospective and comparative study is, to our knowledge, the first to report the frequency of SpSA in stage IV melanoma. Our results suggest that spontaneous autoimmunity, through a rupture of self-tolerance, is a good prognostic factor in a subgroup of patients with stage IV melanoma.
authors.affiliation: Department of Dermatology, CHRU, University of Lille 2, Lille, France. cyril.maire@chru-lille.fr
authors.forename: C
authors.initials: C
authors.lastname: Maire
authors.forename: S
authors.initials: S
authors.lastname: Vercambre-Darras
authors.forename: P
authors.initials: P
authors.lastname: Devos
authors.forename: M
authors.initials: M
authors.lastname: D'Herbomez
authors.forename: S
authors.initials: S
authors.lastname: Dubucquoi
authors.forename: L
authors.initials: L
authors.lastname: Mortier
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001323:Autoantibodies / Q000276:immunology*; D015551:Autoimmunity / Q000502:physiology; D015415:Biomarkers / Q000032:analysis; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008545:Melanoma / Q000276:immunology* / Q000401:mortality* / Q000556:secondary; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012878:Skin Neoplasms / Q000276:immunology* / Q000401:mortality* / Q000473:pathology; D016019:Survival Analysis
chemical_list: D001323:Autoantibodies; D015415:Biomarkers