A case of spontaneous systemic immunity to melanoma associated with cure after amputation for extensive regional recurrence Journal Article
| Authors: | Judge, J. M.; Brill, L. B. 2nd; Smith, K. T.; Deacon, D. H.; Patterson, J. W.; Grosh, W. W.; Jungbluth, A. A.; Gnjatic, S.; Slingluff, C. L. Jr |
| Article Title: | A case of spontaneous systemic immunity to melanoma associated with cure after amputation for extensive regional recurrence |
| Abstract: | Purpose: Survival after amputation for melanoma is short; however, rare long-term survivors are reported. The mechanism for durable systemic tumor control in patients with regional failure is not known. To explore whether systemic tumor immunity may be implicated, tumor and circulating immune responses were examined in a patient who survived disease-free 14 years after hip disarticulation. Methods: A 71-year-old female with extensive regional metastases of melanoma in the left lower extremity underwent amputation for palliative reasons. Tumor was collected at surgery, and blood was collected during follow-up. Tumor sections were evaluated for lymphocytic infiltration and NY-ESO-1 expression by immunohistochemistry. Cellular immune responses to defined tumor antigens were evaluated by ELISPOT assay, and antibody responses to a panel of tumor antigens were assayed by ELISA. Results: The patient's tumor had minimal lymphocytic infiltrate (immunotype A). NY-ESO-1 was strongly expressed by the melanoma cells. Circulating T-cell responses to NY-ESO-1 peptides were observed 6 and 12 years postoperatively, and antibodies to NY-ESO-1 were detected 2-6 years after surgery. Conclusion: The patient described in this report experienced relentless regional tumor progression, with intravascular metastases, and then 14-year systemic disease-free survival after palliative resection, without evidence of melanoma recurrence before death from other causes. Her immune response to NY-ESO-1 likely failed to control established regional metastases because T cells were unable to infiltrate them. It is possible, however, that among other factors, the host immune response may have contributed to systemic protection. © 2013 Springer-Verlag Berlin Heidelberg. |
| Keywords: | adult; human tissue; treatment response; aged; cancer surgery; human cell; histopathology; cancer recurrence; case report; postoperative period; cisplatin; cancer combination chemotherapy; gastrointestinal hemorrhage; paclitaxel; hysterectomy; lymph node dissection; salpingooophorectomy; cancer palliative therapy; palliative care; antigen expression; bcg vaccine; carboplatin; dacarbazine; melanoma; neoplasm recurrence, local; skin neoplasms; membrane proteins; deep vein thrombosis; tumor antigen; carmustine; time factors; survivors; lymphedema; disease severity; cellular immunity; antigens, neoplasm; ny eso 1 antigen; cancer infiltration; antibody response; reoperation; warfarin; melanoma cell; amputation; tumor immunity; cancer of unknown primary site; papillary carcinoma; lymphocytic infiltration; lymphocytes; regional metastasis; antibody; lymph node biopsy; lymphadenopathy; leg amputation; cellulitis; lung nodule; uterus carcinoma; subcutaneous nodule; ny-eso-1; t cell; vagina bleeding; lower extremity; tumor invasion; in-transit metastasis; thrombophlebitis; amputation for melanoma; hip surgery; retroperitoneal adenopathy; septic thrombophlebitis; supraclavicular adenopathy |
| Journal Title: | Cancer Immunology, Immunotherapy |
| Volume: | 62 |
| Issue: | 8 |
| ISSN: | 0340-7004 |
| Publisher: | Springer |
| Date Published: | 2013-08-01 |
| Start Page: | 1327 |
| End Page: | 1334 |
| Language: | English |
| DOI: | 10.1007/s00262-013-1433-7 |
| PROVIDER: | scopus |
| PUBMED: | 23666534 |
| PMCID: | PMC4082724 |
| DOI/URL: | |
| Notes: | --- - "Export Date: 4 September 2013" - "CODEN: CIIMD" - "Source: Scopus" |
