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V. Barak, I. Kaiserman, S. Frenkel, K. Hendler, I. Kalickman, R. Folberg, J. Pe'er; The Dynamics of Serum Biomarkers and Their Role in Predicting Metastatic Uveal Melanoma. Invest. Ophthalmol. Vis. Sci. 2008;49(13):1500.
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The serum biomarkers osteopontin (OPN), S-100, melanoma-inhibitory activity (MIA) and tissue polypeptide-specific antigen (TPS) were found to be elevated in patients with metastatic uveal melanoma, as compared to disease-free patients. The purpose of this study was to examine the changes in these biomarker levels before the development of liver metastases, and to evaluate their potential to predict these metastases.
Patients who developed metastatic uveal melanoma and for whom we had data on the levels of the biomarkers OPN, S-100, MIA and TPS prior to the development of the metastases, were included in the study. The serum biomarker levels were measured using ELISA. Mean marker levels were calculated at 6, 12, 18, 24, and >24 months prior to the confirmation of metastases by liver ultrasound, liver CT and biopsy. The mean marker level in each time window was compared to the mean level in the >24 months time window, using the student's t-test.
Twenty-nine uveal melanoma patients who developed metastases had undergone serum biomarker testing prior to the diagnosis of the metastases. Marker levels were available for an average of 632 + 412 days (range 41 - 1428) prior to the detection of metastases. While mean OPN, S-100 and MIA levels seemed to rise consistently before detection of liver metastases, the changes in TPS levels were not consistent. The lead-time of the examined markers was 6 - 12 months for OPN (p = 0.006), and 6 months for S-100 (p = 0.03) and MIA (p = 0.06). The increase in TPS levels was not significant.
A significant increase in the levels of serum biomarkers OPN, S-100 and MIA prior to the diagnosis of liver metastases in patients with uveal melanoma can predict the development of metastases and may enable earlier therapeutic intervention in these patients, which might be more effective than treating them after the diagnosis of the metastatic disease.
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