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Correlation – HLA typing – outcome in high-risk melanoma patients receiving adjuvant interferon

Forums General Melanoma Community Correlation – HLA typing – outcome in high-risk melanoma patients receiving adjuvant interferon

  • Post
    JerryfromFauq
    Participant

      http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=40&abstractID=32435

      Abstract:

      http://www.asco.org/ASCOv2/Meetings/Abstracts?&vmview=abst_detail_view&confID=40&abstractID=32435

      Abstract:

      Background: Serological typing for both HLA class I and class II antigen expression, has previously shown association of specific HLA antigen expression with clinical response and survival in patients with metastatic melanoma treated with IL-2 (e.g. HLA-DQ1). Purpose: To evaluate the impact of HLA class I (low-resolution) and class II (high-resolution) expression, on the outcome of high-risk melanoma patients receiving adjuvant high-dose interferon. Methods: 181 stage IIB, IIC and III melanoma patients (88 female and 93 male), median age 52.1 years and 246 healthy controls were included in this study. DNA was used for the determination of HLA-A, HLA-B, HLA-Cw, HLA-DRB1 and HLA-DQB1 genotypes. Results: With a median follow-up of 37 months, 59 (group 1) patients have remained with no evidence of recurrence and 122 have recurred (group 2). Statistical significant differences between the two groups, were found in the following genotypes: HLA-A*02 (42% vs. 57.3%, p=0.08), HLA-A*33 (15.2% vs. 6.5%, p=0.05), HLA-B*51 (15.2% vs. 34.4%, p=0.01), HLA-B*57 (11.8% vs. 2.4%, p=0.02). Statistical significant differences between group 1 and healthy controls, were found in the following genotypes: HLA-A*33 (15.2% vs. 6.5%, p=0.05), HLA-B*51 (15.2% vs. 28.5%, p=0.05), HLA-B*57 (11.8% vs. 4.5%, p=0.05), HLA-Cw*03 (23.7% vs. 11%, p=0.01), HLA-Cw*06 (27.1% vs. 16.1%, p=0.06), HLA-DRB1*0701 (27.1% vs. 13.4%, p=0.01), HLA-DRB1*1601 (35.6% vs. 22.3%, p=0.01), HLA-DQB1*0202 (23.8% vs. 10.1%, p=0.09). Conclusions: Statistical significant differences were seen in HLA-A and HLA-B alleles between the patients with high-risk melanoma free of recurrence and those who recurred after treatment with adjuvant interferon. Additionally, differences were seen between healthy controls and melanoma patients free of recurrence.

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    • Replies
        boot2aboot
        Participant

          i have been trying to get my HLA  A021 and BRAF run for two weeks now…don't know if they are doing it or not cause noone is calling me back!!!!

            triggerfish
            Participant

              I'm relatively new to the boards here.  No offense intended, but I'd sure rather NOT be here.  Currently making decisions for my father, who was staged at IIA (although there are some who feel it's closer to IIB or IIC due to the size of his nodule at 4mm). 

              The long and short is that it was a 4mm nodular-type Spindle Cell Melanoma on Dad's shoulder/back area.  WLE was performed with good margins (>2cm per surgeon).  SLN biopsy was negative.  There was focal ulceration and positive mitotic rate.  Apparently, through my research, it appears that the these charateristics are not terribly uncommon with Spindle Cell type tumors.  Dad is BRAF negative.

              He had his WLE in mid-March.  Just had his first Oncologist appt. at UPMC on Wednesday, which is supposedly a world-renowned facility.  Dr. Kirkwood (who happens to be "the guy" on the major study that pioneered the Intereferon craze) recommended Intereferon (the 1-month, followed by 11 months).  Dad was not happy about it, but was trying to stay positive and confident.  He was told he could receive treatment at his local hospital through an Onc. that would work under Kirkwood's direction.  He had that appt. yesterday, and the local Onc. said he absolutely refuses to administer the Interferon, and strongly advises against it in my Dad's case.  My Dad has relatively severe MS and already has pre-existing depression, with a "near" suicide attempt a few years ago (he had the gun in his hand but couldn't pull the trigger).  Those two factors alone were enough to make the decision for the local Onc.  The local Onc. said his options are to go back and receive his treatment through Kirkwood in Pittsburgh, or try to find another local Onc. who will do it.  But again, he strongly urged him to not pursue this treatment.  He made the vaild point that "If a guy BUILT the car, he's gonna try to sell it." in regards to Kirkwood's recommendation. This, of course, has left my Dad feeling terribly confused. 

              I'm a Respiratory Therapist, so I do have some medical background.  I've read the studies and done my homework as thoroughly as possibly during this whirlwind.  I was actually surprised that it was not only "offered" by Dr. Kirkwood, but pretty much insisted upon.  Unfortunately I wasn't able to be present at the appt, as I live on the other end of the state.  But as soon as I heard the treatment plan, I had concerns about it immediately.  My Dad currently takes another form of Interferon (Avenox) for his MS.  It's a once/week injectionm with twhich he has pretty significant side affects.  Sometimes the day after his shot, it's all he can do to walk to the bathroom.  He gets debilitating headaches and body aches, among other symptoms, and has even had convulsions until they adjusted dosage for it.  He's 62 years old and in questionable health as it is.  I just didn't see how an even HIGHER dose of Interferon multiple times per week for a year WOULDN'T put him on flat on his back.  And after pouring through the research, I'm just not very certain at all that the benefits outweigh the potential risks. 

              I feel terrible that my Dad has been placed in this position and is now confused as to what to do, but I AM glad that at least he has both arguments (both for and against) regarding Interferon treatment on the table in front of him. I don't want to make the decision FOR him, although I think he would prefer that.  Instead, I'm trying my best to present the information and urge him to make a decision that HE'S comfortable with.  I've read here in multiple threads that once a decision is made, to never look back, and I've shared thart advice with him. 

              This has been truly one of the most difficult experiences thus far, and I guess I was hoping for advice of any kind.  Thoughts on treatment, etc.  I just want to do the right thing for my Dad, and when you have two such polarizingly different opinions on the matter of treatment, it CAN be quite frustrating and confusing.  I apologize for the lengthy post, and thanks in advance for any insight you could offer.  God bless you all who are going through this, and god bless this site for the invaluable information I've gained already.

              In any case, I came across this post and thought it might be of some interest to us.  But again, I'm new and not familiar with some of the terms of this particular study.  Would someone kindly give me an abbreviated translation if possible?  I'd greatly appreciate it.   

               

               

              triggerfish
              Participant

                I'm relatively new to the boards here.  No offense intended, but I'd sure rather NOT be here.  Currently making decisions for my father, who was staged at IIA (although there are some who feel it's closer to IIB or IIC due to the size of his nodule at 4mm). 

                The long and short is that it was a 4mm nodular-type Spindle Cell Melanoma on Dad's shoulder/back area.  WLE was performed with good margins (>2cm per surgeon).  SLN biopsy was negative.  There was focal ulceration and positive mitotic rate.  Apparently, through my research, it appears that the these charateristics are not terribly uncommon with Spindle Cell type tumors.  Dad is BRAF negative.

                He had his WLE in mid-March.  Just had his first Oncologist appt. at UPMC on Wednesday, which is supposedly a world-renowned facility.  Dr. Kirkwood (who happens to be "the guy" on the major study that pioneered the Intereferon craze) recommended Intereferon (the 1-month, followed by 11 months).  Dad was not happy about it, but was trying to stay positive and confident.  He was told he could receive treatment at his local hospital through an Onc. that would work under Kirkwood's direction.  He had that appt. yesterday, and the local Onc. said he absolutely refuses to administer the Interferon, and strongly advises against it in my Dad's case.  My Dad has relatively severe MS and already has pre-existing depression, with a "near" suicide attempt a few years ago (he had the gun in his hand but couldn't pull the trigger).  Those two factors alone were enough to make the decision for the local Onc.  The local Onc. said his options are to go back and receive his treatment through Kirkwood in Pittsburgh, or try to find another local Onc. who will do it.  But again, he strongly urged him to not pursue this treatment.  He made the vaild point that "If a guy BUILT the car, he's gonna try to sell it." in regards to Kirkwood's recommendation. This, of course, has left my Dad feeling terribly confused. 

                I'm a Respiratory Therapist, so I do have some medical background.  I've read the studies and done my homework as thoroughly as possibly during this whirlwind.  I was actually surprised that it was not only "offered" by Dr. Kirkwood, but pretty much insisted upon.  Unfortunately I wasn't able to be present at the appt, as I live on the other end of the state.  But as soon as I heard the treatment plan, I had concerns about it immediately.  My Dad currently takes another form of Interferon (Avenox) for his MS.  It's a once/week injectionm with twhich he has pretty significant side affects.  Sometimes the day after his shot, it's all he can do to walk to the bathroom.  He gets debilitating headaches and body aches, among other symptoms, and has even had convulsions until they adjusted dosage for it.  He's 62 years old and in questionable health as it is.  I just didn't see how an even HIGHER dose of Interferon multiple times per week for a year WOULDN'T put him on flat on his back.  And after pouring through the research, I'm just not very certain at all that the benefits outweigh the potential risks. 

                I feel terrible that my Dad has been placed in this position and is now confused as to what to do, but I AM glad that at least he has both arguments (both for and against) regarding Interferon treatment on the table in front of him. I don't want to make the decision FOR him, although I think he would prefer that.  Instead, I'm trying my best to present the information and urge him to make a decision that HE'S comfortable with.  I've read here in multiple threads that once a decision is made, to never look back, and I've shared thart advice with him. 

                This has been truly one of the most difficult experiences thus far, and I guess I was hoping for advice of any kind.  Thoughts on treatment, etc.  I just want to do the right thing for my Dad, and when you have two such polarizingly different opinions on the matter of treatment, it CAN be quite frustrating and confusing.  I apologize for the lengthy post, and thanks in advance for any insight you could offer.  God bless you all who are going through this, and god bless this site for the invaluable information I've gained already.

                In any case, I came across this post and thought it might be of some interest to us.  But again, I'm new and not familiar with some of the terms of this particular study.  Would someone kindly give me an abbreviated translation if possible?  I'd greatly appreciate it.   

                 

                 

                triggerfish
                Participant

                  I'm relatively new to the boards here.  No offense intended, but I'd sure rather NOT be here.  Currently making decisions for my father, who was staged at IIA (although there are some who feel it's closer to IIB or IIC due to the size of his nodule at 4mm). 

                  The long and short is that it was a 4mm nodular-type Spindle Cell Melanoma on Dad's shoulder/back area.  WLE was performed with good margins (>2cm per surgeon).  SLN biopsy was negative.  There was focal ulceration and positive mitotic rate.  Apparently, through my research, it appears that the these charateristics are not terribly uncommon with Spindle Cell type tumors.  Dad is BRAF negative.

                  He had his WLE in mid-March.  Just had his first Oncologist appt. at UPMC on Wednesday, which is supposedly a world-renowned facility.  Dr. Kirkwood (who happens to be "the guy" on the major study that pioneered the Intereferon craze) recommended Intereferon (the 1-month, followed by 11 months).  Dad was not happy about it, but was trying to stay positive and confident.  He was told he could receive treatment at his local hospital through an Onc. that would work under Kirkwood's direction.  He had that appt. yesterday, and the local Onc. said he absolutely refuses to administer the Interferon, and strongly advises against it in my Dad's case.  My Dad has relatively severe MS and already has pre-existing depression, with a "near" suicide attempt a few years ago (he had the gun in his hand but couldn't pull the trigger).  Those two factors alone were enough to make the decision for the local Onc.  The local Onc. said his options are to go back and receive his treatment through Kirkwood in Pittsburgh, or try to find another local Onc. who will do it.  But again, he strongly urged him to not pursue this treatment.  He made the vaild point that "If a guy BUILT the car, he's gonna try to sell it." in regards to Kirkwood's recommendation. This, of course, has left my Dad feeling terribly confused. 

                  I'm a Respiratory Therapist, so I do have some medical background.  I've read the studies and done my homework as thoroughly as possibly during this whirlwind.  I was actually surprised that it was not only "offered" by Dr. Kirkwood, but pretty much insisted upon.  Unfortunately I wasn't able to be present at the appt, as I live on the other end of the state.  But as soon as I heard the treatment plan, I had concerns about it immediately.  My Dad currently takes another form of Interferon (Avenox) for his MS.  It's a once/week injectionm with twhich he has pretty significant side affects.  Sometimes the day after his shot, it's all he can do to walk to the bathroom.  He gets debilitating headaches and body aches, among other symptoms, and has even had convulsions until they adjusted dosage for it.  He's 62 years old and in questionable health as it is.  I just didn't see how an even HIGHER dose of Interferon multiple times per week for a year WOULDN'T put him on flat on his back.  And after pouring through the research, I'm just not very certain at all that the benefits outweigh the potential risks. 

                  I feel terrible that my Dad has been placed in this position and is now confused as to what to do, but I AM glad that at least he has both arguments (both for and against) regarding Interferon treatment on the table in front of him. I don't want to make the decision FOR him, although I think he would prefer that.  Instead, I'm trying my best to present the information and urge him to make a decision that HE'S comfortable with.  I've read here in multiple threads that once a decision is made, to never look back, and I've shared thart advice with him. 

                  This has been truly one of the most difficult experiences thus far, and I guess I was hoping for advice of any kind.  Thoughts on treatment, etc.  I just want to do the right thing for my Dad, and when you have two such polarizingly different opinions on the matter of treatment, it CAN be quite frustrating and confusing.  I apologize for the lengthy post, and thanks in advance for any insight you could offer.  God bless you all who are going through this, and god bless this site for the invaluable information I've gained already.

                  In any case, I came across this post and thought it might be of some interest to us.  But again, I'm new and not familiar with some of the terms of this particular study.  Would someone kindly give me an abbreviated translation if possible?  I'd greatly appreciate it.   

                   

                   

                boot2aboot
                Participant

                  i have been trying to get my HLA  A021 and BRAF run for two weeks now…don't know if they are doing it or not cause noone is calling me back!!!!

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