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-immunemanifestations such as spontaneous regression, vitiligo-like reactions or auto-immune retinopathy, which seem to beassociated with better prognosis.Objectives The aim of this prospective study was to evaluate the correlation between spontaneous autoimmunityand survival in patients with stage IV melanoma.Methods From 2007 to 2008, 103 patients were studied with antithyroid and antinuclear auto antibody assaysperformed every 6 months. Any detectable occurrence of a spontaneous self antibody (SpSA) at the upper detectionlimit, 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 knownprimary melanoma (P = 0.044) and in the presence of marker of biologic autoimmunity, independently of previousimmunotherapy (P = 0.045).Conclusions This prospective and comparative study is, to our knowledge, the first to report the frequency ofSpSA 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.Received: 26 May 2011; Accepted: 8 November 2011