Skip to main content
Top
Published in: BMC Cancer 1/2019

Open Access 01-12-2019 | Melanoma | Research article

Eosinophil-cationic protein - a novel liquid prognostic biomarker in melanoma

Authors: Annika Krückel, Alvaro Moreira, Waltraud Fröhlich, Gerold Schuler, Lucie Heinzerling

Published in: BMC Cancer | Issue 1/2019

Login to get access

Abstract

Background

The role of eosinophils in cancer is not yet completely understood, but patients with eosinophilia show a trend towards longer survival in several types of cancer, including melanoma. However, eosinophil count at initial diagnosis of metastatic melanoma does not predict survival. Since eosinophil cationic protein (ECP) mediates anticancer effects, such as tissue remodelling and cytotoxic activity, we investigated this marker as an early prognostic marker in metastatic melanoma.

Methods

Serum of 56 melanoma patients was collected at the time of diagnosis of metastatic disease. ECP levels as measured by ELISA were correlated with overall survival (OS) in patients before systemic therapy with immunotherapy or chemotherapy. Statistical analyses were performed using the Log–Rank (Mantel–Cox) test.

Results

The median OS for patients with high serum ECP above 12.2 ng/ml was 12 months (n = 39), compared to 28 months for patients with ECP below this threshold (n = 17; p = 0.0642). In patients with cutaneous melanoma, excluding patients with uveal and mucosal melanoma, the survival difference was even more striking (p = 0.0393). ECP’s effect size on OS was observed independently of the consecutive therapy. ECP levels were not correlated with LDH levels.

Conclusion

ECP seems to be a novel prognostic serum marker for the outcome of melanoma patients, which is independent of LDH and easy to perform in clinical practice. The striking negative prognostic value of high ECP level is unanticipated and can guide patient management.
Appendix
Available only for authorised users
Literature
1.
go back to reference Nikolin B, Djan I, Trifunovic J, Dugandzija T, Novkovic D, Djan V, Vucinic N. MIA, S100 and LDH as important predictors of overall survival of patients with stage IIb and IIc melanoma. J BUON 2016;21(3):691–697; PMID:27569092. Nikolin B, Djan I, Trifunovic J, Dugandzija T, Novkovic D, Djan V, Vucinic N. MIA, S100 and LDH as important predictors of overall survival of patients with stage IIb and IIc melanoma. J BUON 2016;21(3):691–697; PMID:27569092.
2.
go back to reference Henry L, Fabre C, Guiraud I, Bastide S, Fabbro-Peray P, Martinez J, Lavabre-Bertrand T, Meunier L, Stoebner PE. Clinical use of p-proteasome in discriminating metastatic melanoma patients: comparative study with LDH, MIA and S100B protein. Int J Cancer 2013;133(1):142–148; PMID:23238767; https://doi.org/10.1002/ijc.27991. Henry L, Fabre C, Guiraud I, Bastide S, Fabbro-Peray P, Martinez J, Lavabre-Bertrand T, Meunier L, Stoebner PE. Clinical use of p-proteasome in discriminating metastatic melanoma patients: comparative study with LDH, MIA and S100B protein. Int J Cancer 2013;133(1):142–148; PMID:23238767; https://​doi.​org/​10.​1002/​ijc.​27991.
3.
go back to reference Li N, Mangini J, Bhawan J. New prognostic factors of cutaneous melanoma: a review of the literature. J Cutan Pathol 2002;29(6):324–340; PMID:12135463. Li N, Mangini J, Bhawan J. New prognostic factors of cutaneous melanoma: a review of the literature. J Cutan Pathol 2002;29(6):324–340; PMID:12135463.
4.
go back to reference Utikal J, Schadendorf D, Ugurel S. Serologic and immunohistochemical prognostic biomarkers of cutaneous malignancies. Arch Dermatol Res 2007;298(10):469–477; PMID:17221215. Utikal J, Schadendorf D, Ugurel S. Serologic and immunohistochemical prognostic biomarkers of cutaneous malignancies. Arch Dermatol Res 2007;298(10):469–477; PMID:17221215.
5.
go back to reference Sakkal S, Miller S, Apostolopoulos V, Nurgali K. Eosinophils in cancer: favourable or unfavourable? Curr Med Chem 2016;23(7):650–666; PMID:26785997. Sakkal S, Miller S, Apostolopoulos V, Nurgali K. Eosinophils in cancer: favourable or unfavourable? Curr Med Chem 2016;23(7):650–666; PMID:26785997.
7.
go back to reference Pereira MC, Oliveira DT, Kowalski LP. The role of eosinophils and eosinophil cationic protein in oral cancer: a review. Arch Oral Biol 2011;56(4):353–358; PMID:21112047. Pereira MC, Oliveira DT, Kowalski LP. The role of eosinophils and eosinophil cationic protein in oral cancer: a review. Arch Oral Biol 2011;56(4):353–358; PMID:21112047.
8.
go back to reference Zhang Y, Ren H, Wang L, Ning Z, Zhuang Y, Gan J, Chen S, Zhou D, Zhu H, Tan D, et al. Clinical impact of tumor-infiltrating inflammatory cells in primary small cell esophageal carcinoma. Int J Mol Sci 2014;15(6):9718–9734; PMID: 24886814; doi:https://doi.org/10.3390/ijms15069718. Zhang Y, Ren H, Wang L, Ning Z, Zhuang Y, Gan J, Chen S, Zhou D, Zhu H, Tan D, et al. Clinical impact of tumor-infiltrating inflammatory cells in primary small cell esophageal carcinoma. Int J Mol Sci 2014;15(6):9718–9734; PMID: 24886814; doi:https://​doi.​org/​10.​3390/​ijms15069718.
9.
go back to reference Moreira A, Leisgang W, Schuler G, Heinzerling L. Eosinophilic count as a biomarker for prognosis of melanoma patients and its importance in the response to immunotherapy. Immunotherapy. 2017;9(2):115–121; PMID:28128709; https://doi.org/10.2217/imt-2016-0138. Moreira A, Leisgang W, Schuler G, Heinzerling L. Eosinophilic count as a biomarker for prognosis of melanoma patients and its importance in the response to immunotherapy. Immunotherapy. 2017;9(2):115–121; PMID:28128709; https://​doi.​org/​10.​2217/​imt-2016-0138.
10.
go back to reference von Wasielewski R, Seth S, Franklin J, Fischer R, Hübner K, Hansmann ML, Diehl V, Georgii A. Tissue eosinophilia correlates strongly with poor prognosis in nodular sclerosing Hodgkin’s disease, allowing for known prognostic factors. Blood. 2000;95(4):1207–13 10666192. von Wasielewski R, Seth S, Franklin J, Fischer R, Hübner K, Hansmann ML, Diehl V, Georgii A. Tissue eosinophilia correlates strongly with poor prognosis in nodular sclerosing Hodgkin’s disease, allowing for known prognostic factors. Blood. 2000;95(4):1207–13 10666192.
11.
go back to reference Horiuchi K, Mishima K, Ohsawa M, Sugimura M, Aozasa K. Prognostic factors for well- differentiated squamous cell carcinoma in the oral cavity with emphasis on immunohistochemical evaluation. J Surg Oncol 1993;53(2):92–96; PMID:8501912; doi:https://doi.org/10.1002/jso.2930530209 Horiuchi K, Mishima K, Ohsawa M, Sugimura M, Aozasa K. Prognostic factors for well- differentiated squamous cell carcinoma in the oral cavity with emphasis on immunohistochemical evaluation. J Surg Oncol 1993;53(2):92–96; PMID:8501912; doi:https://​doi.​org/​10.​1002/​jso.​2930530209
13.
go back to reference Murdoch C, Muthana M, Coffelt SB, Lewis CE. The role of myeloid cells in the promotion of tumour angiogenesis. Nat Rev Cancer 2008;8(8):618–631; PMID:18633355. Murdoch C, Muthana M, Coffelt SB, Lewis CE. The role of myeloid cells in the promotion of tumour angiogenesis. Nat Rev Cancer 2008;8(8):618–631; PMID:18633355.
15.
go back to reference Delyon J, Mateus C, Lefeuvre D, Lanoy E, Zitvogel L, Chaput N, Roy S, Eggermont AM, Routier E, Robert C. Experience in daily practice with ipilimumab for the treatment of patients with metastatic melanoma: an early increase in lymphocyte and eosinophil counts is associated with improved survival. Ann. Oncol. 2013;24(6):1697–1703; PMID:23439861; doi:https://doi.org/10.1093/annonc/mdt027 Delyon J, Mateus C, Lefeuvre D, Lanoy E, Zitvogel L, Chaput N, Roy S, Eggermont AM, Routier E, Robert C. Experience in daily practice with ipilimumab for the treatment of patients with metastatic melanoma: an early increase in lymphocyte and eosinophil counts is associated with improved survival. Ann. Oncol. 2013;24(6):1697–1703; PMID:23439861; doi:https://​doi.​org/​10.​1093/​annonc/​mdt027
16.
go back to reference Ferrucci PF, Gandini S, Cocorocchio E, Pala L, Baldini F, Mosconi M, Antonini Cappellini GC, Albertazzi E, Martinoli C. Baseline relative eosinophil count as a predictive biomarker for ipilimumab treatment in advanced melanoma. Oncotarget. 2017;8(45):79809–79815; PMID:29108362; doi:https://doi.org/10.18632/oncotarget.19748. Ferrucci PF, Gandini S, Cocorocchio E, Pala L, Baldini F, Mosconi M, Antonini Cappellini GC, Albertazzi E, Martinoli C. Baseline relative eosinophil count as a predictive biomarker for ipilimumab treatment in advanced melanoma. Oncotarget. 2017;8(45):79809–79815; PMID:29108362; doi:https://​doi.​org/​10.​18632/​oncotarget.​19748.
17.
go back to reference Weide B, Martens A, Hassel JC, Berking C, Postow MA, Bisschop K, Simeone E, Mangana J, Schilling B, Di Giacomo AM, et al. Baseline biomarkers for outcome of melanoma patients treated with pembrolizumab. Clin Cancer Res 2016;22(22):5487–5496; PMID:27185375; doi:https://doi.org/10.1158/1078-0432.CCR-16-0127. Weide B, Martens A, Hassel JC, Berking C, Postow MA, Bisschop K, Simeone E, Mangana J, Schilling B, Di Giacomo AM, et al. Baseline biomarkers for outcome of melanoma patients treated with pembrolizumab. Clin Cancer Res 2016;22(22):5487–5496; PMID:27185375; doi:https://​doi.​org/​10.​1158/​1078-0432.​CCR-16-0127.
18.
19.
go back to reference Carretero R, Sektioglu IM, Garbi N, Salgado OC, Beckhove P, Hämmerling GJ. Eosinophils orchestrate cancer rejection by normalizing tumor vessels and enhancing infiltration of CD8+ T cells. Nat Immunol 2015;16(6):609–617; PMID:25915731; doi:https://doi.org/10.1038/ni.3159. Carretero R, Sektioglu IM, Garbi N, Salgado OC, Beckhove P, Hämmerling GJ. Eosinophils orchestrate cancer rejection by normalizing tumor vessels and enhancing infiltration of CD8+ T cells. Nat Immunol 2015;16(6):609–617; PMID:25915731; doi:https://​doi.​org/​10.​1038/​ni.​3159.
20.
go back to reference Molin D, Glimelius B, Sundström C, Venge P, Enblad G. The serum levels of eosinophil cationic protein (ECP) are related to the infiltration of eosinophils in the tumours of patients with Hodgkin’s disease. Leuk Lymphoma 2001;42(3):457–465; PMID:11699410; doi:https://doi.org/10.3109/10428190109064602. Molin D, Glimelius B, Sundström C, Venge P, Enblad G. The serum levels of eosinophil cationic protein (ECP) are related to the infiltration of eosinophils in the tumours of patients with Hodgkin’s disease. Leuk Lymphoma 2001;42(3):457–465; PMID:11699410; doi:https://​doi.​org/​10.​3109/​1042819010906460​2.
21.
go back to reference Liu YS, Tsai PW, Wang Y, Fan TC, Hsieh CH, Chang MD, Pai TW, Huang CF, Lan CY, Chang HT. Chemoattraction of macrophages by secretory molecules derived from cells expressing the signal peptide of eosinophil cationic protein. BMC Syst Biol 2012;6:105; PMID:22906315; doi:https://doi.org/10.1186/1752-0509-6-105. Liu YS, Tsai PW, Wang Y, Fan TC, Hsieh CH, Chang MD, Pai TW, Huang CF, Lan CY, Chang HT. Chemoattraction of macrophages by secretory molecules derived from cells expressing the signal peptide of eosinophil cationic protein. BMC Syst Biol 2012;6:105; PMID:22906315; doi:https://​doi.​org/​10.​1186/​1752-0509-6-105.
22.
go back to reference Navarro S, Aleu J, Jiménez M, Boix E, Cuchillo CM, Nogués M V. The cytotoxicity of eosinophil cationic protein/ribonuclease 3 on eukaryotic cell lines takes place through its aggregation on the cell membrane. Cell Mol Life Sci 2008;65(2):324–337; PMID:18087674; doi:https://doi.org/10.1007/s00018-007-7499-7. Navarro S, Aleu J, Jiménez M, Boix E, Cuchillo CM, Nogués M V. The cytotoxicity of eosinophil cationic protein/ribonuclease 3 on eukaryotic cell lines takes place through its aggregation on the cell membrane. Cell Mol Life Sci 2008;65(2):324–337; PMID:18087674; doi:https://​doi.​org/​10.​1007/​s00018-007-7499-7.
23.
go back to reference Venge P, Byström J. Eosinophil cationic protein (ECP). Int J Biochem Cell Biol 1998;30(4):433–437; PMID:9675876. Venge P, Byström J. Eosinophil cationic protein (ECP). Int J Biochem Cell Biol 1998;30(4):433–437; PMID:9675876.
25.
27.
go back to reference Venge P, Byström J, Carlson M, Hâkansson L, Karawacjzyk M, Peterson C, Sevéus L, Trulson A. Eosinophil cationic protein (ECP): molecular and biological properties and the use of ECP as a marker of eosinophil activation in disease. Clin Exp Allergy 1999;29(9):1172–1186; PMID:10469025. Venge P, Byström J, Carlson M, Hâkansson L, Karawacjzyk M, Peterson C, Sevéus L, Trulson A. Eosinophil cationic protein (ECP): molecular and biological properties and the use of ECP as a marker of eosinophil activation in disease. Clin Exp Allergy 1999;29(9):1172–1186; PMID:10469025.
Metadata
Title
Eosinophil-cationic protein - a novel liquid prognostic biomarker in melanoma
Authors
Annika Krückel
Alvaro Moreira
Waltraud Fröhlich
Gerold Schuler
Lucie Heinzerling
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2019
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-019-5384-z

Other articles of this Issue 1/2019

BMC Cancer 1/2019 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine