Julia Newton-Bishop, MD
Ulcerated melanoma is associated with worse outcomes and appears to be driven in part by systemic inflammation, which is more common in smokers, obese individuals, and those with vitamin D deficiency, according to melanoma expert Julia Newton-Bishop, MD, part of a team of investigators exploring genetic and environmental predictors of the immune response in patients with primary cutaneous melanoma.
Newton-Bishop discussed these findings, along with the possibility of using vitamin D as a treatment option for melanoma, in a June presentation at the 3rd Annual Noreen O’Neill Melanoma Research Symposium at The Wistar Institute in Philadelphia, Pennsylvania.
Figure. Ulcerated Versus Nonulcerated Melanoma
Investigators found that cigarette smoking reduces survival primarily in patients with strong immune response or inflammation. Overall, the hazard ratio for melanoma-specific survival among smokers was 1.56 (95% CI, 1.11-2.18; P
= .003). However, the adverse effect of smoking was greatest in patients with the strongest immune response. For these individuals, the hazard ratio for melanoma-specific survival was 4.59 (95% CI, 1.68-8.23) compared with 1.78 (95% CI, 1.01-3.13) in the intermediate group and 0.92 (95% CI, 0.56-1.51) for the low-immune subgroup.1,2
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