Risk for nevus transformation and melanoma proliferation and invasion during natalizumab treatment: Four years of dermoscopic follow-up with immunohistological studies and proliferation and invasion assays

摘要

Natalizumab is a monoclonal antibody targeting a4 integrin used to treat multiple sclerosis (MS). Seven cases of melanoma during natalizumab treatment have been reported since 2006?'2 The objective of this study was to assess the effect of natalizumab on nevi transformation and tumor cell proliferation, invasion, and migration in preclinical models of melanoma. Methods | We conducted an observational follow-up of all patients with MS treated with natalizumab in the University Hospital of Nice from January l, 2008, through December 21,2012. Institutional review board approval was waived. Oral informed consent was obtained for each patient. The clinical part of this study expanded a prior study3 of 44 patients from the same cohort. The evolution of nevi under treatment was assessed by clinical dermatologic examination and digital der-moscopy performed every 6 months. Nevi were examined and compared side by side wrth baseline photographs, and excision of suspect lesions was performed based on clinical and dermoscopic criteria. A combined in vitro approach was performed to analyze the effect of natalizumab on the prolifera-tive, invasive, and transmigratory behavior of melanoma cells (detailed information is provided in the eMethods of the Supplement).