**Author details**

Luo et al showed in well constructed paper that isoenzymes of aldehyde dehydrogenase 1A (ALDH) appear as stem cell markers of melanoma, but their presence in serum and their

Adhesion molecule type 1 related to carcinoembryonic antigen (CEACAM 1) has also recently been shown as a promising biomarker by an Israeli team: measuring the serum in a retrospec‐ tive study is correlated with metastatic progression and survival patients with melanoma [29]. The utility of serum DNA of mutated BRAF gene has also recently been presented as a prognostic factor and predictor of response to biochetherapies. This would probably be very

Cancer is a major cause of morbidity and mortality in our society. It shows a huge price and

The prognosis of melanoma is closely linked to early diagnosis. Current treatments have limited effectiveness, and surgery remains the mainstay of treatment. Better treatments are certainly necessary, even with the arrival of molecules such as ipilimumab or vemurafenib that

In the past, the only prognostic factor in melanoma patients has been limited to histology (tumor thickness) and the location of the primary tumor. These parameters are important, but were supplemented by numerous clinical variables, pathological and biological, particularly in patients with advanced melanoma. Recently, the use of serum markers, alone or in combi‐ nation, has been proposed to refine the prognosis of a patient in order to ensure proper tracking and predicting the potential benefits of therapy. More specific or nonspecific markers of melanoma can be measured in the serum of patients, and in most cases, these markers are

Among these biomarkers, LDH and S100B serum biomarkers appear with an independ‐ ent prognostic value, although disputed by some. In advanced melanoma, their dosage is probably more accurate and sensitive than CRP levels (LDH and CRP are obviously more accessible and measured) as shown by some studies, but not ideal. Even if the LDH is incorporated into the new AJCC classification, for some authors, S100B is superior in terms

To a lesser extent due to poor sensitivity or lower specificity, CRP, MIA, and Gal-3 can also be considered as interesting biomarkers. The dosages of new other molecules should be included in future prospective clinical protocols, distinguishing their prognostic value (patient out‐

Storage conditions of serum should also be made clear in all the articles as they have a major influence on results and therefore conclusions. This suggests that a standard methodology

useful for patients treated with vemurafenib. These results need to be confirmed [30].

has many devastating effects. Melanoma is a tragic example of these realities.

enable new perspectives for our patients with metastatic disease.

directly correlated with the tumor mass.

come) and predictive value (response to treatment).

should be set in order to compare the published studies [32].

of prognostic value [31].

prognostic significance has yet to be defined [28].

**4. Discussion**

38 Highlights in Skin Cancer

Pierre Vereecken\*

Address all correspondence to: dr.vereecken@dermatologist.be

CLIDERM (Clinics in Dermatology), European Insititute for Dermatology Practice and Re‐ search (EIDPR), CHIREC et CHIREC CANCER INSTITUTE, Brussels, Belgium
