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In a study that was published in the Journal of the American Academy of Dermatology, February 2006, 117 consecutive melanoma patients were enrolled between January 1997 and August 2004 at Department of Dermatology, Catholic University of the Sacred Heart, Rome, Italy.
Plasma coenzyme Q10 (CoQ10) levels were measured upon enrollment. One hundred twenty five matched volunteers without any clinical suspected pigmented lesions were also utilized in the study.
Researchers found that CoQ10 levels were significantly lower in melanoma patients than in control subjects. Further, it was noted that for melanoma patients with CoQ10 blood levels of less than 0.6 mg per liter, risk of developing metastatic disease increased by 790 percent, compared to those melanoma patients with blood levels of 0.6 mg per liter or higher. In addition, melanoma patients with higher blood levels were noted to have a metastasis-free interval that was almost double compared to patients with lower levels.
Of the 82 patients with low CoQ10 levels, 17 died during the study, compared to none of the 35 patients with higher CoQ10. CoQ10 levels did not vary by sex.
Levels of CoQ10 correlated well with tumor thickness, which is currently the best indicator of melanoma progression. Specifically, lower CoQ10 levels correlated with increased tumor thickness and poorer prognosis.
The study notes that abnormally low plasma levels of CoQ10 previously have been known in patients with cancer of the breast, lung and pancreas. This study may be the first to indicate that lower blood levels of CoQ10 can have an extremely adverse effect. Dr. Rusciani, lead study author, concluded that analysis of their findings suggested baseline CoQ10 levels are a powerful and independent prognostic factor that can be used to estimate risk for melanoma progression.
Statin drugs are known to lower CoQ10 levels. Will we find that melanoma progression is therefore another side effect of statins?
BACKGROUND: Abnormally low plasma levels of coenzyme Q10 (CoQ10) have been found in patients with cancer of the breast, lung, or pancreas. OBJECTIVE: A prospective study of patients with melanoma was conducted to assess the usefulness of CoQ10 plasma levels in predicting the risk of metastasis and the duration of the metastasis-free interval.
METHODS: Between January 1997 and August 2004, plasma CoQ10 levels were measured with high-performance liquid chromatography in 117 consecutive melanoma patients without clinical or instrumental evidence of metastasis according to American Joint Committee on Cancer criteria and in 125 matched volunteers without clinically suspect pigmented lesions. Patients taking CoQ10 or cholesterol-lowering medications and those with a diagnosis of diabetes mellitus were excluded from the study. Multiple statistical methods were used to evaluate differences between patients and control subjects and between patients who did (32.5%) and did not (67.5%) develop metastases during follow-up.
RESULTS: CoQ10 levels were significantly lower in patients than in control subjects (t test: P < .0001) and in patients who developed metastases than in the metastasis-free subgroup (t test: P < .0001). Logistic regression analysis indicated that plasma CoQ10 levels were a significant predictor of metastasis (P = .0013). The odds ratio for metastatic disease in patients with CoQ10 levels that were less than 0.6 mg/L (the low-end value of the range measured in a normal population) was 7.9, and the metastasis-free interval was almost double in patients with CoQ10 levels 0.6 mg/L or higher (Kaplan-Meier analysis: P < .001).
LIMITATIONS: A study with a larger sample, which is currently being recruited, and a longer follow-up will doubtlessly increase the statistical power and enable survival statistics to be obtained.
CONCLUSIONS: Analysis of our findings suggests that baseline plasma CoQ10 levels are a powerful and independent prognostic factor that can be used to estimate the risk for melanoma progression.
Rusciani L, Proietti I, Rusciani A, Paradisi A, Sbordoni G, Alfano C, Panunzi S, De Gaetano A, Lippa S. Low plasma coenzyme Q10 levels as an independent prognostic factor for melanoma progression. J Am Acad Dermatol. Feb 2006, Vol. 54, Issue 2: p. 234-241.