Figure 3. Metastatic efficiency in NSG mice correlated with disease progression in patients.

(A) Side-by-side comparison of distant metastasis in patients versus metastasis in mice for all 22 patients from whom follow-up clinical data were available after tumor banking. Most of the melanomas were lymph node metastases from stage IIIB/C patients at the time of banking. The melanomas were ranked by clinicians in terms of the aggressiveness of disease in patients after banking, based primarily on the rate of metastasis, from 514 at the top (most aggressive) to 498/499 at the bottom (least aggressive). The latest AJCC stage (or stage at time of death) and the time (in months) of survival after tumor banking are indicated in the “most recent survival and staging data” column. The patients with melanomas 514 to 492 formed distant metastases (stage IV disease) and died 3.4 to 40.6 months after melanoma banking. The patient who donated melanoma 600 remained alive at last follow-up, 33.2 months after melanoma banking but had progressed to stage IV disease with brain metastasis. All of the patients who progressed to stage IV disease did so within 22 months of tumor banking. The patients with melanomas 651 to 498/499 did not form distant metastases or progress to stage IV disease. Patient 528 died 40.7 months after melanoma banking with lung cancer and advanced chronic obstructive pulmonary disease but no evidence of melanoma at the time of death. See Table S1 for clinical details. All 16 of the melanomas that formed distant metastases in patients (stage IV disease) also metastasized to multiple organs in NSG mice (see Fig. 2K). Of the 6 melanomas that did not form distant metastases in patients, 5 also did not metastasize widely in mice (no metastasis or only micrometastases in the lungs, no metastasis to other organs; see Fig. 2K). (B) Side by side comparison of brain metastasis in patients and in NSG mice injected subcutaneously with the same melanomas. (C) Kaplan-Meier survival curves for all patients with at least 30 months of follow-up after tumor banking. Patients with melanomas that did not metastasize widely in mice lived significantly longer than all patients or than patients whose melanomas metastasized widely in mice (log-rank test, P<0.05).