Clinical, histological and molecular predictors of metastatic melanoma responses to anti-PD-1 immunotherapy
Menée à partir de données portant sur 70 patients atteints d'un mélanome métastatique traité par immunothérapie anti-PD-1, cette étude identifie des facteurs moléculaires, histologiques ou cliniques associés à la réponse thérapeutique
Background : Prescribing anti-programmed death-1 (PD-1) immunotherapy for advanced melanoma is currently not restricted by any biomarker assessment. Determination of programmed death-ligand-1 (PD-L1)-expression status is technically challenging and is not mandatory, because negative tumours also achieve therapeutic responses. However, reproducible biomarkers predictive of a response to anti-PD-1 therapy could contribute to improving therapeutic decision-making.
Methods : This retrospective study on 70 metastatic melanoma patients was undertaken to evaluate the relationships between clinical, histological, immunohistochemical and/or molecular criteria, and the 6-month objective response rate.
Results : Better objective response rates were associated with metachronous metastases (P = 0.04), PD-L1 tumour- and/or immune-cell status (P = 0.01), CD163+ histiocytes at advancing edges (P = 0.009) of primary melanomas and NRAS mutation (P = 0.019). Moreover, CD163+ histiocytes at advancing edges (P = 0.04) were associated with longer progression-free survival (PFS), and metachronous metastases with longer overall survival (P = 0.02) and PFS (P = 0.049).
Conclusions : Combining these reproducible biomarkers could help improve therapeutic decision-making for patients with progressive disease.
British Journal of Cancer , résumé, 2018