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Dynamics of clinical biomarkers as predictors of immunotherapy benefit in metastatic melanoma patients

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Abstract

Purpose

Baseline LDH, derived neutrophil–lymphocyte ratio (dNLR) and immune-related adverse events (irAEs) are associated with outcomes of patients with metastatic melanoma (MM). We hypothesized whether dynamic shifts in LDH, dNLR and incidence of irAEs may impact the prognosis of MM patients treated with anti-CTLA4 or anti-PD1 as single agents.

Methods

Retrospective analysis of medical charts from MM patients with prospective monitoring of dNLR, LDH values and irAE incidence. Primary endpoint was overall survival (OS).

Results

Patients switching from either high dNLR (≥2.5) to low dNLR (HR: 0.14; 0.03–0.74; p = 0.02) or high LDH (≥1.5 × ULN) to low LDH levels (HR: 0.08; 0.01–0.68; p = 0.02) had significantly better OS than those with high dNLR or LDH scores at the end of cycle 2. Longer OS was also observed in patients developing irAEs ≥ grade 2 as compared to no irAEs (HR: 0.2; 0.05–0.89; p = 0.03).

Conclusions

We found that major shifts in dNLR and LDH measures from baseline to cycle 2 measures and shifts from baseline to cycle 2 are significantly associated with OS in MM patients receiving single agent anti-PD1 therapy. Laboratory changes and clinical variables may help optimize prognostic estimates.

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Authors and Affiliations

  1. Vall D’Hebron University Hospital, Barcelona, Spain

    A. Hernando-Calvo, A. García-Alvarez, C. Ortiz, D. Bodet, V. García-Patos & E. Muñoz-Couselo

  2. Vall D’Hebron Institute of Oncology (VHIO), Barcelona, Spain

    G. Villacampa & R. Dienstmann

  3. Vall D’Hebron University Hospital, Vall D’Hebron Research Institute (VHIR), Barcelona, Spain

    J. A. Recio

Authors
  1. A. Hernando-Calvo
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  2. A. García-Alvarez
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  3. G. Villacampa
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  4. C. Ortiz
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Correspondence to E. Muñoz-Couselo.

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Conflict of interest

RD reported receiving honoraria for speaker activities from Roche, Ipsen, Amgen, Sanofi, Servier Laboratories, Merck Sharp & Dohme; advisory role from Roche and Boehringer Ingelheim; and research grants from Merck and Pierre Fabre. GV reported receiving honoraria for speaker activities from Merck Sharp & Dohme. The rest of the authors declare that they have no conflict of interest.

Ethical approval

All the patients provided consent to participate in secondary research when they provided informed consent to take part of clinical trials in our institution, because of the observational nature of this research manuscript no additional consent was required.

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All the patients provided consent to participate in secondary research when they provided informed consent to take part of clinical trials in our institution.

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Hernando-Calvo, A., García-Alvarez, A., Villacampa, G. et al. Dynamics of clinical biomarkers as predictors of immunotherapy benefit in metastatic melanoma patients. Clin Transl Oncol 23, 311–317 (2021). https://doi.org/10.1007/s12094-020-02420-9

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  • DOI: https://doi.org/10.1007/s12094-020-02420-9

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