Ipilimumab, the first immune-checkpoint inhibitor extending overall survival (OS) in metastatic melanoma patients, has a survival benefit only in a proportion of patients and the development of reliable predictive biomarkers is still an unmet need. To meet this request, we used a multivariate statistical approach to test whether myeloid-derived suppressor cells (MDSC) or other tumor-associated and immunological parameters may serve as predictive or prognostic biomarkers in melanoma patients receiving ipilimumab. By using a standardized approach to determine the circulating levels of four MDSC subsets, we observed a significant expansion of three MDSC subsets at baseline, as compared to controls and, upon treatment, that high levels of CD14(+)/IL4Rα(+) MDSCs were an independent prognostic factor of reduced OS. On the contrary, longer OS was associated to low levels of the proinflammatory proteins IL-6 and CRP and tumor-associated factors S100B and LDH both at baseline and after treatment. Increasing number of total T cells and especially of PD-1(+)/CD4(+) T cells were associated with better prognosis, and upregulation of PD-1(+) expression on CD4(+) T cells upon treatment was associated with lower toxicity. As several parameters were associated to OS, we included these factors in a multivariate survival model, and we identified IL-6 and ECOG PS as independent biomarkers associated with improved OS, whereas high levels of LDH and CD14(+)/IL4Rα(+) MDSCs were negative independent markers of reduced OS.

Clinical implication of tumor-associated and immunological parameters in melanoma patients treated with ipilimumab

DAMUZZO, VERA;SOLITO, SAMANTHA;PINTON, LAURA;CARROZZO, ANNA ELEONORA;VALPIONE, SARA;PIGOZZO, JACOPO;ARBORETTI GIANCRISTOFARO, ROSA;CHIARION SILENI, VANNA;MANDRUZZATO, SUSANNA
2016

Abstract

Ipilimumab, the first immune-checkpoint inhibitor extending overall survival (OS) in metastatic melanoma patients, has a survival benefit only in a proportion of patients and the development of reliable predictive biomarkers is still an unmet need. To meet this request, we used a multivariate statistical approach to test whether myeloid-derived suppressor cells (MDSC) or other tumor-associated and immunological parameters may serve as predictive or prognostic biomarkers in melanoma patients receiving ipilimumab. By using a standardized approach to determine the circulating levels of four MDSC subsets, we observed a significant expansion of three MDSC subsets at baseline, as compared to controls and, upon treatment, that high levels of CD14(+)/IL4Rα(+) MDSCs were an independent prognostic factor of reduced OS. On the contrary, longer OS was associated to low levels of the proinflammatory proteins IL-6 and CRP and tumor-associated factors S100B and LDH both at baseline and after treatment. Increasing number of total T cells and especially of PD-1(+)/CD4(+) T cells were associated with better prognosis, and upregulation of PD-1(+) expression on CD4(+) T cells upon treatment was associated with lower toxicity. As several parameters were associated to OS, we included these factors in a multivariate survival model, and we identified IL-6 and ECOG PS as independent biomarkers associated with improved OS, whereas high levels of LDH and CD14(+)/IL4Rα(+) MDSCs were negative independent markers of reduced OS.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11577/3218218
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