Baseline Peripheral Blood Biomarkers Associated with Clinical Outcome of Advanced Melanoma Patients Treated with Ipilimumab

Abstract : Purpose: To identify baseline peripheral blood biomarkers associated with clinical outcome following ipilimumab treatment in advanced melanoma patients. Experimental Design: Frequencies of myeloid-derived suppressor cells (MDSC) and regulatory T cells (Treg), serum lactate dehydrogenase (LDH), routine blood counts, and clinical characteristics were assessed in 209 patients. Endpoints were overall survival (OS) and best overall response. Statistical calculations were done by Kaplan–Meier and Cox regression analysis, including calibration and discrimination by C-statistics. Results: Low baseline LDH, absolute monocyte counts (AMC), Lin À CD14 þ HLA-DR À/low-MDSC frequencies, and high absolute eosinophil counts (AEC), relative lymphocyte counts (RLC), and CD4 þ CD25 þ FoxP3 þ-Treg frequencies were significantly associated with better survival, and were considered in a combination model. Patients (43.5%) presenting with the best biomarker signature had a 30% response rate and median survival of 16 months. In contrast, patients with the worst biomarkers (27.5%) had only a 3% response rate and median survival of 4 months. The occurrence of adverse events correlated with neither baseline biomarker signatures nor the clinical benefit of ipilimumab. In another model, limited to the routine parameters LDH, AMC, AEC, and RLC, the number of favorable factors (4 vs. 3 vs. 2–0) was also associated with OS (P < 0.001 for all pairwise comparisons) in the main study and additionally in an independent validation cohort. Conclusions: A baseline signature of low LDH, AMC, and MDSCs as well as high AEC, Tregs, and RLC is associated with favorable outcome following ipilimumab. Prospective investigation of the predictive impact of these markers following ipilimu-mab and other treatments, e.g., PD-1 antibodies, is warranted.
Document type :
Journal articles
Complete list of metadatas

Cited literature [50 references]  Display  Hide  Download

https://www.hal.inserm.fr/inserm-01409624
Contributor : Elizabeth Bernardo <>
Submitted on : Tuesday, December 6, 2016 - 9:27:13 AM
Last modification on : Tuesday, August 13, 2019 - 10:50:17 AM
Long-term archiving on: Tuesday, March 21, 2017 - 4:32:04 AM

File

 Restricted access
To satisfy the distribution rights of the publisher, the document is embargoed until : jamais

Please log in to resquest access to the document

Identifiers

Collections

Citation

Alexander Martens, Kilian Wistuba-Hamprecht, Marnix Geukes Foppen, Jianda Yuan, Michael Postow, et al.. Baseline Peripheral Blood Biomarkers Associated with Clinical Outcome of Advanced Melanoma Patients Treated with Ipilimumab. Clinical Cancer Research, American Association for Cancer Research, 2016, 22, pp.2908 - 2918. ⟨10.1158/1078-0432.CCR-15-2412⟩. ⟨inserm-01409624⟩

Share

Metrics

Record views

213