Baseline peripheral blood biomarkers associated with clinical outcome of advanced melanoma patients treated with ipilimumab Journal Article


Authors: Martens, A.; Wistuba-Hamprecht, K.; Foppen, M. G.; Yuan, J.; Postow, M. A.; Wong, P.; Romano, E.; Khammari, A.; Dreno, B.; Capone, M.; Ascierto, P. A.; Di Giacomo, A. M.; Maio, M.; Schilling, B.; Sucker, A.; Schadendorf, D.; Hassel, J. C.; Eigentler, T. K.; Martus, P.; Wolchok, J. D.; Blank, C.; Pawelec, G.; Garbe, C.; Weide, B.
Article Title: 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(-)CD14(+)HLA-DR-/low-MDSC frequencies, and high absolute eosinophil counts (AEC), relative lymphocyte counts (RLC), and CD4(+)CD25(+)FoxP3(+)-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 ipilimumab and other treatments, e.g., PD-1 antibodies, is warranted. (C) 2016 AACR.
Keywords: survival; experience; lymphocyte count; metastatic melanoma; ctla-4 blockade; t-cells; suppressor-cells; prognostic model; expanded access program; cancer
Journal Title: Clinical Cancer Research
Volume: 22
Issue: 12
ISSN: 1078-0432
Publisher: American Association for Cancer Research  
Date Published: 2016-06-15
Start Page: 2908
End Page: 2918
Language: English
ACCESSION: WOS:000377958800011
DOI: 10.1158/1078-0432.ccr-15-2412
PROVIDER: wos
PUBMED: 26787752
PMCID: PMC5770142
Notes: Article -- Source: Wos
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  1. Jedd D Wolchok
    905 Wolchok
  2. Michael Andrew Postow
    362 Postow
  3. Phillip Wong
    80 Wong
  4. Jianda Yuan
    105 Yuan