Department of Pathology, Hôpital Haut-Lévêque (CHU de Bordeaux), 33604, Pessac, France.
Department of Pathology, Oncopole de Toulouse, 31100, Toulouse, France.
Br J Cancer. 2018 Jul;119(2):193-199. doi: 10.1038/s41416-018-0168-9. Epub 2018 Jul 5.
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.
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.
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).
Combining these reproducible biomarkers could help improve therapeutic decision-making for patients with progressive disease.
目前，晚期黑色素瘤患者使用抗程序性死亡受体-1（PD-1）免疫治疗不受任何生物标志物评估的限制。程序性死亡配体-1（PD-L1）表达状态的测定具有技术挑战性，并且不是强制性的，因为阴性肿瘤也能获得治疗反应。然而，具有预测抗 PD-1 治疗反应的可重复生物标志物可能有助于改善治疗决策。
本回顾性研究纳入了 70 名转移性黑色素瘤患者，旨在评估临床、组织学、免疫组织化学和/或分子标准与 6 个月客观缓解率之间的关系。
更好的客观缓解率与异时性转移（P=0.04）、PD-L1 肿瘤和/或免疫细胞状态（P=0.01）、原发性黑色素瘤进展边缘的 CD163+组织细胞（P=0.009）和 NRAS 突变（P=0.019）有关。此外，原发性黑色素瘤进展边缘的 CD163+组织细胞（P=0.04）与更长的无进展生存期（PFS）相关，而异时性转移与更长的总生存期（P=0.02）和 PFS（P=0.049）相关。
结合这些可重复的生物标志物可以帮助改善进展性疾病患者的治疗决策。
