Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Unit of Pharmacy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Target Oncol. 2021 Jul;16(4):529-536. doi: 10.1007/s11523-021-00819-0. Epub 2021 Jun 2.
Since a non-negligible fraction of patients with metastatic melanoma does not experience long-term disease control, even with immunotherapy and targeted therapy, new biomarkers for patient stratification and treatment tailoring are needed in this setting.
We investigated the association of a novel immune-inflammatory blood-based biomarker, the Pan-Immune-Inflammation Value (PIV), with clinical outcomes of patients with metastatic melanoma receiving first-line therapy.
We retrospectively included patients treated at the Fondazione IRCCS Istituto Nazionale dei Tumori of Milan and having an available baseline complete blood cell count (CBC). PIV was calculated as: [neutrophil count (10/mm) × platelet count (10/mm) × monocyte count (10/mm)]/lymphocyte count (10/mm).
A total of 228 patients were included: 119 (52%) had been treated with immunotherapy and 109 (48%) with targeted therapy. PIV was significantly higher in patients with ECOG PS ≥ 1, high disease burden, synchronous metastases, and elevated baseline LDH level. High baseline PIV was independently associated with poor overall survival (adjusted hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.30-3.29; adjusted P = 0.002) and progression-free survival (adjusted HR 1.56; 95% CI 1.01-2.41; adjusted P = 0.044). High PIV was also associated with primary resistance to both immunotherapy (odds ratio [OR]: 3.98; 95% CI 1.45-12.32; P = 0.005) and targeted therapy (OR: 8.42; 95% CI 2.50-34.5; P < 0.001). PIV showed a promising discrimination ability in terms of AIC and c-index when compared with other CBC-based biomarkers.
PIV may guide the treatment decision process and the development of novel first-line treatment strategies in melanoma, but warrants further study and validation.
由于转移性黑色素瘤患者中相当一部分即使接受免疫治疗和靶向治疗也无法长期控制疾病，因此需要新的生物标志物来对患者进行分层和治疗个体化。
我们研究了一种新的免疫炎症性血液生物标志物——全免疫炎症值（PIV）与接受一线治疗的转移性黑色素瘤患者临床结局的相关性。
我们回顾性纳入了在米兰国家肿瘤研究所基金会 IRCCS 接受治疗且有基线完整血细胞计数（CBC）的患者。PIV 的计算方法为：[中性粒细胞计数（10/mm）×血小板计数（10/mm）×单核细胞计数（10/mm）]/淋巴细胞计数（10/mm）。
共纳入 228 例患者：119 例（52%）接受免疫治疗，109 例（48%）接受靶向治疗。ECOG PS≥1、疾病负荷高、同步转移和基线 LDH 水平升高的患者 PIV 明显较高。基线时 PIV 较高与总生存期（调整后的危险比[HR]：2.06；95%置信区间[CI]：1.30-3.29；调整后的 P=0.002）和无进展生存期（调整后的 HR 1.56；95% CI 1.01-2.41；调整后的 P=0.044）较差独立相关。PIV 较高也与免疫治疗（比值比[OR]：3.98；95% CI 1.45-12.32；P=0.005）和靶向治疗（OR：8.42；95% CI 2.50-34.5；P<0.001）的原发性耐药相关。与其他基于 CBC 的生物标志物相比，PIV 在 AIC 和 C 指数方面具有良好的区分能力。
PIV 可能指导黑色素瘤的治疗决策过程和新的一线治疗策略的制定，但需要进一步研究和验证。
