Department of Dermatology, University Hospital Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Germany.
Department for Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany.
J Cancer Res Clin Oncol. 2024 May 25;150(5):275. doi: 10.1007/s00432-024-05812-4.
Adjuvant immunotherapy with immune checkpoint blockade(ICB) has greatly reduced the risk of recurrence and metastatic spread in early and advanced melanoma. However, not all patients benefit from adjuvant treatment: many patients show disease recurrence despite therapy, while those without recurrence harbor the risk for potentially irreversible adverse events. Biomarkers to select patients benefitting most from adjuvant therapy are currently lacking. As body composition assessment using CT images has shown promising results as a prognostic biomarker in stage IV melanoma, we aim to study the applicability of body composition parameters also in adjuvant melanoma treatment.
We analyze body composition features via CT scans in a retrospective cohort of 109 patients with resected stage IIB-IV melanoma receiving an adjuvant first-line treatment with ICB in our department. In this analysis, we focus on the impact of body composition, especially the presence of low skeletal muscle mass (LSMM), on patients' survival and occurrence of adverse events (AEs).
In uni- and multivariate analyses, we identify an association between CT-measured LSMM and melanoma-specific survival in patients treated with adjuvant ICB. Furthermore, LSMM is associated with a lower risk for therapy-related AEs, especially hypothyroidism, fatigue, and xerostomia. Conventional serological biomarkers e.g. S100 and LDH and measures of adipose tissue compartments did not show a correlation with survival or the occurrence of AEs.
LSMM constitutes a novel biomarker for melanoma-specific survival in patients treated with adjuvant ICB.
免疫检查点阻断（ICB）的辅助免疫疗法大大降低了早期和晚期黑色素瘤患者的复发和转移扩散风险。然而，并非所有患者都能从辅助治疗中获益：许多患者尽管接受了治疗，但仍出现疾病复发，而未复发的患者则存在潜在的不可逆不良事件风险。目前缺乏能够选择最受益于辅助治疗的患者的生物标志物。由于使用 CT 图像评估身体成分已显示出作为 IV 期黑色素瘤预后生物标志物的良好结果，我们旨在研究身体成分参数在辅助黑色素瘤治疗中的适用性。
我们通过 CT 扫描分析了在我科接受 ICB 辅助一线治疗的 109 例 IIB-IV 期黑色素瘤切除患者的身体成分特征。在这项分析中，我们重点关注身体成分，尤其是低骨骼肌量（LSMM）对患者生存和不良事件（AE）发生的影响。
在单变量和多变量分析中，我们发现 CT 测量的 LSMM 与接受辅助 ICB 治疗的患者的黑色素瘤特异性生存相关。此外，LSMM 与治疗相关 AE 的风险降低相关，尤其是甲状腺功能减退症、疲劳和口干。传统的血清学生物标志物，如 S100 和 LDH，以及脂肪组织隔室的测量值与生存或 AE 的发生没有相关性。
LSMM 构成了接受辅助 ICB 治疗的黑色素瘤患者的黑色素瘤特异性生存的新型生物标志物。
