Blood Predictive Biomarkers for Nivolumab in Advanced Melanoma

Acta Derm Venereol. 2018 Apr 16;98(4):406-410. doi: 10.2340/00015555-2872.

Abstract

Nivolumab response rate is 40% in metastatic melanoma. Few studies have evaluated pre-treatment biomarkers predictive of response. The aim of this study was to identify potential peripheral blood biomarkers associated with survival in patients with advanced melanoma treated with nivolumab. All advanced melanoma cases treated with anti-programmed cell death protein 1 (anti-PD1) over a 3-year period in the Dermato-Oncology Department, Nantes, France were identified. For each case, 9 potential blood biomarkers were identified. Bivariate and multivariate analyses, adjusted for the American Joint Committee on Cancer (AJCC) classification stage, Eastern Cooperative Oncology Group (ECOG) performance status, lactate dehydrogenase (LDH) level and failure to respond to first-line therapy, were used to test the association between biomarkers and overall survival (primary outcome) or progression-free survival (secondary outcome). Increased monocyte count, leukocyte/lymphocyte ratio and neutrophil/lymphocyte ratio were significantly associated with decreased overall survival after bivariate and multivariate analyses. Increased monocyte count was also significantly associated with decreased progression-free survival. These blood variables are easily measured and could help to predict patient response before the introduction of anti-PD1 therapy.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal / adverse effects
  • Antibodies, Monoclonal / therapeutic use*
  • Antineoplastic Agents, Immunological / adverse effects
  • Antineoplastic Agents, Immunological / therapeutic use*
  • Biomarkers, Pharmacological / blood*
  • Biomarkers, Tumor / blood*
  • C-Reactive Protein / metabolism
  • Clinical Decision-Making
  • Disease-Free Survival
  • Female
  • France
  • Humans
  • L-Lactate Dehydrogenase / blood
  • Leukocyte Count
  • Leukocytes*
  • Lymphocytes
  • Male
  • Melanoma / blood
  • Melanoma / drug therapy*
  • Melanoma / mortality
  • Melanoma / pathology
  • Middle Aged
  • Monocytes
  • Multivariate Analysis
  • Neutrophils
  • Nivolumab
  • Patient Selection
  • Pilot Projects
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Retrospective Studies
  • Skin Neoplasms / blood
  • Skin Neoplasms / drug therapy*
  • Skin Neoplasms / mortality
  • Skin Neoplasms / pathology
  • Time Factors
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents, Immunological
  • Biomarkers, Pharmacological
  • Biomarkers, Tumor
  • Nivolumab
  • C-Reactive Protein
  • L-Lactate Dehydrogenase