The Pan-Immune-Inflammation Value in Patients with Metastatic Melanoma Receiving First-Line Therapy

Springer Science and Business Media LLC - Tập 16 - Trang 529-536 - 2021
Giovanni Fucà1, Teresa Beninato1, Marta Bini1, Laura Mazzeo1, Lorenza Di Guardo1, Carolina Cimminiello1, Giovanni Randon1, Giulia Apollonio1, Ilaria Bisogno1, Marta Del Vecchio2, Claudia Lauria Pantano2, Massimo Di Nicola1, Filippo de Braud1,3, Michele Del Vecchio1
1Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
2Unit of Pharmacy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
3Oncology and Hemato-oncology Department, University of Milan, Milan, Italy

Tóm tắt

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 (103/mm3) × platelet count (103/mm3) × monocyte count (103/mm3)]/lymphocyte count (103/mm3). 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.

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Springer Science and Business Media LLC

Tập 16

529-536

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