Circulating inflammatory proteins associate with response to immune checkpoint inhibition therapy in patients with advanced melanoma



Rossi, Niccolo, Lee, Karla A, Bermudez, Maria V, Visconti, Alessia, Thomas, Andrew Maltez, Bolte, Laura A, Bjork, Johannes R, Ruijter, Laura Kist de, Newton-Bishop, Julia, Harland, Mark
et al (show 16 more authors) (2022) Circulating inflammatory proteins associate with response to immune checkpoint inhibition therapy in patients with advanced melanoma. EBIOMEDICINE, 83. 104235-.

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Abstract

<h4>Background</h4>Inflammation can modulate tumour growth and progression, and influence clinical response to treatment. We investigated the potential of circulating inflammatory proteins for response stratification of immune checkpoint inhibitor (ICI) therapy for advanced melanoma.<h4>Methods</h4>Study subjects were 87 patients with unresectable stage III or IV cutaneous melanoma from the multiple centres across the United Kingdom (UK) and the Netherlands (NL) who received ipilimumab, nivolumab, or pembrolizumab, or a combination of ipilimumab and nivolumab. Serum samples were collected before and during ICI therapy at follow-up visits scheduled every third week over a 12-week period. We performed targeted quantification of 92 proteins involved in inflammation and tested for association of their pre-treatment and on-treatment levels, as well as longitudinal changes, with overall response rate, progression-free survival, and overall survival.<h4>Findings</h4>We observed consistently higher pre-treatment levels of interleukin-6 (IL-6), hepatocyte growth factor (HGF), and monocyte chemotactic protein 2 (MCP-2), in non-responders compared to responders (meta-analysis p=3.31 × 10<sup>-4</sup>, 2.29 × 10<sup>-4</sup>, and 1.02 × 10<sup>-3</sup>, respectively). Patients' stratification according to the median value of IL-6, HGF, and MCP-2 highlighted a cumulative negative effect of pre-treatment levels of the three proteins on response (p=1.13 × 10<sup>-2</sup>), with overall response rate among patients presenting with combined elevated IL-6, HGF, and MCP-2 levels being three-fold lower (26.7%) compared to patients with none of the three proteins elevated (80.0%, p=9.22 × 10<sup>-3</sup>). Longitudinal data analysis showed that on-treatment changes in circulating inflammatory proteins are not correlated with response.<h4>Interpretation</h4>Our findings are in line with an increasing body of evidence that the pro-inflammatory cytokine IL-6 can influence response to ICI in advanced melanoma, and further support a role of circulating HGF and MCP-2 levels as prognostic biomarkers as suggested by previous smaller studies. Inflammatory proteins may serve as predictive biomarkers of ICI response and valuable targets for combination therapy.<h4>Funding</h4>This work was supported by the Seerave Foundation and Dutch Cancer Society.

Item Type: Article
Uncontrolled Keywords: Melanoma, Checkpoint inhibitors, Inflammatory proteins, Response, Survival
Divisions: Faculty of Health and Life Sciences
Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology
Depositing User: Symplectic Admin
Date Deposited: 25 Jan 2023 08:06
Last Modified: 29 Jan 2023 12:39
DOI: 10.1016/j.ebiom.2022.104235
Open Access URL: https://www.thelancet.com/journals/ebiom/article/P...
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URI: https://livrepository.liverpool.ac.uk/id/eprint/3167852