C-reactive protein flare predicts response to checkpoint inhibitor treatment in melanoma
Standard
C-reactive protein flare predicts response to checkpoint inhibitor treatment in melanoma. / Kött, Julian; Zimmermann, Noah; Zell, Tim; Heidrich, Isabel; Geidel, Glenn; Rünger, Alessandra; Smit, Daniel J.; Merkle, Myriam; Parnian, Niousha; Hansen, Inga; Hoehne, Inka; Abeck, Finn; Torster, Leopold; Weichenthal, Michael; Pantel, Klaus; Schneider, Stefan W; Gebhardt, Christoffer.
In: J EUR ACAD DERMATOL, Vol. 38, No. 8, 08.2024, p. 1575–1587.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
Harvard
APA
Vancouver
Bibtex
}
RIS
TY - JOUR
T1 - C-reactive protein flare predicts response to checkpoint inhibitor treatment in melanoma
AU - Kött, Julian
AU - Zimmermann, Noah
AU - Zell, Tim
AU - Heidrich, Isabel
AU - Geidel, Glenn
AU - Rünger, Alessandra
AU - Smit, Daniel J.
AU - Merkle, Myriam
AU - Parnian, Niousha
AU - Hansen, Inga
AU - Hoehne, Inka
AU - Abeck, Finn
AU - Torster, Leopold
AU - Weichenthal, Michael
AU - Pantel, Klaus
AU - Schneider, Stefan W
AU - Gebhardt, Christoffer
N1 - © 2024 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.
PY - 2024/8
Y1 - 2024/8
N2 - BACKGROUND: The treatment of melanoma has been revolutionized by the use of immune checkpoint inhibition (ICI), but many patients do not benefit. Furthermore, immune-related adverse events may occur during therapy. A predictive biomarker is needed to reliably identify patients benefitting. In lung, renal cell and bladder cancer early C-reactive protein (CRP) kinetics were shown to be a predictive biomarker for ICI.OBJECTIVE: Here, we investigate early CRP kinetics as predictive biomarker for ICI in melanoma patients.METHODS: Two independent prospectively collected cohorts were analysed: Cohort 1 (n = 87) with advanced and Cohort 2 (n = 99) with completely resected melanoma. Patients were stratified by in the dynamics of CRP after ICI initiation: A doubling of baseline CRP within 30 days followed by at least a 30% drop within 3 months was classified as a CRP flare. If no doubling of CRP was reported, but a 30% drop within 3 months, patients were classified as CRP responders and all others as CRP non-responders. Analysed factors included clinical characteristics like S100B and LDH. Median follow-up was 1.5 and 1.7 years for Cohorts 1 and 2.RESULTS: In Cohort 1 CRP flare (n = 12), CRP responders (n = 43) and CRP non-responders (n = 32) with a progression-free survival (PFS) of 0.7, 0.6 and 0.2 years (p = 0.017) and an overall survival (OS) of 2.2, 1.5 and 1.0 years (p = 0.014), respectively. Multivariable Cox analysis showed an independent risk reduction of progression for CRP responders by 62% compared to CRP non-responders (p = 0.001). In Cohort 2 CRP flare (n = 13), CRP responders (n = 70) and CRP non-responders (n = 16) the log-rank analysis showed a significant difference between OS and recurrence-free survival (RFS) curves (p = 0.046 and p = 0.049).CONCLUSION: Early CRP kinetics could indicate a response to ICI with improved OS and RFS/PFS. CRP flare and CRP response indicating significantly improved outcomes compared to CRP non-responders.
AB - BACKGROUND: The treatment of melanoma has been revolutionized by the use of immune checkpoint inhibition (ICI), but many patients do not benefit. Furthermore, immune-related adverse events may occur during therapy. A predictive biomarker is needed to reliably identify patients benefitting. In lung, renal cell and bladder cancer early C-reactive protein (CRP) kinetics were shown to be a predictive biomarker for ICI.OBJECTIVE: Here, we investigate early CRP kinetics as predictive biomarker for ICI in melanoma patients.METHODS: Two independent prospectively collected cohorts were analysed: Cohort 1 (n = 87) with advanced and Cohort 2 (n = 99) with completely resected melanoma. Patients were stratified by in the dynamics of CRP after ICI initiation: A doubling of baseline CRP within 30 days followed by at least a 30% drop within 3 months was classified as a CRP flare. If no doubling of CRP was reported, but a 30% drop within 3 months, patients were classified as CRP responders and all others as CRP non-responders. Analysed factors included clinical characteristics like S100B and LDH. Median follow-up was 1.5 and 1.7 years for Cohorts 1 and 2.RESULTS: In Cohort 1 CRP flare (n = 12), CRP responders (n = 43) and CRP non-responders (n = 32) with a progression-free survival (PFS) of 0.7, 0.6 and 0.2 years (p = 0.017) and an overall survival (OS) of 2.2, 1.5 and 1.0 years (p = 0.014), respectively. Multivariable Cox analysis showed an independent risk reduction of progression for CRP responders by 62% compared to CRP non-responders (p = 0.001). In Cohort 2 CRP flare (n = 13), CRP responders (n = 70) and CRP non-responders (n = 16) the log-rank analysis showed a significant difference between OS and recurrence-free survival (RFS) curves (p = 0.046 and p = 0.049).CONCLUSION: Early CRP kinetics could indicate a response to ICI with improved OS and RFS/PFS. CRP flare and CRP response indicating significantly improved outcomes compared to CRP non-responders.
U2 - 10.1111/jdv.19941
DO - 10.1111/jdv.19941
M3 - SCORING: Journal article
C2 - 38466133
VL - 38
SP - 1575
EP - 1587
JO - J EUR ACAD DERMATOL
JF - J EUR ACAD DERMATOL
SN - 0926-9959
IS - 8
ER -