S. Lobo-Martins , D. Martins-Branco , P.M. Semedo , C.M. Alvim , A.M. Monteiro , I. Vendrell , E. Gouveia , M.J. Passos , L. Costa , A. Mansinho , R.T. de Sousa
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The predictive accuracy of the model was evaluated by the receiver operating characteristic (ROC) curve model.</div></div><div><h3>Results</h3><div>We identified 147 patients with a median follow-up of 28.9 months (95% CI 22.5-33.5 months). The median OS (mOS) for the whole cohort was 14.8 months (95% CI 10.8-18.7 months). Overall, 43 and 104 patients were treated with nivolumab and pembrolizumab, respectively. We identified four prognostic factors at baseline: ≥3 metastatic sites [hazard ratio (HR) 1.90, 95% CI 1.21-2.97], performance status by Eastern Cooperative Oncology Group ≥1 (HR 2.02, 95% CI 1.28-3.18), lymphopenia (HR 2.85, 95% CI 1.54-5.27) or increased lactate dehydrogenase (HR 2.08, 95% CI 1.19-3.63). The MELimmune score grouped patients into three risk categories: favourable prognosis (no risk factors; <em>n</em> = 34), intermediate prognosis (one risk factor; <em>n</em> = 65) and poor prognosis (two or more risk factors; <em>n</em> = 48). The mOS was 43.4 (95% CI 32.1-54.7), 14.4 (95% CI 6.8-22.0) and 6.5 (95% CI 3.6-9.4) months for favourable, intermediate and poor prognosis groups, respectively (<em>P</em> < 0.001). The area under the ROC curve was 0.74 (95% CI 0.66-0.82).</div></div><div><h3>Conclusion</h3><div>Using easily accessible variables from daily practice, the MELimmune prognostic score for patients with advanced melanoma treated with anti-PD-1 monotherapy holds potential to be used in clinical practice and prospectively validated in clinical trials.</div></div>","PeriodicalId":73352,"journal":{"name":"Immuno-oncology technology","volume":"25 ","pages":"Article 101043"},"PeriodicalIF":0.0000,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The MELimmune score—prognostic factors for overall survival in advanced melanoma and anti-PD-1 monotherapy—a multicentre, retrospective cohort study\",\"authors\":\"S. Lobo-Martins , D. Martins-Branco , P.M. Semedo , C.M. Alvim , A.M. Monteiro , I. Vendrell , E. Gouveia , M.J. Passos , L. Costa , A. Mansinho , R.T. de Sousa\",\"doi\":\"10.1016/j.iotech.2025.101043\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Immunotherapy has revolutionized advanced melanoma treatment. Several prognostic factors have been studied to predict survival in this setting. We aimed to develop a prognostic score.</div></div><div><h3>Materials and methods</h3><div>A multicentre, retrospective cohort study was conducted including patients with advanced melanoma who started anti-programmed cell death protein 1 (PD-1) monotherapy between January 2016 and October 2019 with ≤2 prior treatment lines. The study endpoint was overall survival (OS). Univariate and multivariate Cox regression identified independent prognostic factors, with 95% confidence intervals (CIs). The predictive accuracy of the model was evaluated by the receiver operating characteristic (ROC) curve model.</div></div><div><h3>Results</h3><div>We identified 147 patients with a median follow-up of 28.9 months (95% CI 22.5-33.5 months). The median OS (mOS) for the whole cohort was 14.8 months (95% CI 10.8-18.7 months). Overall, 43 and 104 patients were treated with nivolumab and pembrolizumab, respectively. We identified four prognostic factors at baseline: ≥3 metastatic sites [hazard ratio (HR) 1.90, 95% CI 1.21-2.97], performance status by Eastern Cooperative Oncology Group ≥1 (HR 2.02, 95% CI 1.28-3.18), lymphopenia (HR 2.85, 95% CI 1.54-5.27) or increased lactate dehydrogenase (HR 2.08, 95% CI 1.19-3.63). The MELimmune score grouped patients into three risk categories: favourable prognosis (no risk factors; <em>n</em> = 34), intermediate prognosis (one risk factor; <em>n</em> = 65) and poor prognosis (two or more risk factors; <em>n</em> = 48). The mOS was 43.4 (95% CI 32.1-54.7), 14.4 (95% CI 6.8-22.0) and 6.5 (95% CI 3.6-9.4) months for favourable, intermediate and poor prognosis groups, respectively (<em>P</em> < 0.001). 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引用次数: 0
摘要
免疫疗法已经彻底改变了晚期黑色素瘤的治疗。已经研究了几个预后因素来预测这种情况下的生存。我们的目标是建立一个预后评分。材料与方法一项多中心、回顾性队列研究纳入了2016年1月至2019年10月期间开始抗程序性细胞死亡蛋白1 （PD-1）单药治疗且≤2个既往治疗线的晚期黑色素瘤患者。研究终点为总生存期（OS）。单因素和多因素Cox回归确定独立预后因素，95%置信区间（ci）。采用受试者工作特征（ROC）曲线模型评价模型的预测准确性。结果147例患者的中位随访时间为28.9个月（95% CI 22.5-33.5个月）。整个队列的中位OS （mOS）为14.8个月（95% CI 10.8-18.7个月）。总体而言，分别有43例和104例患者接受了纳武单抗和派姆单抗治疗。我们在基线时确定了四个预后因素：≥3个转移部位[危险比（HR） 1.90, 95% CI 1.21-2.97]，东部肿瘤合作组的表现状态≥1 (HR 2.02, 95% CI 1.28-3.18)，淋巴细胞减少（HR 2.85, 95% CI 1.54-5.27）或乳酸脱氢酶升高（HR 2.08, 95% CI 1.19-3.63）。mel免疫评分将患者分为三种风险类别：预后良好(无危险因素；N = 34)，预后中等(1个危险因素；N = 65)和预后不良(两个或两个以上危险因素；N = 48)。良好、中度和不良预后组的生存时间分别为43.4 （95% CI 32.1-54.7）、14.4 （95% CI 6.8-22.0）和6.5 （95% CI 3.6-9.4）个月(P <；0.001)。ROC曲线下面积为0.74 （95% CI 0.66-0.82）。结论使用日常实践中易于获取的变量，melt免疫预后评分对于接受抗pd -1单药治疗的晚期黑色素瘤患者具有应用于临床实践和在临床试验中前瞻性验证的潜力。
The MELimmune score—prognostic factors for overall survival in advanced melanoma and anti-PD-1 monotherapy—a multicentre, retrospective cohort study
Background
Immunotherapy has revolutionized advanced melanoma treatment. Several prognostic factors have been studied to predict survival in this setting. We aimed to develop a prognostic score.
Materials and methods
A multicentre, retrospective cohort study was conducted including patients with advanced melanoma who started anti-programmed cell death protein 1 (PD-1) monotherapy between January 2016 and October 2019 with ≤2 prior treatment lines. The study endpoint was overall survival (OS). Univariate and multivariate Cox regression identified independent prognostic factors, with 95% confidence intervals (CIs). The predictive accuracy of the model was evaluated by the receiver operating characteristic (ROC) curve model.
Results
We identified 147 patients with a median follow-up of 28.9 months (95% CI 22.5-33.5 months). The median OS (mOS) for the whole cohort was 14.8 months (95% CI 10.8-18.7 months). Overall, 43 and 104 patients were treated with nivolumab and pembrolizumab, respectively. We identified four prognostic factors at baseline: ≥3 metastatic sites [hazard ratio (HR) 1.90, 95% CI 1.21-2.97], performance status by Eastern Cooperative Oncology Group ≥1 (HR 2.02, 95% CI 1.28-3.18), lymphopenia (HR 2.85, 95% CI 1.54-5.27) or increased lactate dehydrogenase (HR 2.08, 95% CI 1.19-3.63). The MELimmune score grouped patients into three risk categories: favourable prognosis (no risk factors; n = 34), intermediate prognosis (one risk factor; n = 65) and poor prognosis (two or more risk factors; n = 48). The mOS was 43.4 (95% CI 32.1-54.7), 14.4 (95% CI 6.8-22.0) and 6.5 (95% CI 3.6-9.4) months for favourable, intermediate and poor prognosis groups, respectively (P < 0.001). The area under the ROC curve was 0.74 (95% CI 0.66-0.82).
Conclusion
Using easily accessible variables from daily practice, the MELimmune prognostic score for patients with advanced melanoma treated with anti-PD-1 monotherapy holds potential to be used in clinical practice and prospectively validated in clinical trials.
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