Inflammatory and autoimmune predictive markers of response to anti‑PD‑1/PD‑L1 therapy in NSCLC and melanoma

Abstract

Immune checkpoint inhibitors (ICI) are a standard in cancer therapy, but few patients respond to the treatment. The aim of the present study was the determination of immunological markers for monitoring response to ICI. The present study included 74 patients receiving ICI in subsequent [group 1; non-small cell lung cancer (NSCLC)] and first-line setting (group 2; melanoma) and 30 patients with NSCLC receiving first-line chemotherapy. In groups 1 and 2 β-2 microglobulin (B2-MG), neopterin (NPT), IL-6, IL-18, HLA-DRB1 and autoantibodies were assessed after two months of ICI, and before the start of next administration in group 3. In group 1 low level of B2-MG (P<0.0001), NPT (P<0.0001), IL-6 (P<0.0001), IL-18 (P=0.0003), HLA-DRB1*03 (P=0.016) and anti-TPO antibodies (P=0.016) were associated with response >six months.In group 2 high level of B2-MG (P=0.0001), NPT (P=0.0016), IL-6 (P=0.013) and IL-18 (P=0.032) were associated with early disease progression (<six months). Univariate analysis demonstrated that immune-related adverse events were predictive marker of prolonged progression-free survival (PFS) in group 1 (P=0.038) and 2 (P=0.020). Neutrophil-lymphocyte ratio ≥5 before immunotherapy was correlated with shorter PFS in melanoma in multivariate analysis (P=0.007). B2-MG ≥2.5 mg/ml (P= 0.006) and NPT ≥12 nmol/l (P=0.027) were predictors of shorter PFS in group 1. B2-MG ≥2.5 mg/ml was predictor of shorter PFS (P=0.008) in group 2. In group 1 levels of B2-MG, NPT, IL-6 and IL-18 were higher than in group 3. In summary, immunological markers are promising predictive markers for immunotherapy; however, it requires further prospective studies.

Molecular and translational biology of the blood-based VeriStrat® proteomic test used in cancer immunotherapy treatment guidance

“…Different levels of B2M have been shown to be prognostic factors for outcomes in various cancers [68] , [69] , [70] , [71] . Additionally, B2M has been found to correlate with ICI therapeutic response in NSCLC and melanoma [72] , [73] , likely due to its impact on tumor antigen presentation disruption [74] .…”

Molecular & Translational Biology of the Blood-Based VeriStrat® Proteomic Test Used in Cancer Immunotherapy Treatment Guidance

“…Additionally, B2M has been shown to correlate with ICI therapeutic response in NSCLC and melanoma [65,66], likely through disruption of tumor antigen presentation [67].…”

The Role of IL-18 in P2RX7-Mediated Antitumor Immunity

“…High expression of IL-18 is also associated with increased metastases in hepatocellular and breast carcinomas [162,163]. As for the role of IL-18 in predicting patients' response to immunotherapy, it was shown that patients with non-small cell lung cancer who respond to treatment had lower levels of IL-18 compared to non-responders [164], which contrasts with other studies in the same tumor type [140,141].…”