Systematic literature Review for the Association of Biomarkers with Efficacy of Anti-PD-1 Inhibitors in Advanced Melanoma

Abstract

Aim: Summarize the literature assessing biomarkers in predicting efficacy of anti-PD-1 therapy for patients with high-risk unresectable or metastatic melanoma. Materials & methods: Relevant studies were identified via a systematic literature review. Results: About 334 unique biomarkers or biomarker combinations were identified from 121 citations. Neutrophil-to-lymphocyte ratio was the most frequently studied biomarker, followed by C-reactive protein. Fifty-nine biomarkers were significantly associated with overall survival (OS), 51 with progression-free survival (PFS) and 44 with response. Twenty biomarkers were associated with both OS and PFS; two were associated with OS, PFS and response (MHC-II and tumor mutational burden). Conclusion: Numerous biomarkers could potentially predict the efficacy of anti-PD-1-based therapy for melanoma patients. However, confirmatory studies are needed as well as determination of implications for clinical decision-making.

Prognostic Performance of the Derived Neutrophil-to-Lymphocyte Ratio in Stage IV Melanoma Patients Treated with Immune Checkpoint Inhibitors

“…The derived NLR (dNLR), composed of white cell counts (WBC) and absolute neutrophil counts (ANC), has been proposed as a simple alternative to NLR for those studies in which only WBC and ANC have been recorded. Indeed, the absolute lymphocyte count has not been determined in some studies [18][19][20][21][22][23][24][25]. In the present study, we aimed to evaluate the prognostic performance of the dNLR in patients with metastatic CM treated with immune checkpoint inhibitors (ICI).…”

The Neutrophil-to-Lymphocyte Ratio as a Biomarker in Cutaneous Oncology: A Systematic Review of Evidence beyond Malignant Melanoma

“…The evidence from colorectal cancer and melanoma highlights the strong association of elevated NLR values with worse prognosis in patients with localized, high-risk, and metastatic disease [ 8 ]. Similarly, a baseline NLR has a promising prognostic value for the treatment response in melanoma patients receiving immunotherapy, and for the approach to the risk of shortened overall survival and progression-free survival in metastatic melanoma, treated with either metastasectomy or immunotherapies [ 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ].…”

“…Moreover, a baseline NLR is a promising prognostic biomarker for treatment response in melanoma patients receiving immunotherapy, and also, an agnostic, modality-independent predictive factor of shortened overall survival and progression-free survival in metastatic melanoma, treated with either metastasectomy or immunotherapies. Review papers and meta-analysis studies have compiled the pertinent data on this growing body of evidence [ 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ] and will not be reviewed again herein. Herewith, to supplement the evidence of the use of the NLR (and allied hematological biomarkers) in cutaneous oncology, we aim to systematically review, and consequently summarize the evidence on, their application in assessing prognosis, survival, and treatment outcomes in patients with skin malignancies other than malignant melanoma.…”