Predictive Factors in Metastatic Melanoma Treated with Immune Checkpoint Inhibitors: From Clinical Practice to Future Perspective.
Stefano PolettoLuca ParuzzoAlessandro NepoteDaniela CaravelliDario SangioloFabrizio Carnevale-SchiancaPublished in: Cancers (2023)
The introduction of immunotherapy revolutionized the treatment landscape in metastatic melanoma. Despite the impressive results associated with immune checkpoint inhibitors (ICIs), only a portion of patients obtain a response to this treatment. In this scenario, the research of predictive factors is fundamental to identify patients who may have a response and to exclude patients with a low possibility to respond. These factors can be host-associated, immune system activation-related, and tumor-related. Patient-related factors can vary from data obtained by medical history (performance status, age, sex, body mass index, concomitant medications, and comorbidities) to analysis of the gut microbiome from fecal samples. Tumor-related factors can reflect tumor burden (metastatic sites, lactate dehydrogenase, C-reactive protein, and circulating tumor DNA) or can derive from the analysis of tumor samples (driver mutations, tumor-infiltrating lymphocytes, and myeloid cells). Biomarkers evaluating the immune system activation, such as IFN-gamma gene expression profile and analysis of circulating immune cell subsets, have emerged in recent years as significantly correlated with response to ICIs. In this manuscript, we critically reviewed the most updated literature data on the landscape of predictive factors in metastatic melanoma treated with ICIs. We focus on the principal limits and potentiality of different methods, shedding light on the more promising biomarkers.
Keyphrases
- circulating tumor
- body mass index
- clinical practice
- end stage renal disease
- newly diagnosed
- small cell lung cancer
- squamous cell carcinoma
- dendritic cells
- healthcare
- induced apoptosis
- systematic review
- cell free
- electronic health record
- ejection fraction
- case report
- chronic kidney disease
- machine learning
- big data
- circulating tumor cells
- oxidative stress
- physical activity
- patient reported outcomes
- peritoneal dialysis
- cell death
- single molecule
- copy number
- current status
- signaling pathway
- risk factors
- cell cycle arrest
- smoking cessation
- patient reported