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Predicting marker for early progression in unresectable melanoma treated with nivolumab

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Abstract

Background

The objective of this study was to identify predictive markers, including inflammatory and nutritional status measures, of early progressive disease (EPD) in unresectable melanoma patients treated with nivolumab.

Methods

A retrospective review was performed on 39 consecutive patients with unresectable melanoma treated with nivolumab. EPD was defined as progressive disease within 60 days after starting nivolumab according to Response Evaluation Criteria in Solid Tumors version 1.1. The predictive index model [melanoma inflammation index (MII)] was determined by the number of predictive factors.

Results

Seventeen patients had cutaneous melanoma and 22 patients had mucosal melanoma. The overall response rate was 18.4%, and the response rates for cutaneous and mucosal melanoma were 29.4% and 9.5%, respectively. EPD was observed in 13 patients (34.2%). By multivariate analysis, body mass index (BMI) and C-reactive protein to albumin ratio (CAR) were independently and significantly associated with EPD, disease control rate, progression-free survival, and overall survival. Low BMI (cutoff 20) and high CAR (cutoff 0.0055) were predictive factors of EPD and were determined to be prognostic factors. MII, from 0 to 2, was determined by the number of these factors. The incidence of EPD was 0% in the low-risk group (MII = 0), 50% in the intermediate-risk group (MII = 1), and 83% in the high-risk group (MII = 2).

Conclusions

An MII status of low BMI and high CAR may be used to predict EPD in unresectable melanoma patients treated with nivolumab.

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Funding

None of the authors have financial disclosures or funding support.

Author information

Authors and Affiliations

  1. Department of Therapeutic Oncology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Tomohiro Kondo, Motoo Nomura, Shigemi Matsumoto & Manabu Muto

  2. Department of Dermatology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Atsushi Otsuka, Yumi Nonomura & Yo Kaku

  3. Translational Research Department for Skin and Brain Diseases, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606-8507, Japan

    Atsushi Otsuka

  4. Department of Medical Oncology, Kyoto University Graduate School of Medicine, 54 Kawahara-cho, Shogoin, Sakyo-ku, Kyoto, 606–8507, Japan

    Manabu Muto

Authors
  1. Tomohiro Kondo
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  2. Motoo Nomura
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  3. Atsushi Otsuka
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  4. Yumi Nonomura
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  5. Yo Kaku
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  6. Shigemi Matsumoto
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  7. Manabu Muto
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Corresponding author

Correspondence to Motoo Nomura.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Conflict of interest

None of the authors have conflicts of interest to declare.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Kondo, T., Nomura, M., Otsuka, A. et al. Predicting marker for early progression in unresectable melanoma treated with nivolumab. Int J Clin Oncol 24, 323–327 (2019). https://doi.org/10.1007/s10147-018-1345-9

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  • DOI: https://doi.org/10.1007/s10147-018-1345-9

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