Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanoma

Background A substantial proportion of patients with macroscopic stage III melanoma do not benefit sufficiently from adjuvant anti-PD-1 therapy, as they either recur despite therapy or would never have recurred. To better inform adjuvant treatment selection, we have performed translational analyses...

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Main Authors: Annegien Broeks, Michel W J M Wouters, Georgina V Long, Richard A Scolyer, Christian U Blank, Judith M Versluis, Karijn P M Suijkerbuijk, Petros Dimitriadis, Joyce Sanders, James S Wilmott, Alexander Maxwell Menzies, Yvonne M Schrage, Stephanie A Blankenstein, Robert Elens, Willeke A M Blokx, Winan van Houdt, Alexander C J van Akkooi
Format: Article
Language:English
Published: BMJ Publishing Group 2024-04-01
Series:Journal for ImmunoTherapy of Cancer
Online Access:https://jitc.bmj.com/content/12/4/e008125.full
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author Annegien Broeks
Michel W J M Wouters
Georgina V Long
Richard A Scolyer
Christian U Blank
Judith M Versluis
Karijn P M Suijkerbuijk
Petros Dimitriadis
Joyce Sanders
James S Wilmott
Alexander Maxwell Menzies
Yvonne M Schrage
Stephanie A Blankenstein
Robert Elens
Willeke A M Blokx
Winan van Houdt
Alexander C J van Akkooi
author_facet Annegien Broeks
Michel W J M Wouters
Georgina V Long
Richard A Scolyer
Christian U Blank
Judith M Versluis
Karijn P M Suijkerbuijk
Petros Dimitriadis
Joyce Sanders
James S Wilmott
Alexander Maxwell Menzies
Yvonne M Schrage
Stephanie A Blankenstein
Robert Elens
Willeke A M Blokx
Winan van Houdt
Alexander C J van Akkooi
author_sort Annegien Broeks
collection DOAJ
description Background A substantial proportion of patients with macroscopic stage III melanoma do not benefit sufficiently from adjuvant anti-PD-1 therapy, as they either recur despite therapy or would never have recurred. To better inform adjuvant treatment selection, we have performed translational analyses to identify prognostic and predictive biomarkers.Patients and methods Two cohorts of patients with macroscopic stage III melanoma from an ongoing biobank study were included. Clinical data were compared between an observation cohort (cohort 1) and an adjuvant intention cohort (cohort 2). RNA sequencing for translational analyses was performed and treatment subgroups (cohort 1A and cohort 2A) were compared for possible biomarkers, using a cut-off based on the treatment-naïve patients. In addition, two validation cohorts (Melanoma Institute Australia (MIA) and University Medical Centre Utrecht (UMCU)) were obtained.Results After a median follow-up of 26 months of the 98 patients in our discovery set, median recurrence-free survival (RFS) was significantly longer for the adjuvant intention cohort (cohort 2, n=49) versus the observation cohort (cohort 1, n=49). Median overall survival was not reached for either cohort, nor significantly different. In observation cohort 1A (n=24), RFS was significantly longer for patients with high interferon-gamma (IFNγ) score (p=0.002); for adjuvant patients of cohort 2A (n=24), a similar trend was observed (p=0.086). Patients with high B cell score had a longer RFS in cohort 1A, but no difference was seen in cohort 2A. The B cell score based on RNA correlated with CD20+ cells in tumor area but was not independent from the IFNγ score. In the MIA validation cohort (n=44), longer RFS was observed for patients with high IFNγ score compared with low IFNγ score (p=0.046), no difference in RFS was observed according to the B cell score. In both the observation (n=11) and the adjuvant (n=11) UMCU validation cohorts, no difference in RFS was seen for IFNγ and B cell.Conclusions IFNγ has shown to be a prognostic marker in both patients who were and were not treated with adjuvant therapy. B cell score was prognostic but did not improve accuracy over IFNγ. Our study confirmed RFS benefit of adjuvant anti-PD-1 for patients with macroscopic stage III melanoma.
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spelling doaj-art-e0b90991b4304091afe1ffd233fc064c2025-08-20T02:14:49ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262024-04-0112410.1136/jitc-2023-008125Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanomaAnnegien Broeks0Michel W J M Wouters1Georgina V Long2Richard A Scolyer3Christian U Blank4Judith M Versluis5Karijn P M Suijkerbuijk6Petros Dimitriadis7Joyce Sanders8James S Wilmott9Alexander Maxwell Menzies10Yvonne M Schrage11Stephanie A Blankenstein12Robert Elens13Willeke A M Blokx14Winan van Houdt15Alexander C J van Akkooi167 Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands2 Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands4 Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia12 Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital and NSW Health Pathology, Sydney, NSW, Australia1 Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands1 Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands13 Department of Medical Oncology, UMC Utrecht, Utrecht, The Netherlands3 Division of Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands11 Department of Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands5 Melanoma Institute Australia, Sydney, New South Wales, Australia4 Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia2 Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands2 Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands7 Core Facility Molecular Pathology and Biobanking, Netherlands Cancer Institute, Amsterdam, The Netherlands8 Department of Pathology, UMC Utrecht, Utrecht, The Netherlands31 Department of Surgery, Netherlands Cancer Institute, Amsterdam, Netherlands2 Department of Surgical Oncology, Netherlands Cancer Institute, Amsterdam, The NetherlandsBackground A substantial proportion of patients with macroscopic stage III melanoma do not benefit sufficiently from adjuvant anti-PD-1 therapy, as they either recur despite therapy or would never have recurred. To better inform adjuvant treatment selection, we have performed translational analyses to identify prognostic and predictive biomarkers.Patients and methods Two cohorts of patients with macroscopic stage III melanoma from an ongoing biobank study were included. Clinical data were compared between an observation cohort (cohort 1) and an adjuvant intention cohort (cohort 2). RNA sequencing for translational analyses was performed and treatment subgroups (cohort 1A and cohort 2A) were compared for possible biomarkers, using a cut-off based on the treatment-naïve patients. In addition, two validation cohorts (Melanoma Institute Australia (MIA) and University Medical Centre Utrecht (UMCU)) were obtained.Results After a median follow-up of 26 months of the 98 patients in our discovery set, median recurrence-free survival (RFS) was significantly longer for the adjuvant intention cohort (cohort 2, n=49) versus the observation cohort (cohort 1, n=49). Median overall survival was not reached for either cohort, nor significantly different. In observation cohort 1A (n=24), RFS was significantly longer for patients with high interferon-gamma (IFNγ) score (p=0.002); for adjuvant patients of cohort 2A (n=24), a similar trend was observed (p=0.086). Patients with high B cell score had a longer RFS in cohort 1A, but no difference was seen in cohort 2A. The B cell score based on RNA correlated with CD20+ cells in tumor area but was not independent from the IFNγ score. In the MIA validation cohort (n=44), longer RFS was observed for patients with high IFNγ score compared with low IFNγ score (p=0.046), no difference in RFS was observed according to the B cell score. In both the observation (n=11) and the adjuvant (n=11) UMCU validation cohorts, no difference in RFS was seen for IFNγ and B cell.Conclusions IFNγ has shown to be a prognostic marker in both patients who were and were not treated with adjuvant therapy. B cell score was prognostic but did not improve accuracy over IFNγ. Our study confirmed RFS benefit of adjuvant anti-PD-1 for patients with macroscopic stage III melanoma.https://jitc.bmj.com/content/12/4/e008125.full
spellingShingle Annegien Broeks
Michel W J M Wouters
Georgina V Long
Richard A Scolyer
Christian U Blank
Judith M Versluis
Karijn P M Suijkerbuijk
Petros Dimitriadis
Joyce Sanders
James S Wilmott
Alexander Maxwell Menzies
Yvonne M Schrage
Stephanie A Blankenstein
Robert Elens
Willeke A M Blokx
Winan van Houdt
Alexander C J van Akkooi
Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanoma
Journal for ImmunoTherapy of Cancer
title Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanoma
title_full Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanoma
title_fullStr Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanoma
title_full_unstemmed Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanoma
title_short Interferon-gamma signature as prognostic and predictive marker in macroscopic stage III melanoma
title_sort interferon gamma signature as prognostic and predictive marker in macroscopic stage iii melanoma
url https://jitc.bmj.com/content/12/4/e008125.full
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