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. 2023 Mar 9;13(6):1041.
doi: 10.3390/diagnostics13061041.

PD-L1 Tumor Expression as a Predictive Biomarker of Immune Checkpoint Inhibitors' Response and Survival in Advanced Melanoma Patients in Brazil

Bruna Pereira Sorroche  1 , Renan de Jesus Teixeira  1 , Caio Augusto Dantas Pereira  2 , Iara Viana Vidigal Santana  3 , Lazar Vujanovic  4   5 , Vinicius de Lima Vazquez  1   6 , Lidia Maria Rebolho Batista Arantes  1
Affiliations

PD-L1 Tumor Expression as a Predictive Biomarker of Immune Checkpoint Inhibitors' Response and Survival in Advanced Melanoma Patients in Brazil

Bruna Pereira Sorroche et al. Diagnostics (Basel). .

Abstract

Immune checkpoint blockade (ICB) agents are prominent immunotherapies for the treatment of advanced melanoma. However, they fail to promote any durable clinical benefit in a large cohort of patients. This study assessed clinical and molecular predictors of ICB response and survival in advanced melanoma. A retrospective analysis was performed on 210 patients treated with PD-1 or CTLA-4 inhibitors at Barretos Cancer Hospital, Brazil. PD-L1 expression was assessed by immunohistochemistry using formalin-fixed paraffin-embedded tumor tissues collected prior to ICB therapy. Patients were divided into responders (complete and partial response and stable disease for more than 6 months) and non-responders (stable disease for less than 6 months and progressive disease). Among them, about 82% underwent anti-PD-1 immunotherapy, and 60.5% progressed after the ICB treatment. Patients that received ICB as first-line therapy showed higher response rates than previously treated patients. Higher response rates were further associated with superficial spreading melanomas and positive PD-L1 expression (>1%). Likewise, PD-L1 positive expression and BRAF V600 mutations were associated with a higher overall survival after ICB therapy. Since ICBs are expensive therapies, evaluation of PD-L1 tumor expression in melanoma patients should be routinely assessed to select patients that are most likely to respond.

Keywords: PD-L1 expression; immune checkpoint blockade; melanoma; response.

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Conflict of interest statement

The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Figures

Figure 1
Figure 1
Total number of patients with advanced or metastatic melanoma who received treatment with ICB at BCH, by year.
Figure 2
Figure 2
Detection of PD-L1 expression by IHC using the E1L3N antibody, with an optical magnification of 200×. Representative images of PD-L1-(a) negative and -(b) positive expressions are shown.
Figure 3
Figure 3
Pearson correlation analysis between TPS and CPS scores to evaluate PD-L1 expression in advanced melanoma patients’ samples.
Figure 4
Figure 4
Association of (a) BRAF V600 mutation status and (b) source of FFPE tumor samples with PD-L1 expression profile.
Figure 5
Figure 5
Association of (a) systemic ICB treatment line, (b) type of ICB, (c) histological melanoma subtype, (d) BRAF V600 mutation status, and (e) PD-L1 expression with overall survival after the ICB treatment in advanced melanoma patients.
Figure 5
Figure 5
Association of (a) systemic ICB treatment line, (b) type of ICB, (c) histological melanoma subtype, (d) BRAF V600 mutation status, and (e) PD-L1 expression with overall survival after the ICB treatment in advanced melanoma patients.
See this image and copyright information in PMC

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