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Soo Park, MD
Soo Park, MD
Posted: Monday, July 1, 2024
As the therapeutic landscape for patients with metastatic melanoma expands to include immune checkpoint inhibitors, there is an increased need for reliable biomarkers both to predict and monitor response. Elisabetta Ferretti, MD, PhD, of Sapienza University, Rome, and colleagues thus conducted a systematic literature review to evaluate the potential for a noninvasive biomarker signature to inform therapeutic decisions. Their findings were published in the journal Pharmacology & Therapeutics.
“Blood-based liquid biopsy has garnered increasing interest because of its noninvasive nature and reliable performance,” the investigators remarked. “The abundance of detectable and quantifiable molecules and immune cells released into the blood circulation represents a valuable source of potential biomarkers.”
Several of the analyzed studies identified lactate dehydrogenase, whole blood cell counts, and their ratios as predictors of response to immune checkpoint inhibition. Moreover, the review indicated that patients who benefit from such therapy exhibit increased cytotoxic activity within specific lymphocytes, whereas nonresponders seemed to have a more immune-suppressive profile and elevated circulating tumor DNA (ctDNA) levels. The role for effector molecules remains ambiguous, according to the study authors.
“While these findings suggest the possibility of identifying blood-based biomarkers of therapeutic response, better standardization is needed because of variability across studies,” the investigators explained. They also highlighted persisting challenges in analyzing circulating tumor cells, circulating RNA, and extracellular vesicles, as well as in understanding the role of microRNA in antitumor immunity and cancer immune evasion for translation into a clinical test.
On the horizon is the clinical implementation of the Multicancer Early Detection (MCED) blood-based biomarker test, which was approved by the U.S. Food and Drug Administration in 2023 for detecting cancer or response to therapy via analysis of ctDNA methylation patterns or single nucleotide polymorphisms. However, the investigators emphasized the need for extensive research to incorporate this and other novel tools for patient stratification for immunotherapy.
Disclosure: The study authors reported no conflicts of interest.
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