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Soo Park, MD
Soo Park, MD
Posted: Thursday, October 24, 2024
Researchers have developed and validated a novel Web-based nomogram to help predict long-term progression-free survival in patients who have unresectable stage IV melanoma and have undergone first-line anti–PD-1–based therapy. According to Teresa Amaral, MD, PhD, of Eberhard Karls University, Tübingen, Germany, and colleagues, the tool may help clinicians to tailor individualized therapeutic decisions and patient follow-up strategies as well as facilitate risk stratification. The retrospective study upon which the nomogram specifics were based was published in ESMO Open.
Continuous lactate dehydrogenase, neutrophil-to-lymphocyte ratio, markers of tumor burden, and melanoma subtype were the most important progression-free survival predictors found in their study. These clinicopathologic features—as well as S100, body mass index, type of immune checkpoint inhibitor, and presence of liver or brain metastasis—were integrated into the nomogram.
The 719 patients, treated at eight different European centers, included a training cohort of 405 (56%) and a validation cohort of 314 (44%). All patients received first-line treatment between 2014 and 2018 with either anti–PD-1 monotherapy or anti–PD-1 therapy plus anticytotoxic T-lymphocyte–associated protein 4.
Their model “had a C-index of 0.67 in the training cohort and 0.66 in the validation cohort, [and] calibration analysis revealed a favorable correlation between predicted and actual progression-free survival rates,” Dr. Amaral and co-investigators reported. In addition, the model’s performance held among various patient subgroups. They also believe the study’s “robustness” was enhanced by the long median follow-up—more than 50 months.
Anti–PD-1 immunotherapy has revolutionized the melanoma treatment landscape, acknowledged the team, even in some patients with advanced-stage disease. However, between 40% and 60% of patients currently do not derive advantage from it, making a tool to help predict long-term progression-free survival potentially of value.
Disclosure: For full disclosures of the study authors, visit ESMOOpen.com.
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