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The Pan-Immune-Inflammation Value in Patients with Metastatic Melanoma Receiving First-Line Therapy

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Abstract

Background

Since a non-negligible fraction of patients with metastatic melanoma does not experience long-term disease control, even with immunotherapy and targeted therapy, new biomarkers for patient stratification and treatment tailoring are needed in this setting.

Objective

We investigated the association of a novel immune-inflammatory blood-based biomarker, the Pan-Immune-Inflammation Value (PIV), with clinical outcomes of patients with metastatic melanoma receiving first-line therapy.

Patients and Methods

We retrospectively included patients treated at the Fondazione IRCCS Istituto Nazionale dei Tumori of Milan and having an available baseline complete blood cell count (CBC). PIV was calculated as: [neutrophil count (103/mm3) × platelet count (103/mm3) × monocyte count (103/mm3)]/lymphocyte count (103/mm3).

Results

A total of 228 patients were included: 119 (52%) had been treated with immunotherapy and 109 (48%) with targeted therapy. PIV was significantly higher in patients with ECOG PS ≥ 1, high disease burden, synchronous metastases, and elevated baseline LDH level. High baseline PIV was independently associated with poor overall survival (adjusted hazard ratio [HR]: 2.06; 95% confidence interval [CI]: 1.30–3.29; adjusted P = 0.002) and progression-free survival (adjusted HR 1.56; 95% CI 1.01–2.41; adjusted P = 0.044). High PIV was also associated with primary resistance to both immunotherapy (odds ratio [OR]: 3.98; 95% CI 1.45–12.32; P = 0.005) and targeted therapy (OR: 8.42; 95% CI 2.50–34.5; P < 0.001). PIV showed a promising discrimination ability in terms of AIC and c-index when compared with other CBC-based biomarkers.

Conclusions

PIV may guide the treatment decision process and the development of novel first-line treatment strategies in melanoma, but warrants further study and validation.

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Authors and Affiliations

  1. Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Giovanni Fucà, Teresa Beninato, Marta Bini, Laura Mazzeo, Lorenza Di Guardo, Carolina Cimminiello, Giovanni Randon, Giulia Apollonio, Ilaria Bisogno, Massimo Di Nicola, Filippo de Braud & Michele Del Vecchio

  2. Unit of Pharmacy, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

    Marta Del Vecchio & Claudia Lauria Pantano

  3. Oncology and Hemato-oncology Department, University of Milan, Milan, Italy

    Filippo de Braud

Authors
  1. Giovanni Fucà
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  2. Teresa Beninato
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  3. Marta Bini
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  4. Laura Mazzeo
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  5. Lorenza Di Guardo
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  6. Carolina Cimminiello
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  7. Giovanni Randon
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  12. Massimo Di Nicola
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  13. Filippo de Braud
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  14. Michele Del Vecchio
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Corresponding author

Correspondence to Giovanni Fucà.

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Funding

No external funding was used in the preparation of this article.

Conflicts of interest

Giovanni Fucà, Teresa Beninato, Marta Bini, Laura Mazzeo, Lorenza Di Guardo, Carolina Cimminiello, Giovanni Randon, Giulia Apollonio, Ilaria Bisogno, Marta Del Vecchio, Claudia Lauria Pantano, Massimo Di Nicola, Filippo de Braud, and Michele Del Vecchio declare that they have no conflicts of interest that might be relevant to the contents of this article.

Ethics approval

Institutional approval was obtained for the retrospective analysis.

Consent to participate

All patients provided written informed consent to the treatment and data collection for research purposes.

Consent for publication

Not applicable.

Availability of data and material

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

Not applicable.

Author contributions

Study conception and design: GF, MiDV. Acquisition of data: TB, MB, LM, LDG, CC, GR, GA, IB, MaDV, CLP. Analysis of data: GF. Interpretation of data: GF, TB, MDN, FdB, MiDV. Drafting of the manuscript: GF, TB. Critical revision: MB, LM, LDG, CC, GR, GA, IB, MaDV, CLP, MDN, FdB, MiDV. Final approval: GF, TB, MB, LM, LDG, CC, GR, GA, IB, MaDV, CLP, MDN, FdB, MiDV.

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Cite this article

Fucà, G., Beninato, T., Bini, M. et al. The Pan-Immune-Inflammation Value in Patients with Metastatic Melanoma Receiving First-Line Therapy. Targ Oncol 16, 529–536 (2021). https://doi.org/10.1007/s11523-021-00819-0

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  • DOI: https://doi.org/10.1007/s11523-021-00819-0

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