Prognostic model for advanced melanoma patients treated with ICI
April 14, 2023
Abstract
Background:
Risk stratification tools for patients with advanced melanoma (AM) treated with immune checkpoint inhibitors (ICI) are lacking. We identified a new prognostic model associated with overall survival (OS).
Patients and Methods:
A total of 318 treatment naïve patients with AM receiving ICI were collected from a multi-centre retrospective cohort study. LASSO Cox regression identified independent prognostic factors associated with OS. Model validation was carried out on 500 iterations of bootstrapped samples. Harrel’s C-index was calculated and internally validated to outline the model’s discriminatory performance. External validation was carried out in 142 advanced melanoma patients receiving ICI in later lines.
Results:
High white blood cell count (WBC), high lactate dehydrogenase (LDH), low albumin, Eastern Cooperative Oncology Group (ECOG) performance status ≥1, and the presence of liver metastases were included in the model. Patients were parsed into 3 risk groups: favorable (0-1 factors) OS of 52.9 months, intermediate (2-3 factors) OS 13.0 months, and poor (≥4 factors) OS 2.7 months. The C-index of the model from the discovery cohort was 0.69. External validation in later-lines (N = 142) of therapy demonstrated a c-index of 0.65.
Conclusions:
Liver metastases, low albumin, high LDH, high WBC, and ECOG≥1 can be combined into a prognostic model for AM patients treated with ICI.
Source:
Igor Stukalin, Vishal Navani, Mehul Gupta, Yibing Ruan, Devon J Boyne, Dylan E O’Sullivan, Daniel E Meyers, Siddhartha Goutam, Michael Sander, Benjamin W Ewanchuk, Darren R Brenner, Aleksi Suo, Winson Y Cheung, Daniel Y C Heng, Jose G Monzon, Tina Cheng, Development and Validation of a Prognostic Risk Model for Patients with Advanced Melanoma Treated with Immune Checkpoint Inhibitors, The Oncologist, 2023;, oyad073, https://doi.org/10.1093/oncolo/oyad073