PD-L1 and CD8 expression and association with outcomes in patients (pts) with BRAF V600E/K-mutant metastatic melanoma (MM) who received dabrafenib + trametinib (D+T) in the randomized phase 3 COMBI-v study.

Authors

null

Dirk Schadendorf

University Hospital of Essen, Essen, Germany

Dirk Schadendorf , Georgina V. Long , Jean Jacques Grob , Paul D. Nathan , Antoni Ribas , Michael A. Davies , Keith T. Flaherty , Matthew Squires , Savina Jaeger , William Powell , Puay Tan , Caroline Robert

Organizations

University Hospital of Essen, Essen, Germany, Melanoma Institute of Australia and The University of Sydney, Sydney, Australia, Aix-Marseille University, Marseille, France, Mount Vernon Cancer Centre, Northwood, United Kingdom, University of California Los Angeles Jonsson Comprehensive Cancer Center, Los Angeles, CA, The University of Texas MD Anderson Cancer Center, Houston, TX, Dana-Farber Cancer Institute/Harvard Medical School and Massachusetts General Hospital, Boston, MA, Novartis Pharmaceuticals AG, Basel, Switzerland, Novartis Institute for Biomedical Research, Cambridge, MA, Gustave Roussy Comprehensive Cancer Center, Villejuif, France

Research Funding

Pharmaceutical/Biotech Company

Background: The phase 3 COMBI-v study (NCT01597908) showed that D+T significantly improved outcomes vs vemurafenib inpts with BRAFV600E/K–mutant MM. Checkpoint inhibitors also provide clinical benefit in some pts with MM. To date, characterization of markers associated with response to anti–PD-1 therapy has identified positive associations with PD-L1 expression and immune cell infiltration. Here we describe expression of PD-L1 and the T-cell marker CD8 in tumor samples from pts randomized to receive D+T in COMBI-v and associations with clinical outcomes. Methods: Biopsies from 74 of 352 D+T pts (21%) in COMBI-v were assessed for expression of PD-L1 (PD-L1 IHC 22C3 pharmDx assay; Dako) and CD8 (anti-CD8 antibody, clone C8/144B; Dako). PD-L1 positivity was determined as a percentage of stained tumor cells and MEL score (staining on both tumor and mononuclear inflammatory cells; 0 or 1 [negative]: < 1% staining; 2-5 [positive]: ≥ 1% staining; Daud et al. J Clin Oncol. 2016). Results: Of 74 pts analyzed, 54 (73%) had PD-L1–positive tumors, and the largest MEL score subgroup was 2 (45%). A significant association (P< .0001) was observed between PD-L1 and CD8 expression. Overall response rate, tumor shrinkage, progression-free survival, overall survival (OS), and duration of response with D+T were not associated with PD-L1 (MEL score of ≥ 2) or CD8 positivity. However, a significant association (P = .04) with improved OS was observed in tumors with high PD-L1 expression (≥ 20% of cells PD-L1 positive), and a trend (P = .06) was seen in pts with a MEL score of ≥ 3. Among PD-L1–negative pts, improved OS was seen in those with high CD8 positivity (P = .03), particularly in the stromal compartment. Conclusions: These data, representing PD-L1 and CD8 expression profiles for a BRAF-mutant mm population in the context of outcomes following D+T, showed that clinical benefit was maintained regardless of immune phenotype. The results also suggest that an immune component has an impact on outcomes following targeted therapy. Clinical trial information: NCT01597908

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Abstract Details

Meeting

2017 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Advanced/Metastatic Disease

Clinical Trial Registration Number

NCT01597908

Citation

J Clin Oncol 35, 2017 (suppl; abstr 9527)

DOI

10.1200/JCO.2017.35.15_suppl.9527

Abstract #

9527

Poster Bd #

135

Abstract Disclosures