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 Essen, Essen, Germany

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

Organizations

University Hospital Essen, Essen, Germany, Melanoma Institute Australia, The University of Sydney, Royal North Shore and Mater Hospitals, Sydney, Australia, Aix-Marseille University, Marseille, France, Mount Vernon Cancer Centre, Northwood, United Kingdom, University of California, Los Angeles and the 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 Pharma AG, Basel, Switzerland, Novartis, Basel, Switzerland, Novartis Institutes for BioMedical Research, Cambridge, MA, 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 in pts with BRAF V600E/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

Disclaimer

This material on this page is ©2024 American Society of Clinical Oncology, all rights reserved. Licensing available upon request. For more information, please contact licensing@asco.org

Abstract Details

Meeting

2018 ASCO-SITC Clinical Immuno-Oncology Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Developmental Therapeutics,Genitourinary Cancer,Head and Neck Cancer,Lung Cancer,Melanoma/Skin Cancers,Gastrointestinal Cancer,Breast and Gynecologic Cancers,Combination Studies,Implications for Patients and Society,Miscellaneous Cancers,Oncolytic Viruses,Hematologic Malignancies

Sub Track

Biomarkers and Inflammatory Signatures

Clinical Trial Registration Number

NCT01597908

Citation

J Clin Oncol 36, 2018 (suppl 5S; abstr 183)

DOI

10.1200/JCO.2018.36.5_suppl.183

Abstract #

183

Poster Bd #

H10

Abstract Disclosures