Tumor PD-L1 expression and gene panel mutational profile as outcome predictors of PD-1-based checkpoint inhibition therapy in metastatic melanoma: A prospective multicenter DeCOG study.

Authors

null

Selma Ugurel

Department of Dermatology, University Hospital Erlangen and Department of Dermatology, University of Würzburg, Essen, Germany

Selma Ugurel , Klaus Griewank , Susanne Horn , Rudolf Herbst , Patrick Terheyden , Jochen Utikal , Claudia Pföhler , Jens Ulrich , Alexander Kreuter , Peter Mohr , Ralf Gutzmer , Friedegund Elke Meier , Edgar Dippel , Antje Sucker , Jan-Malte Placke , Eva Hadaschik , Jürgen C. Becker , Michael Weichenthal , Dirk Schadendorf

Organizations

Department of Dermatology, University Hospital Erlangen and Department of Dermatology, University of Würzburg, Essen, Germany, University Hospital of Essen, Essen, Germany, Department of Dermatology, University of Duisburg-Essen, Essen, Germany, HELIOS Hauttumorzentrum Erfurt, Erfurt, Germany, Department of Dermatology, Allergy, and Venereology, University of Lübeck, Lübeck, Germany, Skin Cancer Unit, German Cancer Research Center (DKFZ) and Univ Medical Ho, Mannheim, Germany, Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany, Medical Center Quedlinburg, Quedlinburg, Germany, St. Elisabeth Hospital, Oberhausen, University Witten/Herdecke, Oberhausen, Germany, Elbe Kliniken Buxtehude, Buxtehude, Germany, Skin Cancer Center Hannover, Hannover Medical School, Hannover, Germany, Department of Dermatology, University Hospital Dresden, Dresden, Germany, Klinikum Ludwigshafen, Ludwigshafen, Germany, University Hospital Essen, Essen, Germany, Department of Dermatology University Essen, Essen, Germany, Essen University Hospital, Essen, Germany, Translational Skin Cancer Research, Deutsches Konsortium für Translationale Krebsforschung (DKTK), Essen, Germany, University Department of Dermatology, Kiel, Germany, Department of Dermatology, University of Essen; German Cancer Consortium (DKTK), Partner Site Essen, Essen, Germany

Research Funding

Pharmaceutical/Biotech Company
Bristol Myers Squibb, Dermatologic Oncology Group (DeCOG)

Background: PD-1 checkpoint inhibition (CPI) has recently advanced to one of the most effective treatment strategies in melanoma. However, since a considerable proportion of patients shows upfront therapy resistance, baseline predictive biomarkers of therapy outcome are needed. Methods: This prospective multicenter study included metastatic melanoma patients whose formalin-fixed paraffin-embedded tumor tissue samples taken prior to the start of a systemic non-adjuvant therapy of any line were analyzed for PD-L1 expression on tumor cells by immunohistochemistry (clone 28-8, DAKO) and for COSMIC-annotated oncogenic mutations by 29-gene panel sequencing (MiSeq, Illumina). Clinical baseline and follow-up data were collected within the DeCOG multicenter skin cancer registry ADOREG. Results: From 09/2015 until 10/2020, 706 enrolled patients from 15 centers were evaluable for the endpoints best overall response (BOR), progression-free (PFS) and overall survival (OS). Thereof, 540 patients received PD-1-based CPI as first systemic treatment after tumor tissue analysis. 197/540 patients tested positive for PD-L1 (cut-off = 5%) in pre-treatment tumors, and revealed a favourable BOR (objective response 34.4% versus 19.1%; p < 0.0001), PFS (median 10.4 versus 4.2 months; p < 0.0001) and OS (median 45.1 versus 18.8 months; p = 0.001) compared to patients with PD-L1 negative tumors. 47/540 patients presented oncogenic mutations of three or more genes in pre-treatment tumors, and revealed a favourable BOR (objective response 46.8% versus 32.1%; p = 0.041), PFS (median 15.1 versus 6.1 months; p = 0.008) and OS (median not reached versus 25.2 months; p = 0.027) compared to patients whose tumors showed mutations in two or less genes. Multivariable Cox regression including sex, primary site, non-adjuvant systemic pre-treatment, serum LDH, and ECOG performance state demonstrated tumor PD-L1 expression and gene panel mutational profile as independent predictors of survival upon treatment with PD-1-based CPI. In contrast, in 106/706 patients treated with BRAF/MEK inhibitors as first systemic treatment after tumor tissue analysis, no association was found between tumor PD-L1 expression or gene panel mutational profile and therapy outcome. Conclusions: PD-L1 expression quantification and gene panel mutational profiling provide useful outcome predictors of PD-1-based CPI therapy in metastatic melanoma patients.

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Abstract Details

Meeting

2021 ASCO Annual Meeting

Session Type

Poster Session

Session Title

Melanoma/Skin Cancers

Track

Melanoma/Skin Cancers

Sub Track

Biologic Correlates

Citation

J Clin Oncol 39, 2021 (suppl 15; abstr 9568)

DOI

10.1200/JCO.2021.39.15_suppl.9568

Abstract #

9568

Poster Bd #

Online Only

Abstract Disclosures