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Predictive value of peripheral blood immune function testing for efficacy and prognosis in advanced mucosal melanoma
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Abstract:
[Abstract] Objective: To investigate the correlation between peripheral blood lymphocyte immunophenotyping, cytokine levels before and after immune and anti-angiogenesis combined therapy, and treatment efficacy as well as prognosis in patients with advanced mucosal melanoma. Methods: A total of 28 patients with advanced mucosal melanoma admitted to the Drum Tower Hospital of Nanjing University School of Medicine from April 2019 to June 2022 were included in this analysis. All patients received combined treatment of camrelizumab (PD-1 inhibitor) and apatinib (anti-angiogenic drug). Peripheral blood samples were collected before treatment and after two cycles of treatment for lymphocyte immunophenotyping and cytokine level testing. The correlation between these immune markers and treatment efficacy as well as patient prognosis was evaluated. Results: After two cycles of treatment with camrelizumab and apatinib in patients with mucosal melanoma, the proportion of PD-1 positive cytotoxic T lymphocytes (CD3+ CD8+ CD279+ cells) in peripheral blood was significantly reduced (P < 0.001), while the proportion of NK cells (CD3- CD16+ CD56+ cells) was significantly increased (P = 0.0054). Pre-treatment peripheral blood IFN- γ levels were found to be associated with overall survival (OS) (P = 0.013). Patients with low IFN-γ levels had a median OS of 329 days, while the median OS for patients with high IFN-γ levels was not reached. Higher baseline IFN-γ levels were associated with a greater benefit in progressionfree survival (PFS). Conclusion: The proportion of PD-1-positive T lymphocytes, NK cells and IFN-γ levels in peripheral blood may have predictive value for the efficacy and prognosis of advanced mucosal melanoma patients undergoing immunotherapy and antiangiogenesis combined therapy. Future large-sample studies are needed to better characterize the clinical potential of these markers.
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