Immunohistochemistry assessment of tissue neutrophil-to-lymphocyte ratio predicts outcomes in melanoma patients treated with anti-programmed cell death 1 therapy

Author(s)

Teixeira, Renan J. ; de Souza, Vinicius G. ; Sorroche, Bruna P. ; Paes, Victor G. ; Zambuzi-Roberto, Fabiana A. ; Pereira, Caio A. D. ; Vazquez, Vinicius L. ; Arantes, Lidia M. R. B.

• Document type: Journal article
• Source: Melanoma Research; v. 34, n. 3, p. 7-pg., 2024-06-01.

Abstract

Elevated neutrophil-to-lymphocyte ratio (NLR) is associated with diminished immunotherapy response in metastatic melanoma. Although NLR assessment in peripheral blood is established, tissue dynamics remain insufficiently explored. This study aimed to evaluate tissue NLR (tNLR)'s predictive potential through immunohistochemistry in immunotherapy-treated melanoma. Fifty melanoma patients who underwent anti-programmed cell death 1 (PD-1) therapy were assessed. Hematological, clinical and tumor features were collected from medical records. Responses were categorized using the Response Evaluation Criteria in Solid Tumors for immunotherapy (iRECIST) guidelines. Immunohistochemistry for tumor-infiltrating T cells (cluster differentiation 3) and neutrophils (myeloperoxidase) was performed on formalin-fixed paraffin-embedded tumor samples. NLR, derived NLR (dNLR) and tNLR were calculated. Overall survival (OS) and survival following immunotherapy (SFI) were calculated from diagnosis or immunotherapy start to loss of follow-up or death. Patients with high tNLR presented improved OS (P = 0.038) and SFI with anti-PD-1 therapy (P = 0.006). Both NLR and dNLR were associated with OS (P = 0.038 and P = 0.046, respectively) and SFI (P = 0.001 and P = 0.019, respectively). NLR was also associated with immunotherapy response (P = 0.007). In conclusion, tNLR emerged as a novel potential biomarker of enhanced survival post anti-PD-1 therapy, in contrast to classical NLR and dNLR markers. (AU)

• FAPESP's process: 19/07111-9 - Immune-checkpoint inhibitors: immunophenotyping and clinical outcome to predict response at Barretos Cancer Hospital
• Grantee: Lidia Maria Rebolho Batista Arantes
• Support Opportunities: Research Grants - Young Investigators Grants
• FAPESP's process: 21/10922-9 - Targeting the epigenetic profile of CD8+ tumor-infiltrating T cells to overcome the immunosuppressive milieu of hypoxic tumor niches
• Grantee: Bruna Pereira Sorroche
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate
• FAPESP's process: 19/03570-9 - Immune-checkpoint inhibitors: clinical outcome and biomarkers to predict response in Melanoma patients
• Grantee: Bruna Pereira Sorroche
• Support Opportunities: Scholarships in Brazil - Doctorate