[HTML][HTML] Integrative molecular and clinical modeling of clinical outcomes to PD1 blockade in patients with metastatic melanoma

D Liu, B Schilling, D Liu, A Sucker, E Livingstone… - Nature medicine, 2019 - nature.com
D Liu, B Schilling, D Liu, A Sucker, E Livingstone, L Jerby-Arnon, L Zimmer, R Gutzmer…
Nature medicine, 2019nature.com
Immune-checkpoint blockade (ICB) has demonstrated efficacy in many tumor types, but
predictors of responsiveness to anti-PD1 ICB are incompletely characterized. In this study,
we analyzed a clinically annotated cohort of patients with melanoma (n= 144) treated with
anti-PD1 ICB, with whole-exome and whole-transcriptome sequencing of pre-treatment
tumors. We found that tumor mutational burden as a predictor of response was confounded
by melanoma subtype, whereas multiple novel genomic and transcriptomic features …
Abstract
Immune-checkpoint blockade (ICB) has demonstrated efficacy in many tumor types, but predictors of responsiveness to anti-PD1 ICB are incompletely characterized. In this study, we analyzed a clinically annotated cohort of patients with melanoma (n = 144) treated with anti-PD1 ICB, with whole-exome and whole-transcriptome sequencing of pre-treatment tumors. We found that tumor mutational burden as a predictor of response was confounded by melanoma subtype, whereas multiple novel genomic and transcriptomic features predicted selective response, including features associated with MHC-I and MHC-II antigen presentation. Furthermore, previous anti-CTLA4 ICB exposure was associated with different predictors of response compared to tumors that were naive to ICB, suggesting selective immune effects of previous exposure to anti-CTLA4 ICB. Finally, we developed parsimonious models integrating clinical, genomic and transcriptomic features to predict intrinsic resistance to anti-PD1 ICB in individual tumors, with validation in smaller independent cohorts limited by the availability of comprehensive data. Broadly, we present a framework to discover predictive features and build models of ICB therapeutic response.
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