Predictive Factors in Metastatic Melanoma Treated with Immune Checkpoint Inhibitors: From Clinical Practice to Future...

Area of Science:

• Oncology
• Immunology
• Dermatology

Background:

• Immunotherapy, specifically immune checkpoint inhibitors (ICIs), has transformed metastatic melanoma treatment.
• However, response rates to ICIs vary, necessitating the identification of predictive biomarkers.

Purpose of the Study:

• To critically review current literature on predictive factors for ICI response in metastatic melanoma.
• To evaluate the potential and limitations of various predictive biomarkers.

Main Methods:

• Comprehensive literature review of studies investigating predictive factors in metastatic melanoma treated with ICIs.
• Analysis of host-associated, immune system activation-related, and tumor-related factors.
• Evaluation of biomarkers including medical history, gut microbiome, tumor burden markers, and immune cell profiles.

Main Results:

• Predictive factors encompass patient demographics, comorbidities, gut microbiome composition, tumor burden (e.g., LDH, CRP, ctDNA), and tumor characteristics (e.g., TILs, mutations).
• Immune system activation markers, such as IFN-gamma gene expression and circulating immune cell subsets, show significant correlation with ICI response.
• Various methods have limitations and potential that require careful consideration.

Conclusions:

• Identifying predictive factors is essential for optimizing ICI therapy in metastatic melanoma.
• Promising biomarkers are emerging, offering potential for improved patient selection and treatment stratification.
• Further research is needed to validate and integrate these biomarkers into clinical practice.