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Updated: Jun 18, 2026
Predictive Immune Modeling of Solid Tumors
Published on: February 25, 2020
Comprehensive analysis of prognostic biomarkers for immunotherapy response in patients with advanced malignant
Luqiao Li1,2, Yueling Yang3, Rong Huang1
1The Comprehensive Cancer Center of Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, China.
Background:
The efficacy of immunotherapy monotherapy is limited in Chinese patients with melanoma. The aim of this study was to evaluate the prognostic biomarkers in patients with advanced or unresectable malignant melanoma receiving immunotherapy, to identify high-risk subgroups and improve survival stratification.
Methods:
We retrospectively reviewed the records of 62 patients pathologically diagnosed with advanced or unresectable melanoma from February 2019 to October 2022 at Nanjing Drum Tower Hospital and treated with immunotherapy. The complete basic information of patients was collected through medical history review and follow-up, including age, gender, primary tumor site, subtype, stage, metastatic site, and treatment lines. Next-generation sequencing (NGS) of tumor tissue samples was conducted. Hematological specimens were collected before the first immunotherapy session to calculate the neutrophil-to-lymphocyte ratio (NLR) and albumin levels.
Results:
Greater than five metastatic sites, liver metastases, bone metastases, an NLR ≥3, and abnormal albumin levels were associated with shorter progression-free survival (PFS) in patients treated with immunotherapy, and patients who received combination with chemotherapy had better survival. The most commonly altered genes included NRAS (22.6%), CDKN2A (17.7%), KIT (16.1%), CDK4 (14.5%), and MDM2 (14.5%). The KMT2A mutation was independently associated with a shorter PFS. Interestingly, there was no association between MDM2 amplification-a recognized immunotherapy hyperprogressive factor-and melanoma immunotherapy efficacy. Further analysis revealed that most patients with MDM2 amplification received immunotherapy combined with chemotherapy. Stratified analysis showed that patients with MDM2 amplification and no chemotherapy had a shorter PFS, while those treated with combination therapy had a longer PFS.
Conclusions:
NLR ≥3 and the presence of liver metastases were identified as independent prognostic factors. These preliminary findings may help refine prognostic stratification for advanced melanoma patients receiving immunotherapy.
