Tumor infiltrating lymphocytes in lymph node metastases of stage III melanoma correspond to response and survival in nine patients treated with ipilimumab at the time of stage IV disease
Stefan Diem, Omar Hasan Ali, Christoph J Ackermann, David Bomze, Viktor H Koelzer, Wolfram Jochum, Daniel E Speiser, Kirsten D Mertz & Lukas Flatz
abstract
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Prognosis of metastatic melanoma improved with the development of
checkpoint inhibitors. The role of tumor infiltrating lymphocytes
(TILs) in lymph node metastases of stage III melanoma remains
unclear. We retrospectively characterized TILs in primary melanomas
and matched lymph node metastases (stage III melanoma) of patients
treated with the checkpoint inhibitor ipilimumab. Tumor infiltrating
lymphocytes were characterized for CD3, CD4, and CD8 expressions by
immunohistochemistry. 4/9 patients (44%) responded to treatment with
ipilimumab (1 complete and 2 partial remissions, 1 stable disease).
All responders exhibited CD4 and CD8 T-cell infiltration in their
lymph node metastases, whereas all non-responders did not show an
infiltration of the lymph node metastasis with TILs. The correlation
between the presence and absence of TILs in responders vs.
non-responders was statistically significant (p = 0.008).
Median distant metastases free survival, i.e., progression from
stage III to stage IV melanoma, was similar in responders and
non-responders (22.1 vs. 19.3 months; p = 0.462).
Median progression free and overall survival show a trend in favor
of the patients having TIL rich lymph node metastases (6.8 vs.
3.3 months, p = 0.09; and all alive at last follow-up
vs. 8.2 months, respectively, p = 0.08). Our data
suggest a correlation between the T-cell infiltration of the lymph
node metastases in stage III melanoma and the response to ipilimumab
once these patients progress to stage IV disease.
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citation
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Diem S, Hasan Ali O, Ackermann C J, Bomze D, Koelzer V H, Jochum W,
Speiser D E, Mertz K D, Flatz L. Tumor infiltrating lymphocytes in
lymph node metastases of stage III melanoma correspond to response
and survival in nine patients treated with ipilimumab at the time of
stage IV disease. Cancer Immunol Immunother 2017; 67:39-45.
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type
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journal paper/review (English)
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date of publishing
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11-09-2017
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journal title
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Cancer Immunol Immunother (67/1)
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ISSN electronic
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1432-0851
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pages
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39-45
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PubMed
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28894934
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DOI
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10.1007/s00262-017-2061-4
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