The MELimmune score—prognostic factors for overall survival in advanced melanoma and anti-PD-1 monotherapy—a multicentre, retrospective cohort study

• DOI: 10.1016/j.iotech.2025.101043
• Publication Date: 2025-02-03T17:05:33Z
• Authors: S. Lobo-Martins; D. Martins-Branco; P.M. Semedo; C.M. Alvim; A.M. Monteiro; I. Vendrell; E. Gouveia; M.J. Passos; L. Costa; A. Mansinho; R.T. de Sousa
• Keywords: melanoma; anti-PD-1; prognostic factors; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; MELimmune score; RC254-282

Immunotherapy has revolutionized advanced melanoma treatment. Several prognostic factors have been studied to predict survival in this setting. We aimed develop a score. A multicentre, retrospective cohort study was conducted including patients with who started anti-programmed cell death protein 1 (PD-1) monotherapy between January 2016 and October 2019 ≤2 prior treatment lines. The endpoint overall (OS). Univariate multivariate Cox regression identified independent factors, 95% confidence intervals (CIs). predictive accuracy of the model evaluated by receiver operating characteristic (ROC) curve model. 147 median follow-up 28.9 months (95% CI 22.5-33.5 months). OS (mOS) for whole 14.8 10.8-18.7 Overall, 43 104 were treated nivolumab pembrolizumab, respectively. four at baseline: ≥3 metastatic sites [hazard ratio (HR) 1.90, 1.21-2.97], performance status Eastern Cooperative Oncology Group ≥1 (HR 2.02, 1.28-3.18), lymphopenia 2.85, 1.54-5.27) or increased lactate dehydrogenase 2.08, 1.19-3.63). MELimmune score grouped into three risk categories: favourable prognosis (no factors; n = 34), intermediate (one factor; 65) poor (two more 48). mOS 43.4 32.1-54.7), 14.4 6.8-22.0) 6.5 3.6-9.4) favourable, groups, respectively (P < 0.001). area under ROC 0.74 0.66-0.82). Using easily accessible variables from daily practice, anti-PD-1 holds potential be used clinical practice prospectively validated trials.