This study evaluates whether interferon-gamma (IFN-γ) expression in tumor tissue and peripheral blood can serve as a predictive biomarker of response to immune checkpoint inhibitors in the first-line treatment of metastatic melanoma. Although immune checkpoint inhibitors have substantially improved outcomes in metastatic melanoma, not all patients respond to therapy. Reliable biomarkers that could help identify patients most likely to benefit from treatment are still lacking. This study investigates the association between IFN-γ expression levels and objective treatment response. In addition, the study explores whether characteristics of the gut microbiome are associated with immunotherapy outcomes. The results may contribute to improved patient stratification and personalized treatment approaches in metastatic melanoma.
Immune checkpoint inhibitors have significantly improved survival in patients with metastatic melanoma. However, treatment response varies considerably, and a substantial proportion of patients do not achieve durable benefit. The identification of predictive biomarkers remains an important unmet clinical need. This prospective, single-arm interventional study evaluates biological markers in patients receiving first-line immune checkpoint inhibitor therapy for metastatic melanoma. The primary objective is to assess whether interferon-gamma (IFN-γ) expression in tumor tissue and peripheral blood is associated with objective response to treatment. Tumor IFN-γ expression is assessed using immunohistochemistry, and peripheral blood IFN-γ concentration is measured using enzyme-linked immunosorbent assay (ELISA). The study also evaluates additional biomarkers, including PD-L1 expression, to explore their potential predictive value. Furthermore, the study investigates the relationship between gut microbiome composition and treatment outcomes. Microbiome diversity and bacterial taxonomic profiles are analyzed from stool samples to determine whether microbial characteristics are associated with response to immunotherapy. The study is conducted at a single tertiary oncology center and includes adult patients with metastatic melanoma receiving standard-of-care first-line immune checkpoint inhibitor therapy. The findings aim to support improved risk stratification and biomarker-guided therapeutic decision-making.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
132
PD-1 inhibitor used as first-line immunotherapy in patients with metastatic malignant melanoma.
PD-1 inhibitor used as first-line immunotherapy in patients with metastatic malignant melanoma.
Combination immunotherapy with PD-1 inhibitor (nivolumab) and CTLA-4 inhibitor (ipilimumab) used as first-line treatment in metastatic malignant melanoma.
Institute of Oncology Ljubljana
Ljubljana, Slovenia
Objective Response Rate (ORR) Assessed by Immune-Related RECIST (irRECIST)
Objective response rate defined as the proportion of participants achieving complete response (CR) or partial response (PR) according to immune-related Response Evaluation Criteria in Solid Tumors (irRECIST), based on CT or PET/CT imaging assessment.
Time frame: Up to 28 weeks after treatment initiation
Tumor Tissue IFN-Gamma Expression Assessed by Immunohistochemistry (IHC)
Interferon-gamma (IFN-γ) expression in tumor tissue measured using immunohistochemistry (IHC). Expression will be quantified using the Histochemical Score (H-score), a semi-quantitative scoring system ranging from 0 to 300. Higher H-scores indicate higher IFN-γ expression levels in tumor tissue.
Time frame: Baseline (within 4 weeks before treatment initiation)
Peripheral Blood IFN-Gamma Concentration Measured by ELISA
Interferon-gamma (IFN-γ) concentration in peripheral blood measured using enzyme-linked immunosorbent assay (ELISA) and reported in picograms per milliliter (pg/mL).
Time frame: Baseline and up to 28 weeks after treatment initiation
Gut Microbiome Alpha Diversity Index Assessed by 16S rRNA Sequencing
Gut microbiome diversity assessed from stool samples using 16S rRNA sequencing. Alpha diversity will be quantified using the Shannon diversity index.
Time frame: Baseline (up to 4 weeks before treatment initiation)
Relative Abundance of Bacterial Taxa in Stool Samples Assessed by 16S rRNA Sequencing
Relative abundance (%) of bacterial taxa assessed from stool samples using 16S rRNA sequencing.
Time frame: Baseline (up to 4 weeks before treatment initiation)
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