Nose in malignant mesothelioma—Prediction of response to immune checkpoint inhibitor treatment

Recent clinical trials with immune checkpoint inhibitors (ICIs) have shown that a subgroup of patients with malignant pleural mesothelioma (MPM) could benefit from these agents. However, there are no accurate biomarkers to predict who will respond. The aim of this study was to assess the accuracy of...

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Bibliographic Details
Published in:European journal of cancer (1990) 2021-07, Vol.152, p.60-67
Main Authors: Disselhorst, Maria J., de Vries, Rianne, Quispel-Janssen, Josine, Wolf-Lansdorf, Marguerite, Sterk, Peter J., Baas, Paul
Format: Article
Language:English
Subjects:
Biomarkers
Clinical trials
Confidence intervals
CTLA-4 protein
Data processing
Electronic noses
eNose
Immune checkpoint inhibitors
Malignant pleural mesothelioma (MPM)
Mesothelioma
Patients
PD-1 protein
Solid tumors
Statistical analysis
Statistical tests
Subgroups
Technology assessment
Tumors
Volatile organic compound (VOC)
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Summary:Recent clinical trials with immune checkpoint inhibitors (ICIs) have shown that a subgroup of patients with malignant pleural mesothelioma (MPM) could benefit from these agents. However, there are no accurate biomarkers to predict who will respond. The aim of this study was to assess the accuracy of exhaled breath analysis using electronic technology (eNose) for discriminating between responders to ICI and non-responders. This proof-of-concept prospective observational study was part of an intervention study (INITIATE) in patients with recurrent MPM who were treated with nivolumab (anti-PD-1) plus ipilimumab (anti-CTLA-4). At baseline and after six weeks of treatment, breath profiles were collected by an eNose. Modified Response Evaluation Criteria in Solid Tumors were used to assess efficacy at 6-month follow-up. For data processing and statistics, we used independent t-test analyses followed by linear discriminant and receiver-operating characteristic (ROC) analysis. Exhaled breath data of 31 MPM patients who received nivolumab plus ipilimumab were available at baseline. There were 16 with and 15 without a response after 6 months of treatment. At baseline, breath profiles significantly differed between responders and non-responders, with a cross validation value of 71%. The ROC-AUC after internal cross-validation was 0.90 (confidence interval: 0.80–1.00). An eNose is able to discriminate at baseline between responders and non-responders to nivolumab plus ipilimumab in MPM, thereby potentially identifying a subgroup of patients that will benefit from ICI treatment. •An eNose is able to discriminate responders to ICI treatment in MPM.•Breath profile changes during ICI treatment in MPM.•An eNose could be a tool for predicting response to nivolumab plus ipilimumab in patients with MPM.
ISSN:0959-8049
1879-0852
DOI:10.1016/j.ejca.2021.04.024