PMID- 37331867 OWN - NLM STAT- MEDLINE DCOM- 20230915 LR - 20231213 IS - 1878-4046 (Electronic) IS - 1076-6332 (Linking) VI - 30 Suppl 1 DP - 2023 Sep TI - Subcutaneous Fat Abundance and Density Are Associated with an Enhanced Response to Immunotherapy in Metastatic Melanoma: A Retrospective Cohort Study. PG - S257-S267 LID - S1076-6332(23)00247-7 [pii] LID - 10.1016/j.acra.2023.05.007 [doi] AB - RATIONALE AND OBJECTIVES: Despite the impressive efficacy of immune checkpoint inhibitors (ICIs) in the treatment of metastatic melanoma, not all patients respond to therapy. In addition, ICI harbors the risk for serious adverse events (AEs), highlighting the need for novel biomarkers predicting treatment response and occurrence of AEs. Recently, the identification of enhanced response to ICI in obese patients has indicated that body composition might influence treatment efficacy. The aim of the current study is to assess radiologic measurements of body composition as biomarkers for treatment response and AEs to ICI in melanoma. MATERIALS AND METHODS: In the current work, we analyze adipose tissue abundance and density, as well as muscle mass via computed tomography scans in a retrospective cohort of 100 patients with non-resectable stage III/IV melanoma receiving first-line treatment with ICI in our department. From these, we investigate the impact of the subcutaneous adipose tissue gauge index (SATGI) and other parameters of body composition on treatment efficacy and occurrence of AEs. RESULTS: Low SATGI was associated with prolonged progression-free survival (PFS) in univariate and multivariate analyses (hazard ratio 2.56 [95% CI 1.18-5.55], P = .02), as well as an enhanced objective response rate (50.0% vs 27.1%; P = .02). Further analysis with a random forest survival model highlighted a nonlinear relationship between SATGI and PFS with a clear separation into high- and low-risk cohorts separated by the median. Finally, a significant enrichment of cases with vitiligo, but no other AEs, was observed in the SATGI-low cohort (11.5% vs 0%; P = .03). CONCLUSION: We identify SATGI as a biomarker predicting treatment response to ICI without increased risk for severe AEs in melanoma. CI - Copyright (c) 2023 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved. FAU - Mengoni, Miriam AU - Mengoni M AD - Department of Dermatology, University Hospital Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany. Electronic address: miriam.mengoni@med.ovgu.de. FAU - Braun, Andreas Dominik AU - Braun AD AD - Department of Dermatology, University Hospital Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany. FAU - Hinnerichs, Mattes Simon AU - Hinnerichs MS AD - Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany. FAU - Tuting, Thomas AU - Tuting T AD - Department of Dermatology, University Hospital Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany. FAU - Surov, Alexey AU - Surov A AD - Department of Radiology and Nuclear Medicine, University Hospital Magdeburg, Magdeburg, Germany; Department of Radiology, Neuroradiology and Nuclear Medicine, Johannes Wesling University Hospital, Ruhr University, Bochum, Germany. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230616 PL - United States TA - Acad Radiol JT - Academic radiology JID - 9440159 RN - 0 (Biomarkers) SB - IM MH - Humans MH - Retrospective Studies MH - *Melanoma/diagnostic imaging/drug therapy/pathology MH - Biomarkers MH - Immunotherapy/methods MH - Subcutaneous Fat MH - Melanoma, Cutaneous Malignant OTO - NOTNLM OT - Adipose tissue OT - Biomarker OT - Body composition OT - Immunotherapy OT - Melanoma COIS- Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: MM reports travel support from Pierre Fabre Pharma GmbH unrelated to this work. In addition, MM also reports honoraria for presentations and advisory tasks unrelated to this work from Novartis Pharma GmbH, Sun Pharmaceutical Industries Ltd., and MSD Sharp & Dohme GmbH unrelated to this work. EDAT- 2023/06/19 00:42 MHDA- 2023/09/15 06:42 CRDT- 2023/06/18 21:55 PHST- 2023/04/06 00:00 [received] PHST- 2023/05/07 00:00 [revised] PHST- 2023/05/08 00:00 [accepted] PHST- 2023/09/15 06:42 [medline] PHST- 2023/06/19 00:42 [pubmed] PHST- 2023/06/18 21:55 [entrez] AID - S1076-6332(23)00247-7 [pii] AID - 10.1016/j.acra.2023.05.007 [doi] PST - ppublish SO - Acad Radiol. 2023 Sep;30 Suppl 1:S257-S267. doi: 10.1016/j.acra.2023.05.007. Epub 2023 Jun 16.