Exploring the relation between TGF-β pathway activity and response to checkpoint inhibition in patients with metastatic melanoma

Stefan G van Ravensteijn*, Avital L Amir, Daniele V F Tauriello, Carla M L van Herpen, Marye J Boers-Sonderen, Yvonne J W Wesseling, Anne G C van Brussel, Diederick M Keizer, Henk M W Verheul, Kalijn F Bol

*Corresponding author for this work

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Abstract

Introduction: Immune checkpoint inhibition (ICI) is highly effective for the treatment of melanoma, but intrinsic resistance is present in a subgroup of patients. TGF-β pathway activity may play a role in this resistance by preventing T-cells from entering the tumor microenvironment, causing immune escape. We investigated the association of TGF-β signal transduction pathway activity with resistance to ICI treatment in advanced melanoma. Furthermore, other pathway activities were analyzed to better understand their potential role in ICI resistance. Method: The activity of 8 signaling pathways (TGF-β, Hedgehog, MAPK, AR, NOTCH, PI3K, JAK/STAT1-2, and NFkB) was analyzed from tumor tissue from patients with advanced melanoma. Pathway activity scores (PAS) were explored for associations with survival and response to ICI in 34 patients (19 non-responders and 15 responders). A second, independent method to investigate the predictive value of TGF-β pathway activation was conducted by determining levels of phosphorylated SMAD2. Results: The mean TGF-β PAS of responders vs non-responders was 53.9 vs 56.8 (P = 0.265). No significant relation with progression-free survival was detected for TGF-β activity (P = 0.078). No association between pSMAD2 staining and treatment response or survival was identified. In contrast, Hedgehog scores of responders versus non-responders were 35.7 vs 41.6 (P = 0.038). High Hedgehog PAS was the sole significant predictor of resistance to ICI (OR 0.88, P = 0.033) and worse progression-free survival (HR 1–1.1, P = 0.012). Conclusion: TGF-β pathway activation showed no significant relation with treatment response to ICI or survival in patients with advanced melanoma. Hedgehog PAS was identified as a possible biomarker associated with both treatment response and survival.

Original languageEnglish
Article numberuxae108
JournalClinical and Experimental Immunology
Volume219
Issue number1
Early online date30 Nov 2024
DOIs
Publication statusPublished - 1 Jan 2025

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Publisher Copyright:
© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Immunology.

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