TNF signature in advanced melanoma patients treated with immune checkpoint inhibitors: Results from the MELANF-alpha; clinical study.
By: Mathieu Virazels, Amélie Lusque, Stéphanie Brayer, Matthieu Genais, Carine Dufau, Jean Milhès, Thomas Filleron, Cécile Pagès, Vincent Sibaud, Laurent Mortier, Olivier Dereure, Maha Ayyoub, Amandine Fabre, Nathalie Andrieu-Abadie, Vera Pancaldi, Céline Colacios, Nicolas Meyer, Bruno Ségui, Anne Montfort

Unité Mixte de Recherche INSERM 1037, CNRS 5071, Université Toulouse III-Paul Sabatier, Centre de Recherches en Cancérologie de Toulouse (CRCT), Toulouse, France.
2025-2-14; doi: 10.1002/ijc.35416
Abstract

Resistance to immune checkpoint inhibitors (ICI) in cancer patients is not fully understood, and predictive biomarkers are lacking. MELANFα (NCT03348891) is an open-label, prospective, multicenter cohort of 60 patients with advanced melanoma receiving ICI (bitherapy: ipilimumab + nivolumab; monotherapy: pembrolizumab or nivolumab). The primary objective was to evaluate whether changes in plasma TNF between baseline (W0) and week 12 (W12) identified patients with non-progressive disease at W12. Secondary and exploratory objectives were to assess the association between plasma TNF, tumor response, and changes in circulating T cells. Plasma TNF increased along therapy, but its W12/W0 fold change was not associated with non-progressive disease at W12. However, plasma TNF levels at W12 were significantly higher in non-responders than in responders across therapies (p = .0129). The remodeling of circulating T cell subpopulations was mostly triggered by bitherapy. Increased proportions of circulating central memory and effector memory CD8 T cells after bitherapy were positively and negatively associated with response to treatment, respectively. In this cohort, circulating T cells from responders and non-responders also displayed distinct molecular characteristics. Indeed, responders showed an increased proportion of CD8 T cells with low enrichment of TNF-related pathways and high cytotoxic potential, while non-responders displayed increased proportions of circulating CD8 EM T cells enriched for TNF-related pathways and directed toward cytokine expression. In conclusion, our study shows that elevated plasma TNF and enriched TNF pathways in T cells are associated with poorer clinical outcomes, reinforcing the notion that TNF may dampen ICI efficacy.



© 2025 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.

PMID:40098565






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