The association between pretreatment emotional distress and response to tumor-infiltrating lymphocyte therapy in advanced melanoma

Egeler, Mees D. and Klobuch, Sebastian and Tak, Willemijn S. and Rohaan, Maartje W. and Borch, Troels H. and Noringriis, Inge. M. and Tissier, Renaud and Lucas, Minke W. and van Houdt, Winan and Akkooi, Alexander C. J. van and Jedema, Inge and Donia, Marco and Blank, Christian U. and Svane, Inge Marie and Haanen, John B. A. G. and Poll-Franse, Lonneke V. van de (2025) The association between pretreatment emotional distress and response to tumor-infiltrating lymphocyte therapy in advanced melanoma. EUROPEAN JOURNAL OF CANCER, 227: 115640. ISSN 0959-8049, 1879-0852

Full text not available from this repository. (Request a copy)

Abstract

Aims: Adoptive cell therapy (ACT) using tumor-infiltrating lymphocytes (TILs) has demonstrated benefit for patients with advanced melanoma refractory to first-line immune checkpoint inhibitors (ICIs). However, predictive biomarkers for TIL therapy response are limited. Preclinical studies suggest that emotional distress (ED) may impair antitumor immune responses. We conducted a post-hoc analysis of the phase III TIL trial (NCT02278887) to evaluate the association between pretreatment ED and TIL therapy outcomes. Methods: ED was evaluated using a composite score derived from the Impact of Event Scale and the emotional functioning subscale of the EORTC QLQ-C15-PAL. Patients were stratified into elevated ED (n = 32) or normal ED (n = 40) groups using a median split approach. To evaluate whether the obtained results were dependent on the ED classification method, a sensitivity analysis was conducted to compare TIL therapy outcomes between patients with composite ED scores in the lowest tertile (normal ED, n = 26) and highest tertile (elevated ED, n = 25). Results: Elevated ED was associated with a reduced objective response rate (37 % vs. 69 %; adjusted odds ratio, 0.28; 95 % confidence interval [CI], 0.19-0.75; P = 0.013) and decreased progression-free survival rates at 1year (31 % vs. 58 %) and 2-years (16 % vs. 35 %; adjusted hazard ratio, 1.84; 95 % CI, 1.03-3.26; P = 0.038). Sensitivity analysis using the tertile grouping method showed a similar trend (odds ratio, 0.35; 95 % CI, 0.11-1.08, P = 0.072). Conclusion: Our findings suggest that elevated ED before TIL therapy is associated with reduced therapeutic outcomes, underscoring the need for further investigation into the stress-immune-cancer axis.

Item Type: Article
Uncontrolled Keywords: EORTC QLQ-C15-PAL; CANCER-PATIENTS; STRESS; QUESTIONNAIRE; METASTASIS; VALIDATION; IPILIMUMAB; IMPACT; MICE; Melanoma; Survival; Emotional distress; Immunotherapy; Clinical outcomes
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Hals-Nasen-Ohren-Heilkunde
Depositing User: Dr. Gernot Deinzer
Date Deposited: 20 Apr 2026 05:37
Last Modified: 20 Apr 2026 05:37
URI: https://pred.uni-regensburg.de/id/eprint/67671

Actions (login required)

View Item View Item