Ipilimumab Prognostic Score in Progressive Metastatic Melanoma Patients. A Retrospective Analysis on Behalf of Italian Melanoma Intergroup

Olga Nigro ,Marconcini Riccardo,A Nuzzo ,De Rosa Francesco ,Di Guardo Lorenza Alessia ,Marco Tucci ,Stefania Crucitta ,Melissa Bersanelli ,Alessio Cortellini ,Annalisa Todisco ,Falcone Alfredo ,S Manacorda ,Marco Palla ,Stucci Luigia Stefania ,Paolo Fava ,P Di Giuseppe

doi:10.32474/oajom.2021.04.000187

Abstract

Approximately 80% of all viruses are RNA viruses and they contain their specific RNA helicases. Defective RNA helicases have been linked to infectious diseases (Viral Infections). Materials and Methods: The articles have gone through many types of research from the beginning of the epidemic of Coronaviruses through history and we introduced the neglected hypothesis of Shifting balance theory, Bateson–Dobzhansky–Muller model & Quantum evolution. In the ancestral population, the genotype is AABB. When two populations become isolated from each other, new mutations can arise. In one population A evolves into a, and in the other B evolves into b. When the two populations hybridize it is the first time A and B interact with each other. When these alleles are incompatible, we speak of Dobzhansky–Muller incompatibilities plus the role of MMA in mitochondria in spreading SARS-CoV-19 through populations and the result of an infection in COVID-19...

Highlights

Metastatic melanoma is one of the most aggressive solid tumors [1], and its management has been improved over the past few years thanks to new immune checkpoint inhibitors and targeted therapies [2,3,4,5,6]
Eastern Cooperative Oncology Group (ECOG) PS 0 and Neutrophile Lymphocyte Ratio (NLR)
The present study is a multicenter retrospective analysis conducted in multiple Italian Centers, in which we collected data related to patients with metastatic melanoma treated with Ipilimumab after treatment with Anti-PD1 and with BRAF and MEK inhibitors if BRAF mutated: our goal is to identify clinical characteristics or routine laboratory facilities tests which may have a prognostic connotation regarding the efficacy of Ipilimumab; this analysis may potentially help clinicians in choosing Ipilimumab monotherapy in this setting instead of other experimental combinations in specific subgroups of patients

Summary

Introduction

Metastatic melanoma is one of the most aggressive solid tumors [1], and its management has been improved over the past few years thanks to new immune checkpoint inhibitors and targeted therapies [2,3,4,5,6]. Standard first line treatment of metastatic melanoma includes antibody targeting Programmed cell death protein 1 (PD1) Nivolumab or Pembrolizumab [2, 3], associated with Anti-Cytotoxic T-Lymphocyte Antigen 4 (CTLA4) Ipilimumab, and, in case of BRAF v600 mutation, the use of BRAF and MEK inhibitors [4,5,6]. The present study is a multicenter retrospective analysis conducted in multiple Italian Centers, in which we collected data related to patients with metastatic melanoma treated with Ipilimumab after treatment with Anti-PD1 and with BRAF and MEK inhibitors if BRAF mutated: our goal is to identify clinical characteristics or routine laboratory facilities tests which may have a prognostic connotation regarding the efficacy of Ipilimumab; this analysis may potentially help clinicians in choosing Ipilimumab monotherapy in this setting instead of other experimental combinations in specific subgroups of patients. We evaluate the prognostic role of some relevant clinical or laboratories parameters for Ipilimumab used in late line after AntiPD1 progression to define patients that benefit most from Ipilimumab monotherapy in this setting

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