Application of the Scottish inflammatory prognostic score to the south-east Scotland cancer network real-world melanoma cohort

BackgroundThe Scottish Inflammatory Prognostic Score (SIPS) has been shown to predict survival in patients with advanced/metastatic non-small cell lung cancer (NSCLC) receiving first-line pembrolizumab monotherapy. SIPS uses serum albumin and neutrophil measurements, routinely collected prior to treatment commencement, to generate a score of 0-2 (Table). We aimed to assess the prognostic utility of SIPS in patients with unresectable/metastatic melanoma treated with first-line pembrolizumab.MethodsAll patients treated with first line pembrolizumab for unresectable/metastatic cutaneous melanoma at a Scottish Regional Cancer Centre between 2013-2020 were included. Data extracted comprised patient demographics, oncological diagnosis and staging, first-line metastatic treatment details, radiological responses, and mortality status. Patients were stratified by SIPS. Progression-Free Survival (PFS) and Overall Survival (OS) were defined as the time from cycle 1, day 1 pembrolizumab monotherapy to progression or death (from any cause) respectively, or censorship. The relationship between SIPS and survival outcomes was evaluated.Results145 patients were included. Median age was 71 (range 32-90) years and 58% were male. The minimum follow-up time of censored patients was 14.7 months. 92 (63%), 37 (26%) and 16 (11%) of patients were SIPS 0, 1 or 2 respectively. SIPS stratified both PFS and OS (both p<0.001) (Table). Table: 1116P SIPS 0 (Albumin ≥35 g/l and Neutrophils ≤7.5 x109/L) SIPS 1 (Albumin ≥35 g/l and Neutrophils >7.5 x109/L OR Albumin <35 g/l and Neutrophils ≤7.5 x109/L) SIPS 2 (Albumin <35 g/l and Neutrophils >7.5 x109/L) Progression-Free Survival 23.7 Months 5.0 Months 1.8 Months Overall Survival 34.4 Months 7.0 Months 3.3 Months ConclusionsAs in NSCLC, SIPS may predict survival outcomes in patients with cutaneous melanoma, treated with pembrolizumab. In those with SIPS 2 we suggest careful consideration as to the merits of pembrolizumab therapy when discussing this option with patients. SIPS warrants further investigation, both through external validation in melanoma patients receiving pembrolizumab, and applicability to other treatment options, such as ipilimumab/nivolumab.Legal entity responsible for the studyThe authors.FundingHas not received any funding.DisclosureAll authors have declared no conflicts of interest.