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J Immunother. 2019 Apr;42(3):89-93. doi: 10.1097/CJI.0000000000000255.

Immunoglobulin G and Subclasses as Potential Biomarkers in Metastatic Melanoma Patients Starting Checkpoint Inhibitor Treatment.

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Institute of Immunobiology.
Departments of Oncology/Hematology.
Department of Oncology/Hematology, Spital Grabs, Grabs.
Dermatology, Allergology and Venerology, Kantonsspital St. Gallen.
Labormedizinisches Zentrum Dr. Risch Ostschweiz AG, St. Gallen.
Department of Dermatology, University of Zurich, University of Zurich Hospital, Zurich.
Center of Laboratory Medicine, University Institute of Clinical Chemistry, University of Bern, Bern.
Private University in the Principality of Liechtenstein, Triesen, Liechtenstein.
Immunodeficiency Clinic, Medical Outpatient Unit and Immunodeficiency Laboratory, Department of Biomedicine, University Hospital, Basel.
Department of Laboratory Medicine, Kantonsspital Graubünden, Chur, Switzerland.


Checkpoint inhibitors have improved survival of metastatic melanoma. However, reliable biomarkers to predict response are still needed. Immunoglobulin G (IgG) antibody subclasses reflect immunocompetence in individuals and are known to be involved in essential functions in our immune system. This prospective study evaluated the association between serum IgG with its subclasses IgG1, IgG2, IgG3, and IgG4 and antitumor response according to RECIST 1.1. Serum samples from 49 patients were prospectively collected before the start of treatment with a checkpoint inhibitor. We observed a statistically significant association of baseline IgG2 with response to therapy (P=0.011). After defining optimal cutpoints, we found significant associations between total IgG (>9.66 g/L, P=0.038), IgG1 (>6.22 g/L, P=0.025), IgG2 (>2.42 g/L, P=0.019), and IgG3 (>0.21 g/L, P=0.034) with progression-free survival. Prolonged overall survival was associated with elevated IgG2 (>2.42 g/L, P=0.043). Together, these findings define total IgG and subclasses as predictors of clinical successful checkpoint inhibition in metastatic melanoma patients.

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