ArticleNature medicine2023
Association between pretreatment emotional distress and neoadjuvant immune checkpoint blockade response in melanoma.
Article in Nature medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02977052 (Multicenter Phase 2 Study to Identify of the Optimal Neo-Adjuvant Combination Scheme of Ipilimumab and Nivolumab), which is not on this map. Cited by 39 papers, 1 of them a synthesis that pooled it.
What it found
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Multicenter Phase 2 Study to Identify of the Optimal Neo-Adjuvant Combination Scheme of Ipilimumab and Nivolumab (OpACIN-neo)
Who cites it
39 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Psychological Factors Related to Treatment Outcomes in Head and Neck Cancer.Advances in therapy · 2024Pooled it
- Identification of key symptoms impacting HRQOL in advanced renal cell carcinoma: nivolumab plus cabozantinib versus sunitinib in CheckMate 9ER.The oncologist · 2026Trial
- Precision palliative care in advanced/recurrent esophageal cancer patients treated with anti-PD-1/PD-L1 immunotherapy (ESO-Shanghai 25): a randomized, phase III Trial.Future oncology (London, England) · 2026Trial
- Trial
- Inflammatory Stress Determines the Need for Chemotherapy in Patients with HER2-Positive Esophagogastric Adenocarcinoma Receiving Targeted Therapy and Immunotherapy.Cancer immunology research · 2025Trial
- Psychological stress and tumor progression: Molecular mechanisms and therapeutic implications (Review).Oncology letters · 2026Review
- Emotional distress and clinical response to neoadjuvant chemoimmunotherapy in resectable non-small-cell lung cancer: a protocol for the prospective observational NeoFUSE-Lung cohort study.Translational lung cancer research · 2026Article
- A programmed cell death learning signature predicts immunotherapy response and identifies AP1S1 as a regulator of immune exclusion in breast cancer.Chinese journal of cancer research = Chung-kuo yen cheng yen chiu · 2026Article
- Psychological Stress Promotes Tumor Growth in Hepatocellular Carcinoma Models Through Myeloid Signaling.Cancer science · 2026Article
- Biography as the Missing Variable in Drug Development: A Case for Bio-Biographical Mechanistic Profiling.Clinical pharmacology and therapeutics · 2026Article
- Medicine's 'Basic' Mistake: How the Molecular Revolution Displaced an Entire Category of Inquiry.Journal of evaluation in clinical practice · 2026Review
- Article
- Endogenous glucocorticoids and glucocorticoid receptor signaling: Dual regulators of PD-1/PD-L1 immunotherapy efficacy in the tumor microenvironment.Chinese medical journal · 2026Review
- Emerging Perspectives on Adverse Childhood Experiences and Brain Cancer Immunotherapy.Cancers · 2026Article
- Olanzapine enhances the response of PD-(L)1 inhibitor immunotherapy: A retrospective efficacy analysis in advanced malignancies.iScience · 2026Article
- Neutrophil extracellular traps in cancer.Nature reviews. Cancer · 2026Review
- Lessons from neoadjuvant immunotherapy in melanoma: understanding antitumour immunity and tumour escape.Nature reviews. Immunology · 2026Review
- The impact of concomitant medications on treatment outcomes in patients with cancer receiving immune checkpoint inhibitors.Nature reviews. Cancer · 2026Review
- Psychological distress as a putative host-state determinant of cancer immunotherapy response.Frontiers in immunology · 2026Review
- Emotional distress is associated with neuroendocrine-immune remodeling and less favorable neoadjuvant immunotherapy outcomes in oral squamous cell carcinoma.Frontiers in immunology · 2026Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Neoadjuvant immune checkpoint blockade (ICB) outperforms adjuvant ICB for treatment of stage IIIB-D melanoma, but potential biomarkers of response, such as interferon-gamma (IFNγ) signature and tumor mutational burden (TMB), are insufficient. Preclinical studies suggest that emotional distress (ED) can negatively affect antitumor immune responses via β-adrenergic or glucocorticoid signaling. We performed a post hoc analysis evaluating the association between pretreatment ED and clinical responses after neoadjuvant ICB treatment in patients with stage IIIB-D melanoma in the phase 2 PRADO trial ( NCT02977052 ). The European Organisation for Research and Treatment of Cancer scale for emotional functioning was used to identify patients with ED (n = 28) versus those without (n = 60). Pretreatment ED was significantly associated with reduced major pathologic responses (46% versus 65%, adjusted odds ratio 0.20, P = 0.038) after adjusting for IFNγ signature and TMB, reduced 2-year relapse-free survival (74% versus 91%, adjusted hazard ratio 3.81, P = 0.034) and reduced 2-year distant metastasis-free survival (78% versus 95%, adjusted hazard ratio 4.33, P = 0.040) after adjusting for IFNγ signature. RNA sequencing analyses of baseline patient samples could not identify clear β-adrenergic- or glucocorticoid-driven mechanisms associated with these reduced outcomes. Pretreatment ED may be a marker associated with clinical responses after neoadjuvant ICB in melanoma and warrants further investigation. ClinicalTrials.gov registration: NCT02977052 .
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