Evidence map›Paper›PMID 40379272›Full record

ArticleJournal for immunotherapy of cancer2025

Sensitivity to immune checkpoint inhibitors in BRAF/MEK inhibitor refractory melanoma.

Riyaben P Patel, Lydia Rui Jia Lim, Reem Saleh, Darius Schenk, Michael K Lee, Emily Lelliott, Aparna D Rao, Shaghayegh Arabi, Lorey Smith, Anna S Trigos and 3 more

Abstract read
In one paragraph

Article in Journal for immunotherapy of cancer, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Review
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  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Riyaben P PatelPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0001-8916-0307
Lydia Rui Jia LimPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0002-4031-7809
Reem SalehPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0002-8292-1895
Darius SchenkPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Michael K LeePeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Emily LelliottOlivia Newton-John Cancer Research Institute, Heidelberg, Victoria, Australia.
Aparna D RaoPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0002-6394-0011
Shaghayegh ArabiPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Lorey SmithPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0001-6130-978X
Anna S TrigosPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.ORCID http://orcid.org/0000-0002-5915-2952
Nicole HaynesPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Grant A McArthurPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Karen E SheppardPeter MacCallum Cancer Centre, Melbourne, Victoria, Australia karen.sheppard@petermac.org.ORCID http://orcid.org/0000-0002-2798-4703

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundResistance to BRAF and MEK inhibitors (BRAFi/MEKi) in metastatic melanoma frequently results in cross-resistance to immune checkpoint inhibitors (ICI), limiting effective treatment options. However, a subset of BRAFi/MEKi-resistant patients remains responsive to second-line ICI, suggesting heterogeneous underlying resistance mechanisms. This study aimed to explore the tumor immune microenvironment in BRAFi/MEKi-resistant melanoma to uncover factors influencing sensitivity to second-line ICI therapy.

methodTo investigate mechanisms underlying resistance and responsiveness to second-line ICIs, BRAFi/MEKi-resistant melanoma mouse models were used. Flow cytometry was employed to analyze immune cell populations within the tumor microenvironment, focusing on changes in CD8+T effector cells and other key immune subsets. RNA sequencing was performed to profile transcriptomic changes in resistant tumors, providing insights into the signaling pathways associated with resistance. Clinical samples from BRAFi/MEKi-resistant patients were further evaluated for correlations between immune profiles and key signaling pathways to support findings from the preclinical models.

resultsUsing BRAFi/MEKi-resistant melanoma mouse models, we observed distinct alterations in the tumor-immune microenvironment. Tumors exhibiting resistance showed a significant increase in CD8+T effector cells following BRAFi/MEKi treatment, suggesting an immune-stimulatory response. Mechanistic analysis identified the activation of the EGFR-STAT signaling pathway as a key driver of intrinsic resistance in these models. Notably, these tumors retained sensitivity to second-line ICI therapy, contrasting with NRAS-driven BRAFi/MEKi-resistant tumors, which demonstrated cross-resistance to ICIs. Supporting these findings, clinical samples from BRAFi/MEKi-resistant patients revealed a correlation between elevated EGFR activation and higher immune scores, indicating potential sensitivity to ICI therapy in this subset of patients.

conclusionEGFR overexpression emerges as a potential predictive biomarker for responsiveness to second-line ICIs in BRAFi/MEKi-resistant melanoma. These findings underscore the need for stratified therapeutic approaches and highlight EGFR as a target for improving outcomes in ICI therapy.

Indexed as

Drug Resistance, NeoplasmImmune Checkpoint InhibitorsMelanomaProtein Kinase InhibitorsProto-Oncogene Proteins B-rafAnimalsCell Line, TumorFemaleHumansMiceTumor MicroenvironmentBRAF protein, humanImmune Checkpoint InhibitorsProtein Kinase InhibitorsProto-Oncogene Proteins B-rafImmune Checkpoint InhibitorsSkin CancerSubcutaneousTumor infiltrating lymphocyte - TILTumor microenvironment - TME

Identifiers

PMID40379272
PMCPMC12083385

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.