Plasma exchange and radiation resensitize immunotherapy-refractory melanoma: a phase I trial

Jacob J. Orme (), Henan Zhang, Prashanth Lingamaneni, Yohan Kim, Roxane Lavoie, Maddy Dorr, Paul Dizona, Jacob Hirdler, Elizabeth A. Bering, Joanina K. Gicobi, Michelle Hsu, Heather Dale, Daniel S. Childs, Lisa A. Kottschade, Robert R. McWilliams, Matthew S. Block, Aaron S. Mansfield, Svetomir N. Markovic, Ken Olivier, Dawn Owen, Scott Lester, Daniel Ma, Roxana S. Dronca, Haidong Dong, Fabrice Lucien, Annie T. Packard, Jeffrey L. Winters and Sean S. Park
Additional contact information
Jacob J. Orme: Mayo Clinic
Henan Zhang: Mayo Clinic
Prashanth Lingamaneni: Mayo Clinic
Yohan Kim: Mayo Clinic
Roxane Lavoie: Mayo Clinic
Maddy Dorr: Mayo Clinic
Paul Dizona: Mayo Clinic
Jacob Hirdler: Mayo Clinic
Elizabeth A. Bering: Mayo Clinic
Joanina K. Gicobi: Mayo Clinic
Michelle Hsu: Mayo Clinic
Heather Dale: Mayo Clinic
Daniel S. Childs: Mayo Clinic
Lisa A. Kottschade: Mayo Clinic
Robert R. McWilliams: Mayo Clinic
Matthew S. Block: Mayo Clinic
Aaron S. Mansfield: Mayo Clinic
Svetomir N. Markovic: Mayo Clinic
Ken Olivier: Mayo Clinic
Dawn Owen: Mayo Clinic
Scott Lester: Mayo Clinic
Daniel Ma: Mayo Clinic
Roxana S. Dronca: Mayo Clinic
Haidong Dong: Mayo Clinic
Fabrice Lucien: Mayo Clinic
Annie T. Packard: Mayo Clinic
Jeffrey L. Winters: Mayo Clinic
Sean S. Park: Mayo Clinic

Nature Communications, 2025, vol. 16, issue 1, 1-11

Abstract: Abstract Immune checkpoint inhibitors (ICI) are effective for advanced melanoma. However, most develop ICI resistance. Tumor-derived soluble PD-L1 (sPD-L1) and other immunosuppressive factors drive resistance. We hypothesized that therapeutic plasma exchange (TPE) may remove sPD-L1 from circulation and overcome ICI resistance. Patients with metastatic ICI-resistant melanoma and elevated sPD-L1 received radiotherapy to a minority of metastatic lesions, TPE, and ICI re-challenge. Primary endpoints were adverse events and sPD-L1 reduction. Secondary endpoints included overall survival, response, and progression-free survival. Correlative studies included changes in sPD-L1, other immunosuppressive factors, and immune cell phenotypes. Eighteen patients were included. Treatment was well-tolerated, and levels of sPD-L1 were reduced by TPE (mean 78%, p

Date: 2025
References: Add references at CitEc
Citations:

Downloads: (external link)
https://www.nature.com/articles/s41467-025-57865-9 Abstract (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-025-57865-9

Ordering information: This journal article can be ordered from
https://www.nature.com/ncomms/

DOI: 10.1038/s41467-025-57865-9

Access Statistics for this article

Nature Communications is currently edited by Nathalie Le Bot, Enda Bergin and Fiona Gillespie

More articles in Nature Communications from Nature
Bibliographic data for series maintained by Sonal Shukla () and Springer Nature Abstracting and Indexing ().