The density and spatial tissue distribution of CD8⁺ and CD163⁺ immune cells predict response and outcome in melanoma patients receiving MAPK inhibitors.

At multivariate analysis, after adjusting for stage, LDH, PS, treatment received (BRAFi+MEKi vs BRAFi), subsequent immunotherapy (yes/no), metastatic MPs with high intratumoral, but not peritumoral, CD8 + T cells density showed a barely detectable statistically significant difference in terms of OS (HR 0.65, 95% CI 0.41–1.04, p = 0.072) (Fig. 4 ).

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2) metastatic MPs with absent/low intratumoral CD8 + T cells and high intratumoral CD163 + macrophages showed a nearly statistically significant shorter PFS compared to those with the opposite profile, while the same profile (low CD8 + T cells/high CD163 + macrophages) in the peritumoral space did not exhibit any tendency; 3) the response rate of patients with high intratumor CD163 + macrophages was lower than those with absent or low CD163 + intratumor infiltration, while the response rate was not affected by changes in the peritumoral CD163 + macrophages.

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