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High expression of a spliced variant of FKBP51 in peripheral blood mononuclear cells of melanoma patients may be related to PDL-1 on tumour and predictive of response to Ipilimumab
  1. Ester Simeone1,
  2. Maria fiammetta Romano2,
  3. Antonio Maria Grimaldi1,
  4. Assunta Esposito1,
  5. Marcello Curvietto1,
  6. Miriam Paone1,
  7. Giovanni Rinaldi1,
  8. Gianluca Di monta1,
  9. Massimiliano Di marzo1,
  10. Federica Hauber1,
  11. Lucia Festino1,
  12. Anna D'Angelillo3,
  13. Simona Romano2,
  14. Stefania Staibano2,
  15. Gennaro Ilardi2,
  16. Rita Bisogni2,
  17. Nicola Mozzillo1 and
  18. Paolo Antonio Ascierto4
  1. Aff1 Istituto Tumori di Napoli, Fondazione Pascale Italy
  2. Aff2 grid.4691.a000000010790385XUniversity of Naples, Federico II Italy
  3. Aff3 grid.411489.10000000121682547University of Catanzaro Magna Grecia Italy
  4. Aff4 grid.417893.00000000108072568Istituto Nazionale Tumori, Fondazione "G Pascale" Naples Italy

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Meeting abstracts


Identifying molecular biomarkers in melanoma may provide useful diagnostic and therapeutic tools. Melanoma delivers immune suppressive stimuli through the pathway PDL-1/PD-1. Recent data suggest tumour-cell expression of PD-L1 in melanoma may be driven by constitutive oncogenic pathways. FK506 binding protein 51 (FKBP51), is an immunophilin that is highly expressed in melanoma and in tumour infiltrating lymphocytes (TIL). It is capable of immune suppression and has a relevant role in the progression of this tumour. We explored the expression of a variant generated by alternative splicing of FKBP51(FKBP51s) on TIL and its potential relation to PDL-1 in metastatic melanoma patients during Ipilimumab therapy (IPI).


We collected melanoma samples (12 primaries and 64 metastases) and peripheral blood mononuclear cells (PBMC) of 76 metastatic melanoma patients at week 0,1,4,7,10 and 12 of IPI.

We measured expression levels of FKBP51s on TIL (range 7.0-36.0, arbitrary unit) and PDL-1 on tumour, by quantitative polymerase chain reaction (QPCR) and by immunohistochemical assay with a cutoff of 5%, respectively.


Expression of PDL-1 was found in 16% (2/12) and 40% (26/64) of primary and metastatic melanomas, respectively.

In melanoma negative for PDL-1, a low/no expression of FKBP51s was observed in TILs. In PDL-1 expressing melanomas, FKBP51s stained >80% of TILs. In addition, in melanoma negative for PDL-1, but with numerous PDL-1+ infiltrating macrophages, 10-15% of FKBP51s+ TILs was measured.

We found 29% of patients (22/76) had increased levels of FKBP51s (high FKBP51s) and PDL-1 positive, while 69% (53/76) had low levels (low FKBP51s) and PDL-1 negative at baseline (week 0). Indeed 11/22 (50%) of high FKBP51s responded to IPI and only 12/53 (23%) of low FKBP51s were responders (p < 0.01).

Furthermore, in responders patients we observed a decrease of the levels of FKBP51s during IPI therapy.


We identified a spliced isoform of FKBP51 as a molecule associated to PDL-1, whose expression is increased in PBMCs of melanoma patients. High expression and reduction during IPI therapy may provide a potential predictive biomarker of response. These findings need more exploration.


Written informed consent was obtained from the patient for publication of this abstract and any accompanying images. A copy of the written consent is available for review by the Editor of this journal.