It is a question many ponder - "Now that I've responded to anti-PD-1, if I recur...what should I do???" Here is a bit of info toward that answer.....
Outcomes of long-term responders to anti-programmed death 1 and anti-programmed death ligand 1 when being rechallenged with the same anti-programmed death 1 and anti-programmed death ligand 1 at progression. Bernard-Tessier, Baldine, Martin, et al. Eur J Cancer. 2018 July 30.
Long-term responders have been
observed with anti-programmed death 1 and anti-programmed death
ligand 1 (anti-PD(L)1). Optimal duration of therapy in responding and
stable disease (SD) patients is unclear with various attitudes
encompassing treatment until progression disease, stopping therapy
after a defined time frame.
We report the experience of 13
patients who discontinued immune checkpoint inhibitor in phase I
trials as per protocol while experiencing a tumour-controlled
disease. According to protocols, patients could restart the same
immunotherapy if radiological or clinical progression occurred.
Patients were treated for colorectal
microsatellite instability-high genotype (n = 5),
urothelial carcinoma (n = 3), melanoma (n = 2),
non-small-cell lung cancer (n = 2) and triple-negative
breast cancer (n = 1) for a median time of 12 months (range
10.6-12). Patients achieved 1 (8%) complete response, 10 (77%)
partial response (PR) and 2 (15%) SD. The median progression-free
survival 1 (PFS1) defined as the time from the first infusion until
progression was 24.4 months (range 15.8-49). The median time
free-treatment after discontinuation was 12.6 months (range 4-39.7).
Eight patients experienced disease progression and were retreated.
Best responses observed after rechallenging were 2 PR (25%) and
6 SD (75%). Median PFS2 defined from the first day of retreatment
until disease progression or the last news was 12.9 months (range
5-35.4). No grade 3/4 events occurred during the study period.
Our data suggest that anti-PD(L)1
therapy should be resumed if progression occurs after a planned
anti-PD(L)1 interruption. Further prospective studies are needed to
confirm these results.
Small numbers here and not all are melanoma patients. But, some responses on the re-do. Hang tough, ratties! Hang tough! - c
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