医学
中止
内科学
彭布罗利珠单抗
队列
毒性
进行性疾病
无容量
外科
黑色素瘤
胃肠病学
疾病
癌症
免疫疗法
癌症研究
作者
Yanina Jansen,Elisa A. Rozeman,Robert M. Mason,Simone M. Goldinger,Marnix H Geukes Foppen,Lise Hoejberg,Henrik Schmidt,J.V. van Thienen,John B.A.G. Haanen,Leena Tiainen,Inge Marie Svane,Siru Mäkelä,Teofila Seremet,Ana Arance,Reinhard Dummer,Lars Bastholt,Marta Nyakas,Oddbjørn Straume,Alexander M. Menzies,Georgina V. Long,Victoria Atkinson,Christian U. Blank,Bart Neyns
标识
DOI:10.1093/annonc/mdz110
摘要
Programmed cell death protein 1 (PD-1) blocking monoclonal antibodies improve the overall survival of patients with advanced melanoma but the optimal duration of treatment has not been established.This academic real-world cohort study investigated the outcome of 185 advanced melanoma patients who electively discontinued anti-PD-1 therapy with pembrolizumab (N = 167) or nivolumab (N = 18) in the absence of disease progression (PD) or treatment limiting toxicity (TLT) at 14 medical centres across Europe and Australia.Median time on treatment was 12 months (range 0.7-43). The best objective tumour response at the time of treatment discontinuation was complete response (CR) in 117 (63%) patients, partial response (PR) in 44 (24%) patients and stable disease (SD) in 16 (9%) patients; 8 (4%) patients had no evaluable disease (NE). After a median follow-up of 18 months (range 0.7-48) after treatment discontinuation, 78% of patients remained free of progression. Median time to progression was 12 months (range 2-23). PD was less frequent in patients with CR (14%) compared with patients with PR (32%) and SD (50%). Six out of 19 (32%) patients who were retreated with an anti-PD-1 at the time of PD obtained a new antitumour response.In this real-world cohort of advanced melanoma patients discontinuing anti-PD-1 therapy in the absence of TLT or PD, the duration of anti-PD-1 therapy was shorter when compared with clinical trials. In patients obtaining a CR, and being treated for >6 months, the risk of relapse after treatment discontinuation was low. Patients achieving a PR or SD as best tumour response were at higher risk for progression after discontinuing therapy, and defining optimal treatment duration in such patients deserves further study. Retreatment with an anti-PD-1 at the time of progression may lead to renewed antitumour activity in some patients.NCT02673970 (https://clinicaltrials.gov/ct2/show/NCT02673970?cond=melanoma&cntry=BE&city=Jette&rank=3).
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