Immune Checkpoint Inhibitors Rechallenge Efficacy in Non–Small-Cell Lung Cancer Patients

Gobbini, Elisa; Toffart, Anne Claire; Pérol, Maurice; Assié, Jean-Baptiste; Duruisseaux, M.; Coupez, D; Dubos, Catherine; Westeel, Virginie; Delaunay, Myriam; Guisier, Florian; Veillon, Rémi; Gounant, V.; Leprieur, Étienne Giroux; Vanel, François-Roger; Chaabane, Nouha; Dansin, Éric; Babey, H.; Decroisette, C.; Barlési, Fabrice; Daniel, Catherine; Fournel, P.; Mezquita, Laura; Oulkhouir, Youssef; Cañellas, A.; Duchemann, Boris; Molinier, Olivier; Alcazer, Vincent; Moro-Sibilot, Denis; Levra, Matteo Giaj

doi:10.1016/j.cllc.2020.04.013

Cited by 42 publications

(67 citation statements)

References 23 publications

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“…Although there are very few reports on rechallenge with ICIs, it has been reported that poor PS and low BMI are predictors of a negative impact on progression-free survival, 12,13 and that patients who discontinue their initial ICI therapy due to toxicity or clinical judgment are associated with a favorable prognosis. 14 In this study, there were no significant differences in PS, BMI, or reasons for discontinuation of initial ICI therapy between the responder and nonresponder groups. However, in the responder group, initial ICI therapy was discontinued in eight of 11 (72.7%) patients due to PD.…”

Section: Discussionmentioning

confidence: 49%

“…In recent years, the development of biomarkers for therapeutic efficacy and prognosis, such as tumor mutation burden and tumor microenvironment, has been vigorously pursued. 11 Several predictors of antitumor efficacy of ICIs have been reported; however, these reports are limited 12 , 13 , 14 , 15 , 16 , 17 because rechallenge with ICIs is not a standard treatment. Moreover, there are no reports focusing on patients who respond to rechallenge with ICIs, and the clinical characteristics and prognosis of patients who benefit from rechallenge with ICIs remain unclear.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and predictors of rechallenge with immune checkpoint inhibitors in non‐small cell lung cancer

et al. 2022

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Background: The efficacy of rechallenge with immune checkpoint inhibitors (ICIs) in non-small cell lung cancer (NSCLC) patients has not yet been fully clarified. This study aimed to identify the clinical characteristics of patients with NSCLC who benefited from rechallenge with ICIs. Methods: We retrospectively reviewed the clinical records of 24 patients who were diagnosed with NSCLC and rechallenged with ICIs between August 2016 and July 2021.Results: Of the 24 patients included in the study, 11 were in the responder group (45.8%) and 13 in the nonresponder group (54.2%). The number of patients who used a different ICI from that used in the initial therapy was significantly higher in the responder group than in the nonresponder group (p = 0.006). Multivariate analysis identified lung metastasis and female sex as significant independent risk factors for nonresponse to rechallenge with ICIs. Compared to the nonresponder group, the duration of treatment after rechallenge with ICIs was significantly longer in the responder group (p = 0.016), and there was a trend toward longer overall survival (p = 0.059). Conclusions: Patients with lung cancer who were rechallenged with ICIs and without progressive disease after initial ICI therapy were able to continue ICI therapy for a longer period of time. This may be associated with longer survival. Patients with lung metastases and female patients are more likely to be nonresponsive to rechallenge with ICIs. Administration of a different type of ICI from that used in the initial ICI therapy may result in disease control. K E Y W O R D S immune checkpoint inhibitors, lung neoplasm, non-small-cell lung carcinoma

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Section: Discussionmentioning

confidence: 49%

Section: Introductionmentioning

confidence: 99%

Efficacy and predictors of rechallenge with immune checkpoint inhibitors in non‐small cell lung cancer

et al. 2022

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“…Moreover, the risk of colitis was also demonstrated to be higher with PD-1 than with PD-L1 inhibitors. As irAE onset has been indicated as a predictor for ICI treatment efficacy ( Rogado et al, 2019 ; Zhou et al, 2020 ), rechallenging ICI treatment is an option for selected patients after discontinuation due to toxicity or clinical decision ( Gobbini et al, 2020 ). The risk of colitis with different ICI agents may inform tailoring of ICI treatment for patients previously diagnosed with immune-related colitis.…”

Section: Discussionmentioning

confidence: 99%

Common Immune-Related Adverse Events of Immune Checkpoint Inhibitors in the Gastrointestinal System: A Study Based on the US Food and Drug Administration Adverse Event Reporting System

et al. 2021

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Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment; however, immune-related adverse events (irAEs) in the gastrointestinal (GI) system commonly occur. In this study, data were obtained from the US Food and Drug Administration adverse event reporting system between July 2014 and December 2020. Colitis, hepatobiliary disorders, and pancreatitis were identified as irAEs in our study. Reporting odds ratio (ROR) with information components (IC) was adopted for disproportionate analysis. A total of 70,330 adverse events were reported during the selected period, 4,075 records of which were associated with ICIs. GI toxicities have been reportedly increased with ICI, with ROR025 of 17.2, 6.7, and 2.3 for colitis, hepatobiliary disorders, and pancreatitis, respectively. The risks of colitis, hepatobiliary disorders, and pancreatitis were higher with anti-CTLA-4 treatment than that with anti-PD-1 (ROR025 2.6, 1.3, and 1.1, respectively) or anti-PD-L1 treatment (ROR025 4.8, 1.3, and 1.3, respectively). Logistic analysis indicated that hepatobiliary disorders and pancreatitis more frequently occurred in female patients (adjusted odds ratio, 1.16 and 1.52; both p < 0.05). Consistently, polytherapy was a strong risk factor for colitis (adjusted odds ratio 2.52, p < 0.001), hepatobiliary disorders (adjusted odds ratio 2.50, p < 0.001), and pancreatitis (adjusted odds ratio 2.29, p < 0.001) according to multivariate logistic analysis. This pharmacovigilance analysis demonstrated an increased risk of all three GI irAEs associated with ICI therapies. The comparative analysis offered supportive insights on selecting GI irAEs for patients treated with ICIs.

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“…They found that switching ICI class therapy obtained a superior outcome, with over 50% of patients experiencing stable or partial regression disease. Gobbini et al (231) demonstrated that NSCLC patients discontinuing for irAEs had more prolonged survival than those discontinuing for disease progression. After ICI rechallenge, the recurrence rate of irAEs varied from 37% to 78% (227,(232)(233)(234).…”

Section: Rechallenge and Recurrencementioning

confidence: 99%

Immune Checkpoint Inhibitor-Associated Colitis: From Mechanism to Management

et al. 2021

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Immune checkpoint inhibitors (ICIs), as one of the innovative types of immunotherapies, including programmed cell death-1 (PD-1), programmed cell death-ligand 1 (PD-L1), and cytotoxic T lymphocyte antigen 4 (CTLA-4) inhibitors, have obtained unprecedented benefit in multiple malignancies. However, the immune response activation in the body organs could arise immune-related adverse events (irAEs). Checkpoint inhibitor colitis (CIC) is the most widely reported irAEs. However, some obscure problems, such as the mechanism concerning gut microbiota, the confusing differential diagnosis with inflammatory bowel disease (IBD), the optimal steroid schedule, the reintroduction of ICIs, and the controversial prognosis features, influence the deep understanding and precise diagnosis and management of CIC. Herein, we based on these problems and comprehensively summarized the relevant studies of CIC in patients with NSCLC, further discussing the future research direction of this specific pattern of irAEs.

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Immune Checkpoint Inhibitors Rechallenge Efficacy in Non–Small-Cell Lung Cancer Patients

Cited by 42 publications

References 23 publications

Efficacy and predictors of rechallenge with immune checkpoint inhibitors in non‐small cell lung cancer

Efficacy and predictors of rechallenge with immune checkpoint inhibitors in non‐small cell lung cancer

Common Immune-Related Adverse Events of Immune Checkpoint Inhibitors in the Gastrointestinal System: A Study Based on the US Food and Drug Administration Adverse Event Reporting System

Immune Checkpoint Inhibitor-Associated Colitis: From Mechanism to Management

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