Response to immunotherapy rechallenge after interval chemotherapy in a patient with head and neck cancer

Cabezas-Camarero, Santiago; Cabrera‐Martín, María Nieves; Pérez‐Segura, Pedro

doi:10.1097/cad.0000000000000706

Cited by 11 publications

(3 citation statements)

References 25 publications

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“…In the case of immunotherapy, the mechanism of action, involving resetting the immune memory, and the possibility of predicting clinical response from biomarkers [21,22], the notion of a second course of immunotherapy is an attractive one. Retreatment with PD-1 inhibitor, as a subsequent therapy, has been reported in limited numbers of patients in randomised clinical trials of nivolumab or pembrolizumab in NSCLC [19,23,24] and there are a limited number of reports of rechallenge with immunotherapy, which have generally involved small numbers of patients [25][26][27][28][29][30][31]. Regarding the relative benefit of rechallenge compared to the initial treatment course, the available data are encouraging [27,28] even though no definitive conclusions can be drawn given the limited experience and the heterogeneity in the definitions of retreatment and in the protocols used.…”

mentioning

confidence: 99%

Immunotherapy rechallenge after nivolumab treatment in advanced non-small cell lung cancer in the real-world setting: A national data base analysis

Levra¹,

Cotté²,

Corre³

et al. 2020

Lung Cancer

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Nivolumab is now a reference treatment for patients with advanced non-small cell lung cancer (NSCLC) after failure of prior platinum-based chemotherapy. Little data are available on treatment approaches following discontinuation of nivolumab and on the interest of a second course of immunotherapy after nivolumab discontinuation. The aims of this study were to describe treatment pathways following nivolumab discontinuation and to describe survival following retreatment with immunotherapy. Materials and methods: The analysis includes all patients with NSCLC recorded in a national hospital database, starting nivolumab in 2015-2016. Nivolumab treatment was considered discontinued if ≥3 infusions were missed. Patients starting a second course of PD-1 inhibitor following nivolumab discontinuation were analysed according to the duration of their initial nivolumab treatment course. Results: 10,452 patients were included (71 % men; mean age: 63.8 ± 9.6 years; squamous histology: 44 %). Median nivolumab treatment duration was 2.8 months [IQR :1.4-6.9]. Median OS was 11.5 months [95 %CI: 11.1-11.9]; 5118 (53.4 %) patients received post nivolumab therapy lines: 1517 (29.6 %) of these received a second course of PD-1 inhibitor, either after a treatment-free interval (resumption: n = 1127) or after intervening chemotherapy (rechallenge: n = 390). Median OS after nivolumab discontinuation was 15.0 months [13.9-16.7] in the resumption group and 18.4 months [14.8-21.9] in the rechallenge group. Median OS was significantly longer in patients with an initial nivolumab treatment duration ≥3 months. Conclusion: In this real-world setting, outcome after retreatment with a PD-1 inhibitor following a first course of nivolumab was significantly better in patients with a longer duration of initial nivolumab treatment.

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confidence: 99%

Immunotherapy rechallenge after nivolumab treatment in advanced non-small cell lung cancer in the real-world setting: A national data base analysis

Levra¹,

Cotté²,

Corre³

et al. 2020

Lung Cancer

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“…We did not find any prospective trial published on this issue and we identified 14 full papers (five case reports and nine case series) reporting the outcomes of 74 patients treated according to this strategy ( Fig. 1, Table 1) (16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29). Data search ended the 25th January 2020.…”

Section: Methodsmentioning

confidence: 99%

Literature meta-analysis about the efficacy of anti-programmed death protein 1 and anti-programmed death ligand 1 re-challenge in cancer patients

Gobbini¹,

Charles²,

Toffart³

et al. 2020

Preprint

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Background Immune checkpoint inhibitor (ICPis) re-challenge could be an attractive therapeutic option considering its good safety profile. However, little data is available regarding anti-PD-1/anti-PD-L1 retreatment. We conducted a meta-analysis focusing on outcomes of solid cancer patients performing this strategy. Methods Fourteen full papers involving 74 patients were included. Individual data about best response or progression-free survival (PFS) upon the first and second course of anti-PD-1/ anti-PD-L1 were collected. Results Non-small-cell lung cancer (53%) and melanoma (34%) were the most represented cancers. Higher objective response (46% versus 24%, p = 4.10 -4 ) and disease control rates (73% versus 52%, p = 7.10 -3 ) were obtained upon the first ICPi course compared to re-challenge. No association between responses obtained with the two ICPis courses was found ( p = 3.10 -1 ). The PFS upon the first ICPi (PFS1) was longer than that after re-challenge (PFSR) (6.6 versus 2.8 months, hazard ratio (HR) 0.57, p = 2.10 -3 ). A longer PFSR was obtained in patients with a longer PFS1 ( p = 6.10 -3 ), in those who discontinued the first ICPi due to toxicity or per protocol (8.8 versus 2.1 months if disease progression occurs, p = 2.10 -3 ), and in those not receiving intercalated treatment between the two ICPis (6.6 versus 2.1 months for the treated ones, p = 1.10 -3 ). Conclusion Anti-PD-1/anti-PD-L1 re-challenge showed interesting clinical activity in selected patients, mainly in those achieving a long-term response upon the first ICPi course, that do not discontinue therapy because of disease progression, or that are able to keep a treatment-free period.

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“…Tedbirt et al [144] had similar findings. Cabezas et al [145] described one patient with squamous cell carcinoma of the head and neck who paused the initial PD-L1 treatment owing to PD and achieved a PR after receiving paclitaxel followed by nivolumab rechallenge. Levra et al [44] found that patients who underwent chemotherapy between two lines of ICI treatments had a median OS of 18.1 months (95% CI 14.6-21.6), while those who did not had a median OS of 14.8 months (95% CI 13.4-16.5).…”

Section: Interventions During Immunotherapiesmentioning

confidence: 99%

Current Status in Rechallenge of Immunotherapy

Hu,

Wang,

Jia

et al. 2023

Int. J. Biol. Sci.

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The treatment of malignant tumors has entered the era of immunotherapy, and immune checkpoint inhibitors (ICIs) have brought significant benefits to patients. However, some patients are required to discontinue treatment with ICIs owing to factors such as disease progression and intolerable side effects. Faced with limited subsequent treatment options and complex medical needs, we searched PubMed, Embase, Cochrane library, and the NIH clinical trials database and found that ICI rechallenge could be a relevant clinical strategy. The factors that could affect the rechallenge efficacy include the patients' characteristics, therapeutic strategy selection, and the timing of treatment. Multiple factors are used to identify target population, of which clinical features and PD-L1 expression are more potential. Both single ICI rechallenge and combination therapy may have survival benefits. Patients who have tolerated initial immunotherapy well could undergo ICI rechallenge, while patients who have experienced grade 3 or higher immune-related adverse events should be carefully assessed prior to rechallenge. Interventions and the interval between two courses of ICI will clearly have an impact on the efficacy of subsequent treatment. Preliminary data evaluation supports further investigation on ICI rechallenge to identify the factors that could contribute to its efficacy.

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Response to immunotherapy rechallenge after interval chemotherapy in a patient with head and neck cancer

Cited by 11 publications

References 25 publications

Immunotherapy rechallenge after nivolumab treatment in advanced non-small cell lung cancer in the real-world setting: A national data base analysis

Immunotherapy rechallenge after nivolumab treatment in advanced non-small cell lung cancer in the real-world setting: A national data base analysis

Literature meta-analysis about the efficacy of anti-programmed death protein 1 and anti-programmed death ligand 1 re-challenge in cancer patients

Current Status in Rechallenge of Immunotherapy

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