The utility of chemotherapy after immunotherapy failure in metastatic melanoma: A multicenter case series.

Goldinger, Simone M.; Lo, Serigne; Hassel, Jessica C.; Forschner, Andrea; McKean, Meredith; Zimmer, Lisa; Khoo, Christine; Dummer, Reinhard; Eroglu, Zeynep; Buchbinder, Elizabeth I.; Ascierto, Paolo A.; Gutzmer, Ralf; Rozeman, Elisa A.; Höeller, Christoph; Johnson, Douglas B.; Gesierich, Anja; Kölblinger, Peter; Benannoune, Naima; Cohen, Justine V.; Menzies, Alexander M.

doi:10.1200/jco.2018.36.15_suppl.e21588

Cited by 16 publications

(19 citation statements)

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“…Our results are in accordance with articles published by Karachaliou et al, 45 Goldinger et al 46 Weber et al 47 and Ribas et al 5 but differ from those by Hadash et al , St Jean et al and Markovi et al 32,33,37 whose studies showed improved outcomes for patients treated by CC after ICI than patients treated by CC who were not previously treated by ICI. Additionally a retrospective study also suggested an improved clinical outcome in seven patients treated by carboplatin and paclitaxel after progression on ICI 36 which suggests that the synergistic effect of ICI may be dependent of the type of CC used.…”

Section: Discussionsupporting

confidence: 91%

Decreased survival in patients treated by chemotherapy after targeted therapy compared to immunotherapy in metastatic melanoma

et al. 2021

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Background Cytotoxic chemotherapy (CC) is currently used in metastatic melanoma after patients have developed resistance to immune checkpoint inhibitors (ICI) and/or Mitogen‐Activated Protein Kinase inhibitors (MAPKi). We sought to evaluate if a previous treatment by ICI or MAPKi influences clinical outcomes in patients treated by CC in metastatic melanoma. Methods Eighty‐eight patients with a metastatic melanoma, treated by CC after a previous treatment by ICI or MAPKi between January 2009 and October 2019, were retrospectively analyzed. Progression‐Free‐Survival (PFS), Overall Survival (OS), Overall Response Rate (ORR), and Disease Control Rate (DCR) were evaluated in patients treated by CC according to their prior treatment by ICI or MAPKi. Results Patients treated by CC after ICI tended to have a better median PFS (2.81 months (2.39–5.30) versus 2.40 months (0.91–2.75), p = 0.023), median OS (6.03 months (3.54–11.54) versus 4.44 months (1.54–8.59), p = 0.27), DCR (26.0% vs. 10.5%, p = 0.121) and ORR (22.0% vs. 7.9% p = 0.134) than those previously treated by MAPKi. Conclusions A prior treatment by an MAPKi may be associated with a worse response to CC than ICI, and further investigations should be performed to confirm if there is a clinical benefit to propose CC in this setting.

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Section: Discussionsupporting

confidence: 91%

Decreased survival in patients treated by chemotherapy after targeted therapy compared to immunotherapy in metastatic melanoma

et al. 2021

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“…Median OS from chemotherapy start was 7.1 months (95% CI, 6.5–8 months), as compared to 12 months in our study. [ 10 ] What differentiates our study is the higher proportion of patients treated with an anti-PD1 just prior to chemotherapy (78% vs 42% in the study of Goldinger et al). Moreover, the patients in our study were treated recently (in 2017) and benefited from several treatments that were more effective and numerous than those before 2011.…”

Section: Discussionmentioning

confidence: 62%

Chemotherapy efficacy after first-line immunotherapy in 18 advanced melanoma patients

Saint‐Jean

Fronteau²,

Peuvrel

et al. 2020

Medicine

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In BRAF wild type advanced melanoma, immune checkpoint blockers such as anti-PD1 (anti-programmed cell death 1) are usually continued beyond progression for a hypothetical rare further response. Chemotherapy as a second-line option is considered ineffective by many practitioners based on historical data. Continuing anti-PD1 beyond progression has a high health-economic impact and is not recommended by the FDA. This study aimed to describe the efficacy and survival of advanced melanoma patients who received second-line (or more) chemotherapy after immunotherapy failure. This was a retrospective single center study conducted in a French University Hospital during an 11-month period. All advanced melanoma patients treated with chemotherapy after immunotherapy failure were included. Eighteen patients were analyzed. Therapeutic response to chemotherapy was evaluable in 16 patients: partial response was achieved in 3/16 (19%), stable disease in 1/16 (6%) and progressive disease in 12/16 (75%). Median overall survival from chemotherapy start was 12 months. Median progression-free survival was 5.4 months. The 6-month overall survival rate was 81% and the 6-month progression-free survival rate was 40%. Although the disease control rate with chemotherapy was low (25%), survival data in our study are far superior to those previously published. This could be linked to a high proportion of patients treated with anti-PD1 just prior to chemotherapy, which may suggest a potential synergy between immunotherapy and chemotherapy.

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“…The dramatic immune response may be ascribed to the sensitization of tumor cells to immunotherapy followed by chemotherapeutics. Interestingly, similar reports across multiple tumor types according to treatments in the above-mentioned sequence yielded greater therapeutic effect than historical responses in metastatic non-small cell lung cancer (Shiono et al, 2019), metastatic gastroesophageal adenocarcinoma (Chakrabarti, Dong, Paripati, Ross, & Yoon, 2018), and metastatic melanoma (Goldinger et al, 2018).…”

Section: Enhance the Immunogenicity Of The Initial Tumormentioning

confidence: 80%

“…Cancer nanomedicines that carry vaccines or combine with immunotherapy offer alternatives to trigger tumor-specific cytotoxic effects (Figure 4) and simultaneously convert the immune status of tumors and remove biological barriers for T cell infiltration. A quantity of preclinical studies has shown that the nanovaccine immunotherapy has shown profound therapeutic effects in many types of solid tumors (Chen, Chen, Yang, et al, 2019;Gong, Zhang, Zhang, Li, & Liang, 2019;Ni et al, 2018). For instance, albumin nanovehicle has been shown to have high co-delivery efficiency of vaccines cytosine-phosphate-guanine oligodeoxynucleotides (CpG) and imaging agent (Evans blue) to LNs (Zhu et al, 2017) and 100 times higher accumulation in the tumor site than free CpG via intravenous injection.…”

Section: Nanomedicine For the Combined Cancer Immunotherapymentioning

confidence: 99%

Regulation of cancer‐immunity cycle and tumor microenvironment by nanobiomaterials to enhance tumor immunotherapy

Yang

Zhang

2020

WIREs Nanomed Nanobiotechnol

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In the past decade, we have witnessed the revolution in cancer therapy, especially in the rapid development of cancer immunotherapy. In particular, the introduction of nanomedicine has achieved great improvement in breaking the limitations of and immunological tolerance caused by clinic‐approved immunotherapies (cancer vaccine, CAR‐T, and immune checkpoint blockade) to enhance immunogenicity, antigen presentation and T lymphocyte infiltration for eradicating the primary tumors and distant metastases simultaneously. However, some fundamental but significant issues still need to be thoroughly clarified before the combination of nanomedicine and immunotherapy moves toward clinical translation such as biological safety and synergistic mechanisms of nanomaterials in the systematic immune responses. Therefore, in this review, the role of nanomaterials in cancer immunotherapy is summarized, mainly focusing on the effective activation and long‐term stimulation of both the innate and the adaptive immune responses and regulation of or remodeling the tumor microenvironment, especially the tumor immunosuppressive microenvironment. Also, we elaborate on the targets and challenges of nanomaterials in the cancer‐immunity cycle, summarize several main strategies to convert the cold tumor immune microenvironment to the hot one, and illustrate the progress in regulation of tumor immune microenvironment by targeting specific immunosuppressive cells. Finally, we prospect the nano‐combined immunotherapy strategies in tumor‐targeting, normalization of tumor immune environment and modification of macrophages. This article is characterized under: Therapeutic Approaches and Drug Discovery > Emerging Technologies Diagnostic Tools > In Vivo Nanodiagnostics and Imaging Nanotechnology Approaches to Biology > Nanoscale Systems in Biology Therapeutic Approaches and Drug Discovery > Nanomedicine for Oncologic Disease

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The utility of chemotherapy after immunotherapy failure in metastatic melanoma: A multicenter case series.

Cited by 16 publications

References 0 publications

Decreased survival in patients treated by chemotherapy after targeted therapy compared to immunotherapy in metastatic melanoma

Decreased survival in patients treated by chemotherapy after targeted therapy compared to immunotherapy in metastatic melanoma

Chemotherapy efficacy after first-line immunotherapy in 18 advanced melanoma patients

Regulation of cancer‐immunity cycle and tumor microenvironment by nanobiomaterials to enhance tumor immunotherapy

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