What is the optimal duration, dose and frequency for anti-PD1 therapy of non-small cell lung cancer?

Abstract

Over the past decade, immune checkpoint inhibitors (ICIs) have transformed the management of multiple malignancies including lung cancer. However, the optimal use of these agents in terms of duration, dose and administration frequency remains unknown. Focusing on anti-PD1 agents nivolumab and pembrolizumab in the context of non-small cell lung cancer, we argue that several lines of evidence suggest current administration regimens of these drugs may result in overtreatment with potentially important implications for cost, quality of life and toxicity. This review summarizes evidence for the scope to optimize anti-PD1 regimens, the limitations of existing data and potential approaches to solve these problems including with a novel multi-arm clinical trial design implemented in the recently opened REFINE-Lung study.

The synergistic immunotherapeutic impact of engineered CAR-T cells with PD-1 blockade in lymphomas and solid tumors: a systematic review

“…PD-1 antibody significantly increased the level of IFN-g, granzyme-B, and a proliferation marker of T-cell that is Ki-67; the CAR-T cell combined with anti PD-1 showed significantly higher anti-tumor response compared to only CAR-T cells and isotype control antibody (123). However, the optimal doses and frequencies of administration of anti PD-1 may not be generalized as different targets for immunotherapy and different agents show different dose response characteristics (124). Thus, in the case of cell extrinsic combination therapy, the doses of PD-1 blocking agents vary based on tumor type and grading, and there may be a need for repeated administration of anti PD-1 antibodies at a regular interval.…”

“…Although extrinsic combination therapy shows promising results, there are some drawbacks associated with it. Kuah et al (2023) suggested optimizing the doses of anti PD-1 drugs as current administration regimens may result in overtreatment with potentially important implications for cost, quality of life, and toxicity (124).…”

Guidelines and Multidisciplinary Care Are Essential to Improve Survival Rates and Quality of Life Globally for Women with Gestational Trophoblastic Disease

“…The huge steps made in other malignancies such as melanoma and lung cancer with regard to checkpoint immunotherapies including PD-1 targeting agents begged the question as to whether similar success might be seen in GTN in the rare situation that standard chemotherapy is not effective [8]. The discovery that PDL1 inhibition was beneficial in 3 out of 4 patients who had failed existing therapies and were expected to die has led to a revolution in the treatment of GTN.…”