Stopping immunotherapy in responding melanoma: real-world outcomes

  • Jansen YJL & al.
  • Ann Oncol
  • 28 Mar 2019

  • curated by Brian Richardson, PhD
  • Univadis Clinical Summaries
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Takeaway

  • 78% of patients with advanced melanoma who discontinued anti-programmed cell death protein 1 (PD-1) therapy in the absence of disease progression or treatment-limiting toxicity remained progression-free at median 18-month follow-up.
  • Progression was less likely with achievement of complete response (CR).

Why this matters

  • The optimal duration of anti-PD-1 therapy is not well established.

Key results

  • Median time on treatment, 12 (range, 0.7-43) months.
  • At discontinuation, 63% of patients had achieved CR, 24% had achieved partial response (PR), and 9% had stable disease.
  • 78% remained progression-free at a median follow-up of 18 (range, 0.7-48) months posttreatment.
  • Patients with CR had lower risk for progression (14%) than those with PR (32%; HR, 2.99; P=.002) or SD (50%; HR, 5.15; P<.001>
  • Among patients with CR, those treated ≥6 months (median PFS, 18.9 months vs not reached; P<.05>
    • No difference in progression with CR in patients treated for 6-12, 12-18, 18-24, or 24 months (P>.05 for all).
  • 32% of patients with disease progression achieved a new CR or PR after retreatment with anti-PD-1 therapy.

Study design

  • Real-world study of 185 patients with advanced melanoma who discontinued anti-PD-1 therapy (N=167 pembrolizumab, 18 nivolumab),
  • Funding: None.

Limitations

  • Retrospective design.

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