Discontinuation of anti-PD-1 monotherapy in advanced melanoma-Outcomes of daily clinical practice

被引：21

作者：

van Zeijl, Michiel C. T. ^{[1
,2
]}

van den Eertwegh, Alfons J. M. ^{[3
]}

Wouters, Michel W. J. M. ^{[1
,4
,5
]}

de Wreede, Liesbeth C. ^{[5
]}

Aarts, Maureen J. B. ^{[6
]}

van den Berkmortel, Franchette W. P. J. ^{[7
]}

de Groot, Jan-Willem B. ^{[8
]}

Hospers, Geke A. P. ^{[9
]}

Kapiteijn, Ellen

Piersma, Djura ^{[10
]}

van Rijn, Rozemarijn S. ^{[11
]}

Suijkerbuijk, Karijn P. M. ^{[12
]}

ten Tije, Albert J. ^{[13
]}

van Der Veldt, Astrid A. M. ^{[14
]}

Vreugdenhil, Gerard ^{[15
]}

van Der Hoeven, Jacobus J. M. ^{[16
]}

Haanen, John B. A. G. ^{[17
,18
]}

机构：

[1] Dutch Inst Clin Auditing, Sci Dept, Leiden, Netherlands

[2] Leiden Univ, Dept Med Oncol, Med Ctr, Leiden, Netherlands

[3] Amsterdam UMC, Locat VUmc, Dept Med Oncol, Amsterdam, Netherlands

[4] Netherlands Canc Inst, Dept Surg Oncol, Amsterdam, Netherlands

[5] Leiden Univ, Dept Biomed Data Sci, Med Ctr, Leiden, Netherlands

[6] Maastricht Univ, Dept Med Oncol, Med Ctr, Maastricht, Netherlands

[7] Zuyderland Med Ctr, Dept Med Oncol, Sittard Geleen, Netherlands

[8] Isala Oncol Ctr, Dept Med Oncol, Zwolle, Netherlands

[9] Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands

[10] Med Spectrum Twente, Dept Internal Med, Enschede, Netherlands

[11] Med Ctr Leeuwarden, Dept Internal Med, Leeuwarden, Netherlands

[12] Univ Med Ctr Utrecht, Dept Med Oncol, Utrecht, Netherlands

[13] Amphia Hosp, Dept Internal Med, Breda, Netherlands

[14] Erasmus MC, Dept Med Oncol, Rotterdam, Netherlands

[15] Maxima Med Ctr, Dept Internal Med, Eindhoven, Netherlands

[16] Radboudumc, Dept Med Oncol, Nijmegen, Netherlands

[17] Netherlands Canc Inst, Div Med Oncol, Plesmanlaan 121, NL-1066 CX Amsterdam, Netherlands

[18] Netherlands Canc Inst, Div Mol Oncol & Immunol, Plesmanlaan 121, NL-1066 CX Amsterdam, Netherlands

来源：

INTERNATIONAL JOURNAL OF CANCER | 2022年 / 150卷 / 02期

关键词：

advanced melanoma; anti-PD-1; discontinuation; immunotherapy; real-world; METASTATIC MELANOMA; SURVIVAL; PEMBROLIZUMAB; IPILIMUMAB;

D O I：

10.1002/ijc.33800

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

There is no consensus on the optimal treatment duration of anti-PD-1 for advanced melanoma. The aim of our study was to gain insight into the outcomes of anti-PD-1 discontinuation, the association of treatment duration with progression and anti-PD-1 re-treatment in relapsing patients. Analyses were performed on advanced melanoma patients in the Netherlands who discontinued first-line anti-PD-1 monotherapy in the absence of progressive disease (n = 324). Survival was estimated after anti-PD-1 discontinuation and with a Cox model the association of treatment duration with progression was assessed. At the time of anti-PD-1 discontinuation, 90 (28%) patients had a complete response (CR), 190 (59%) a partial response (PR) and 44 (14%) stable disease (SD). Median treatment duration for patients with CR, PR and SD was 11.2, 11.5 and 7.2 months, respectively. The 24-month progression-free survival and overall survival probabilities for patients with a CR, PR and SD were, respectively, 64% and 88%, 53% and 82%, 31% and 64%. Survival outcomes of patients with a PR and CR were similar when anti-PD-1 discontinuation was not due to adverse events. Having a PR at anti-PD-1 discontinuation and longer time to first response were associated with progression [hazard ratio (HR) = 1.81 (95% confidence interval, CI = 1.11-2.97) and HR = 1.10 (95% CI = 1.02-1.19; per month increase)]. In 17 of the 27 anti-PD-1 re-treated patients (63%), a response was observed. Advanced melanoma patients can have durable remissions after (elective) anti-PD-1 discontinuation.

引用

页码：317 / 326

页数：10

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