Among 17 patients with advanced or recurrent non-small cell lung cancer, one (5.9%) achieved partial response after immune checkpoint inhibitor rechallenge.
Nine patients (52.9%) had stable disease following the rechallenge with .
The median after rechallenge was 4.0 months (range: 0.4-8.0 months).
The median from the initial immune checkpoint inhibitor treatment was 31.0 months (range: 7.6-46.8 months).
Of 10 patients with immune-related adverse events during the first treatment, five experienced these events again after rechallenge.
Four patients had relapsed immune-related adverse events, with two experiencing grade 3 or higher pneumonitis.
Almost all immune-related adverse events during rechallenge were manageable.
Simplified
BACKGROUND: Based on several phase III studies, (ICIs) are essential and promising drugs for the treatment of non-small cell lung cancer (NSCLC). However, in patients previously treated with ICI, the efficacy and safety of rechallenging the same or another type of ICI inhibitor remain unclear. Moreover, clinical data about the efficacy of switching the administration of anti-programmed death-1 (PD-1) antibodies (e.g. nivolumab, pembrolizumab) and anti-programmed death-ligand 1 (PD-L1) antibodies (e.g. atezolizumab) as ICI rechallenge are limited. Thus, the current study aimed to evaluate the efficacy and safety of such treatment strategy in NSCLC patients.
METHODS: We retrospectively reviewed the medical records of 17 patients with advanced or recurrent NSCLC who received both anti-PD-1 and anti-PD-L1 antibodies during their clinical courses.
RESULTS: Among the 17 patients, one (5.9%) and nine (52.9%) achieved partial response and stable disease, respectively, after ICI rechallenge. The median of ICI rechallenge in these patients was 4.0 (range: 0.4-8.0) months, and the median from the start of the initial ICI was 31.0 (range: 7.6-46.8) months. Of the 10 patients who developed immune-related adverse events (irAEs) during the first ICI treatment, five presented with these events after the readministration of ICI. Among them, four experienced relapsed irAEs and two patients had pneumonitis, which is a grade 3 or higher irAE. Almost all irAEs during the rechallenge treatment were manageable.
CONCLUSIONS: Switching the administration of anti-PD-1 and anti-PD-L1 antibodies as ICI rechallenge could be a treatment option for some NSCLC patients.
KEY POINTS: • Significant findings of the study In this study, switching the administration of anti-PD-1 and anti-PD-L1 antibodies as ICI rechallenge could be an effective and safe treatment option for some patients with advanced or recurrent NSCLC. • What this study adds Switching the administration of ICI may increase the efficacy of readministration. However, the mechanism is unknown. Thus, further accumulation of cases is required, and extensive investigations must be conducted to elucidate the mechanism and benefits of such treatment.
Key numbers
1 of 17
Partial Response Rate
One patient achieved partial response after rechallenge.
9 of 17
Stable Disease Rate
Nine patients achieved stable disease after ICI rechallenge.
4.0 months
Median
Median after switching was 4.0 months.
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