Sylvia C Kurz1, Lais P Cabrera1, David Hastie1, Raymond Huang1, Prashin Unadkat1, Mikael Rinne1, Lakshmi Nayak1, Eudocia Q Lee1, David A Reardon1, Patrick Y Wen2. 1. From the Laura and Isaac Perlmutter Cancer Center (S.C.K.), Brain Tumor Center, NYU Langone Medical Center, New York; Dana-Farber Cancer Institute (L.P.C., D.H., M.R., L.N., E.Q.L., D.A.R., P.Y.W.), Center for Neuro-Oncology; and Department of Radiology (R.H., P.U.), Brigham and Women's Hospital, Boston, MA. 2. From the Laura and Isaac Perlmutter Cancer Center (S.C.K.), Brain Tumor Center, NYU Langone Medical Center, New York; Dana-Farber Cancer Institute (L.P.C., D.H., M.R., L.N., E.Q.L., D.A.R., P.Y.W.), Center for Neuro-Oncology; and Department of Radiology (R.H., P.U.), Brigham and Women's Hospital, Boston, MA. pwen@partners.org.
Abstract
OBJECTIVE: To investigate the question of whether salvage therapy with the programmed cell death protein 1 (PD-1)-blocking antibodies nivolumab or pembrolizumab with or without bevacizumab offers clinical or survival benefit in patients with recurrent high-grade gliomas (HGGs). METHODS: This was a single-institution retrospective observational study in 31 adult patients who received pembrolizumab (Keytruda) or nivolumab (Opdivo) with or without concurrent bevacizumab for recurrent high-grade glioma. RESULTS: Median progression-free survival (mPFS) from first anti-PD-1 dose was 3.2 months (95% confidence interval [CI] 2.2-4.2), and there was no difference in patients receiving nivolumab (mPFS 3.8 months, 95% CI 1.7-5.8) compared to patients receiving pembrolizumab (mPFS 2.3 months, 95% CI 1.7-2.8, log rank 3.1, p = 0.08). There was also no difference in mPFS if patients had previously received bevacizumab (mPFS 3.2 months, 95% CI 2-4.3) or were bevacizumab naive (mPFS 3.7, 95% CI 0-7.9, log rank 1.3, p = 0.3). The median survival from date of first anti-PD-1 dose was 6.6 months (95% CI 4.2-9.1). CONCLUSION: Salvage therapy with nivolumab or pembrolizumab with or without bevacizumab does not confer a survival benefit in this heavily pretreated unselected patient population. Until the results of the currently ongoing clinical trials become available, the use of PD-1-blocking antibodies should be considered in selected individuals only. CLASSIFICATION OF EVIDENCE: This retrospective observational study provides Class IV evidence that for patients with recurrent HGGs, salvage therapy with nivolumab or pembrolizumab does not significantly improve survival.
OBJECTIVE: To investigate the question of whether salvage therapy with the programmed cell death protein 1 (PD-1)-blocking antibodies nivolumab or pembrolizumab with or without bevacizumab offers clinical or survival benefit in patients with recurrent high-grade gliomas (HGGs). METHODS: This was a single-institution retrospective observational study in 31 adult patients who received pembrolizumab (Keytruda) or nivolumab (Opdivo) with or without concurrent bevacizumab for recurrent high-grade glioma. RESULTS: Median progression-free survival (mPFS) from first anti-PD-1 dose was 3.2 months (95% confidence interval [CI] 2.2-4.2), and there was no difference in patients receiving nivolumab (mPFS 3.8 months, 95% CI 1.7-5.8) compared to patients receiving pembrolizumab (mPFS 2.3 months, 95% CI 1.7-2.8, log rank 3.1, p = 0.08). There was also no difference in mPFS if patients had previously received bevacizumab (mPFS 3.2 months, 95% CI 2-4.3) or were bevacizumab naive (mPFS 3.7, 95% CI 0-7.9, log rank 1.3, p = 0.3). The median survival from date of first anti-PD-1 dose was 6.6 months (95% CI 4.2-9.1). CONCLUSION: Salvage therapy with nivolumab or pembrolizumab with or without bevacizumab does not confer a survival benefit in this heavily pretreated unselected patient population. Until the results of the currently ongoing clinical trials become available, the use of PD-1-blocking antibodies should be considered in selected individuals only. CLASSIFICATION OF EVIDENCE: This retrospective observational study provides Class IV evidence that for patients with recurrent HGGs, salvage therapy with nivolumab or pembrolizumab does not significantly improve survival.
Authors: Thomas N Seyfried; Laura Shelton; Gabriel Arismendi-Morillo; Miriam Kalamian; Ahmed Elsakka; Joseph Maroon; Purna Mukherjee Journal: Neurochem Res Date: 2019-04-25 Impact factor: 3.996
Authors: Tian Tian; Ruyu Liang; Gulsah Erel-Akbaba; Lorenzo Saad; Pierre J Obeid; Jun Gao; E Antonio Chiocca; Ralph Weissleder; Bakhos A Tannous Journal: ACS Nano Date: 2022-01-31 Impact factor: 18.027
Authors: Erik Ladomersky; Lijie Zhai; Kristen L Lauing; April Bell; Jiahui Xu; Masha Kocherginsky; Bin Zhang; Jennifer D Wu; Joseph R Podojil; Leonidas C Platanias; Aaron Y Mochizuki; Robert M Prins; Priya Kumthekar; Jeffrey J Raizer; Karan Dixit; Rimas V Lukas; Craig Horbinski; Min Wei; Changyou Zhou; Graham Pawelec; Judith Campisi; Ursula Grohmann; George C Prendergast; David H Munn; Derek A Wainwright Journal: Clin Cancer Res Date: 2020-06-16 Impact factor: 12.531