Hiromi Watanabe1, Toshio Kubo2, Kiichiro Ninomiya1, Kenichiro Kudo3, Daisuke Minami4, Etsuko Murakami5, Nobuaki Ochi6, Takashi Ninomiya1,7, Daijiro Harada8, Masayuki Yasugi9, Eiki Ichihara1, Kadoaki Ohashi1, Keiichi Fujiwara4, Katsuyuki Hotta1,10, Masahiro Tabata2, Yoshinobu Maeda11, Katsuyuki Kiura1. 1. Allergy and Respiratory Medicine, Okayama University Hospital, Okayama, Japan. 2. Center for Clinical Oncology, Okayama University Hospital, Okayama, Japan. 3. Respiratory Medicine, Iwakuni Medical Center, Iwakuni, Japan. 4. Respiratory Medicine, Okayama Medical Center, Okayama, Japan. 5. Respiratory Medicine, Japanese Red Cross Society Himeji Hospital, Himeji, Japan. 6. General Internal Medicine 4, Kawasaki Medical School, Okayama, Japan. 7. Health Service Center, Okayama University, Okayama, Japan. 8. Respiratory Medicine, Shikoku Cancer Center, Matsuyama, Japan. 9. Respiratory Medicine, Chugoku Central Hospital, Fukuyama, Japan. 10. Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan. 11. Hematology and Oncology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan.
Abstract
INTRODUCTION: Immune checkpoint inhibitors (ICIs) have demonstrated long survival for the treatment of advanced non-small cell lung cancer (NSCLC). However, the effect and safety of ICI rechallenge have not been fully evaluated. The aim of this study was to investigate the efficacy and safety of ICI rechallenge in NSCLC patients. METHODS: We defined 'rechallenge' as re-administration of ICIs for patients who were previously treated with ICIs and discontinued treatment for any reason, and received subsequent chemotherapy. We retrospectively analyzed the histories of 434 patients with advanced NSCLC who received ICIs from December 2015 to December 2017 at seven centers. RESULTS: A total of 317 patients discontinued the ICI treatment, and 14 patients (4.4%) received ICI rechallenge. All 14 patients discontinued the first ICI due to disease progression. Eight patients received the same kind of ICIs, and six patients received different ICIs. Median progression-free survival and overall survival were 1.5 months [95% confidence interval (CI): 0.8-2.6] and 6.5 months [95% CI: 1.4-19.0], respectively. The objective response rate was 7.1%, and the disease control rate was 21.4%. Two of three patients who achieved at least a stable disease, received radiotherapy between the first and second ICIs. Adverse events were not significantly different compared with the first ICIs. CONCLUSIONS: In this study, the effect of ICI rechallenge was limited. Careful consideration of the administration of ICI rechallenge is necessary. This report involved a small number of cases, so further large prospective studies are warranted to confirm the efficacy of ICI rechallenge and to investigate predictive markers to identify a patient population in which ICI rechallenge is effective.
INTRODUCTION: Immune checkpoint inhibitors (ICIs) have demonstrated long survival for the treatment of advanced non-small cell lung cancer (NSCLC). However, the effect and safety of ICI rechallenge have not been fully evaluated. The aim of this study was to investigate the efficacy and safety of ICI rechallenge in NSCLCpatients. METHODS: We defined 'rechallenge' as re-administration of ICIs for patients who were previously treated with ICIs and discontinued treatment for any reason, and received subsequent chemotherapy. We retrospectively analyzed the histories of 434 patients with advanced NSCLC who received ICIs from December 2015 to December 2017 at seven centers. RESULTS: A total of 317 patients discontinued the ICI treatment, and 14 patients (4.4%) received ICI rechallenge. All 14 patients discontinued the first ICI due to disease progression. Eight patients received the same kind of ICIs, and six patients received different ICIs. Median progression-free survival and overall survival were 1.5 months [95% confidence interval (CI): 0.8-2.6] and 6.5 months [95% CI: 1.4-19.0], respectively. The objective response rate was 7.1%, and the disease control rate was 21.4%. Two of three patients who achieved at least a stable disease, received radiotherapy between the first and second ICIs. Adverse events were not significantly different compared with the first ICIs. CONCLUSIONS: In this study, the effect of ICI rechallenge was limited. Careful consideration of the administration of ICI rechallenge is necessary. This report involved a small number of cases, so further large prospective studies are warranted to confirm the efficacy of ICI rechallenge and to investigate predictive markers to identify a patient population in which ICI rechallenge is effective.
Authors: Vaia Florou; Christopher Nevala-Plagemann; Kristin E Barber; Jenna N Mastroianni; Courtney C Cavalieri; Ignacio Garrido-Laguna Journal: JCO Precis Oncol Date: 2020-06-30
Authors: Ryan S Chiang; Ashton A Connor; Brant A Inman; Wen-Chi Foo; David N Howell; John F Madden; Matthew J Ellis; Aparna S Rege; Michael R Harrison Journal: Case Rep Urol Date: 2020-12-23