BACKGROUND: After the cessation of immune checkpoint inhibitor (ICI) therapy due to an immune-related adverse event (irAE), it remains unclear whether retreatment with ICI is more effective than its discontinuation. To explore the clinical significance of its retreatment, patients with non-small cell lung cancer (NSCLC) who had treatment interruption of nivolumab due to irAEs were identified and the clinical differences between discontinuation and retreatment with nivolumab were retrospectively reviewed. METHODS: 49 (26%) of 187 patients treated with nivolumab experienced the cessation of treatment due to a serious irAE. Retreatment was chosen in 21 patients (retreatment cohort), while 28 patients discontinued treatment (discontinuation cohort). RESULTS: The most common irAEs requiring treatment cessation in 49 patients included pneumonitis (59.2%), adrenal insufficiency (8.2%), liver dysfunction (8.2%) renal dysfunction (8.2%), colitis (6.1%), hypothyroidism (4.1%), and rash (2.0%). The frequency of grade 3 or 4 initial irAEs did not differ between the retreatment and discontinuation cohorts; however, the incidence of renal dysfunction and colitis was higher in the retreatment cohort than in the discontinuation cohort. Retreatment with nivolumab displayed an overall response rate of 15%, without a significant increase in irAEs. The median overall survival and progression-free survival did not differ significantly between the retreatment and discontinuation cohorts, irrespective of the efficacy of prior nivolumab. CONCLUSIONS: Retreatment exhibited a slightly higher efficacy without a significant increase in irAEs; however, the clinical significance of retreatment and discontinuation was similar in NSCLC patients that led to treatment interruption due to any irAE after initial nivolumab.
BACKGROUND: After the cessation of immune checkpoint inhibitor (ICI) therapy due to an immune-related adverse event (irAE), it remains unclear whether retreatment with ICI is more effective than its discontinuation. To explore the clinical significance of its retreatment, patients with non-small cell lung cancer (NSCLC) who had treatment interruption of nivolumab due to irAEs were identified and the clinical differences between discontinuation and retreatment with nivolumab were retrospectively reviewed. METHODS: 49 (26%) of 187 patients treated with nivolumab experienced the cessation of treatment due to a serious irAE. Retreatment was chosen in 21 patients (retreatment cohort), while 28 patients discontinued treatment (discontinuation cohort). RESULTS: The most common irAEs requiring treatment cessation in 49 patients included pneumonitis (59.2%), adrenal insufficiency (8.2%), liver dysfunction (8.2%) renal dysfunction (8.2%), colitis (6.1%), hypothyroidism (4.1%), and rash (2.0%). The frequency of grade 3 or 4 initial irAEs did not differ between the retreatment and discontinuation cohorts; however, the incidence of renal dysfunction and colitis was higher in the retreatment cohort than in the discontinuation cohort. Retreatment with nivolumab displayed an overall response rate of 15%, without a significant increase in irAEs. The median overall survival and progression-free survival did not differ significantly between the retreatment and discontinuation cohorts, irrespective of the efficacy of prior nivolumab. CONCLUSIONS: Retreatment exhibited a slightly higher efficacy without a significant increase in irAEs; however, the clinical significance of retreatment and discontinuation was similar in NSCLCpatients that led to treatment interruption due to any irAE after initial nivolumab.
Authors: Marco Russano; Alessio Cortellini; Raffaele Giusti; Alessandro Russo; Federica Zoratto; Francesca Rastelli; Alain Gelibter; Rita Chiari; Olga Nigro; Michele De Tursi; Sergio Bracarda; Stefania Gori; Francesco Grossi; Melissa Bersanelli; Lorenzo Calvetti; Vincenzo Di Noia; Mario Scartozzi; Massimo Di Maio; Paolo Bossi; Alfredo Falcone; Fabrizio Citarella; Francesco Pantano; Corrado Ficorella; Marco Filetti; Vincenzo Adamo; Enzo Veltri; Federica Pergolesi; Mario Alberto Occhipinti; Linda Nicolardi; Alessandro Tuzi; Pietro Di Marino; Serena Macrini; Alessandro Inno; Michele Ghidini; Sebastiano Buti; Giuseppe Aprile; Eleonora Lai; Marco Audisio; Salvatore Intagliata; Riccardo Marconcini; Davide Brocco; Giampiero Porzio; Marta Piras; Erika Rijavec; Francesca Simionato; Clara Natoli; Marcello Tiseo; Bruno Vincenzi; Giuseppe Tonini; Daniele Santini Journal: Cancer Immunol Immunother Date: 2021-08-31 Impact factor: 6.968
Authors: Andrew C Johns; Lai Wei; Madison Grogan; Rebecca Hoyd; John F P Bridges; Sandipkumar H Patel; Mingjia Li; Marium Husain; Kari L Kendra; Gregory A Otterson; Jarred T Burkart; Ashley E Rosko; Barbara L Andersen; David P Carbone; Dwight H Owen; Daniel J Spakowicz; Carolyn J Presley Journal: J Geriatr Oncol Date: 2021-02-21 Impact factor: 3.929
Authors: Dan Zhao; Haiqing Li; Isa Mambetsariev; Chen Chen; Rebecca Pharaon; Jeremy Fricke; Angel R Baroz; Prakash Kulkarni; Yan Xing; Erminia Massarelli; Marianna Koczywas; Karen L Reckamp; Kim Margolin; Ravi Salgia Journal: Cancers (Basel) Date: 2021-05-28 Impact factor: 6.639