Pembrolizumab Plus Ipilimumab Following Anti-PD-1/L1 Failure in Melanoma
| العنوان: | Pembrolizumab Plus Ipilimumab Following Anti-PD-1/L1 Failure in Melanoma |
|---|---|
| المؤلفون: | Vernon K. Sondak, Andrew Poklepovic, Nikhil I. Khushalani, Jason J. Luke, Sunil Babu, Sigrun Hallmeyer, Zeynep Eroglu, Mario R. Velasco, Emily F. Higgs, Bruce Brockstein, Daniel J Olson, Thomas Krausz, Madhuri Bajaj, Timothy Carll, Riyue Bao, Jose Lutzky, Theodore Karrison, Brian W. Labadie, Thomas F. Gajewski, Yuanyuan Zha |
| المصدر: | J Clin Oncol |
| بيانات النشر: | American Society of Clinical Oncology (ASCO), 2021. |
| سنة النشر: | 2021 |
| مصطلحات موضوعية: | Adult, Male, 0301 basic medicine, Oncology, Cancer Research, medicine.medical_specialty, medicine.medical_treatment, Programmed Cell Death 1 Receptor, Ipilimumab, Pembrolizumab, Antibodies, Monoclonal, Humanized, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, RAPID COMMUNICATIONS, Antineoplastic Combined Chemotherapy Protocols, medicine, Humans, Melanoma, Language, Aged, Aged, 80 and over, biology, business.industry, Anti pd 1, Immunotherapy, Middle Aged, medicine.disease, 030104 developmental biology, 030220 oncology & carcinogenesis, biology.protein, Female, Antibody, business, medicine.drug |
| الوصف: | PURPOSE Combination of antiprogrammed cell death protein-1 (PD-1) plus anti–cytotoxic T-cell lymphocyte-4 (anti-CTLA-4) immunotherapy shows greater response rates (RRs) than anti-PD-1 antibody alone in melanoma, but RR after initial anti-PD-1 and programmed death ligand-1 (PD-L1) antibody progression awaits robust investigation. Anti-CTLA-4 antibody alone after anti-PD-1/L1 antibody progression has a historical RR of 13%. We report the results of the first prospective clinical trial evaluating ipilimumab 1 mg/kg plus pembrolizumab following progression on anti-PD-1 immunotherapy. METHODS Patients with advanced melanoma who had progressed on anti-PD-1/L1 antibody as immediate prior therapy (including non–anti-CTLA-4 antibody combinations) were eligible. Patients received pembrolizumab 200 mg plus ipilimumab 1 mg/kg once every 3 weeks for four doses, followed by pembrolizumab monotherapy. The primary end point was RR by irRECIST. After 35 patients, the trial met the primary end point and was expanded to enroll a total of 70 patients to better estimate the RR. RESULTS Prior treatments included 60 on anti-PD-1 antibody alone and 10 on anti-PD-1/L1 antibody–based combinations. Thirteen patients had progressed in the adjuvant setting. The median length of prior treatment with anti-PD-1/L1 antibody was 4.8 months. Response assessments included five complete and 15 partial responses, making the irRECIST RR 29% among the entire trial population. The median progression-free survival was 5.0 months, and the median overall survival was 24.7 months. The median duration of response was 16.6 months. There was no difference in median time on prior anti-PD1/L1 or time to PD1 + CTLA4 initiation between responders and nonresponders. Grade 3-4 drug-related adverse events occurred in 27% of patients. Responses occurred in PD-L1–negative, non-T-cell–inflamed, and intermediate tumor phenotypes. CONCLUSION To our knowledge, this is the first prospective study in melanoma of pembrolizumab plus low-dose ipilimumab after anti-PD-1/L1 immunotherapy failure, demonstrating significant antitumor activity and tolerability. |
| تدمد: | 1527-7755 0732-183X |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f53f50387d5994f75ceeba750e8bc2f9Test https://doi.org/10.1200/jco.21.00079Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....f53f50387d5994f75ceeba750e8bc2f9 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 15277755 0732183X |
|---|