Real-World efficiency of pembrolizumab in metastatic melanoma patients following adjuvant anti-PD1 treatment

<h2>Abstract</h2><h3>Background</h3> Postoperative treatment of patients with either BRAF/MEK inhibitors or anti-PD1 antibodies in the adjuvant setting results in improved recurrence free survival and has therefore become a standard of care for most patients with resected stage III melanoma. For patients who need systemic treatment after failure of adjuvant immune checkpoint inhibitors, there is insufficient evidence regarding efficacy of a retreatment with anti-PD1 antibodies. <h3>Methods</h3> From the European Melanoma Treatment Registry (EUMelaReg) we have identified 74 patients and evaluated the clinical characteristics and outcome of anti-PD1 retreatment with pembrolizumab in these patients. The primary objectives were overall response rate and progression-free survival stratified by type of recurrence, i.e. whether recurrence occurred while on adjuvant anti-PD1, or later during follow up. In addition, the analysis was stratified for patients, who terminated adjuvant treatment early due to side effects. <h3>Results</h3> The ORR of pembrolizumab retreatment in 1st line after recurrence (n=51) was 37.3 %, which did not differ significantly between type of recurrence (40.9 % in early vs. 34.5 % in late recurrence). Patients who discontinued adjuvant anti-PD1 for toxicity had a higher ORR (52.9 %) compared to patients who completed the treatment (37.5 %) or discontinued due to disease progression (23.1 %). PFS in 1st line retreatment was comparable between the groups with a median PFS (95 % CI) of 7.4 (2.3-NR) months and 6.1 (3.4–13.1) months in early and late recurrence, respectively. <h3>Conclusion</h3> Retreatment with pembrolizumab may be a valuable treatment option after failure of adjuvant immunotherapy, in particular in patients who have stopped adjuvant treatment for side effects.

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Publication Details

Journal
EJC Skin Cancer
Published
2024-10-10
DOI
https://doi.org/10.1016/j.ejcskn.2024.100271
Citations
1
Primary Topic
Cancer Immunotherapy and Biomarkers
Type
article
Field-Weighted Citation Impact
0.28
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article

Real-World efficiency of pembrolizumab in metastatic melanoma patients following adjuvant anti-PD1 treatment

Shan Jiang, Marc Bender, Michael Weichenthal, Paolo A. Ascierto et al.
1 citations
EJC Skin Cancer
Cancer Immunotherapy and Biomarkers
0.28
article

Real-World efficiency of pembrolizumab in metastatic melanoma patients following adjuvant anti-PD1 treatment

Shan Jiang, Marc Bender, Michael Weichenthal, Paolo A. Ascierto, Eva Ellebæk, Dirk Schadendorf, Christina H. Bruvik Ruhlmann, José Luís Zamora Manzano, Friedegund Meier, Reinhard Dummer, Peter G. Mohr, Iva Gavrilova, Inge Marie Svane, Dimitrios C. Ziogas, Ulrike Leiter, Helen J Gogas, Johanna Mangana, Pablo Cerenzuela, Lidija Kandolf
article en
1 citations

Abstract

<h2>Abstract</h2><h3>Background</h3> Postoperative treatment of patients with either BRAF/MEK inhibitors or anti-PD1 antibodies in the adjuvant setting results in improved recurrence free survival and has therefore become a standard of care for most patients with resected stage III melanoma. For patients who need systemic treatment after failure of adjuvant immune checkpoint inhibitors, there is insufficient evidence regarding efficacy of a retreatment with anti-PD1 antibodies. <h3>Methods</h3> From the European Melanoma Treatment Registry (EUMelaReg) we have identified 74 patients and evaluated the clinical characteristics and outcome of anti-PD1 retreatment with pembrolizumab in these patients. The primary objectives were overall response rate and progression-free survival stratified by type of recurrence, i.e. whether recurrence occurred while on adjuvant anti-PD1, or later during follow up. In addition, the analysis was stratified for patients, who terminated adjuvant treatment early due to side effects. <h3>Results</h3> The ORR of pembrolizumab retreatment in 1st line after recurrence (n=51) was 37.3 %, which did not differ significantly between type of recurrence (40.9 % in early vs. 34.5 % in late recurrence). Patients who discontinued adjuvant anti-PD1 for toxicity had a higher ORR (52.9 %) compared to patients who completed the treatment (37.5 %) or discontinued due to disease progression (23.1 %). PFS in 1st line retreatment was comparable between the groups with a median PFS (95 % CI) of 7.4 (2.3-NR) months and 6.1 (3.4–13.1) months in early and late recurrence, respectively. <h3>Conclusion</h3> Retreatment with pembrolizumab may be a valuable treatment option after failure of adjuvant immunotherapy, in particular in patients who have stopped adjuvant treatment for side effects.

EJC Skin CancerVol. 2
Merck & Co., Inc., Rahway, NJ, USA (United States) (US), Military Medical Academy (RS), National and Kapodistrian University of Athens (GR), University of Zurich (CH), Odense University Hospital (DK), Gentofte Hospital (DK), Christian-Albrechts-Universität zu Kiel (DE), University Hospital of Zurich (CH), National Center for Tumor Diseases (DE), University Hospital Schleswig-Holstein (DE), Essen University Hospital (DE), Elbe Kliniken Stade-Buxtehude (DE), Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale" (IT), National Center of Radiobiology and Radiation Protection (BG), Danish Cancer Society (DK), Hospital Universitario Virgen de la Arrixaca (ES), Hospital Universitari Germans Trias i Pujol (ES), University Hospital Carl Gustav Carus (DE), Clinical Research Center Kiel (DE), Technische Universität Dresden (DE), University of Tübingen (DE), University of Health Sciences Antigua (AG), University of Lübeck (DE)
Zero hunger
Openalex Percentile: Top 35%
Cancer Immunotherapy and Biomarkers
0.28
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