Please use this identifier to cite or link to this item: https://ahro.austin.org.au/austinjspui/handle/1/26911
Title: Re-induction ipilimumab following acquired resistance to combination ipilimumab and anti-PD-1 therapy.
Austin Authors: Hepner, Adriana;Atkinson, Victoria G;Larkin, James;Burrell, Rebecca A;Carlino, Matteo S;Johnson, Douglas B;Zimmer, Lisa;Tsai, Katy K;Klein, Oliver ;Lo, Serigne N;Haydon, Andrew;Bhave, Prachi;Lyle, Megan;Pallan, Lalit;Pires da Silva, Ines;Gerard, Camille;Michielin, Olivier;Long, Georgina V;Menzies, Alexander M
Affiliation: Department of Oncology, Lausanne University Hospital CHUV, Lausanne, Switzerland
Helen Diller Family Comprehensive Cancer Center, University of California San Francisco, CA, USA
Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
The Royal Marsden, NHS Foundation Trust, London, UK
University of QLD and Princess Alexandra and Greenslopes Private Hospital, Brisbane, Australia
Alfred Health, Melbourne, Australia
Monash University, Melbourne, Australia
Olivia Newton-John Cancer Wellness and Research Centre
Melanoma Institute Australia, The University of Sydney, NSW, Australia
Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
Royal North Shore and Mater Hospitals, NSW, Australia.
Cairns Private Hospital, Cairns, Australia
Instituto do Cancer do Estado de Sao Paulo, SP, Brazil
Crown Princess Mary Cancer Centre Westmead and Blacktown Hospitals, Australia
Royal North Shore and Mater Hospitals, NSW, Australia
Department of Dermatology, University Hospital Essen, Essen, Germany
Austin Health
Issue Date: 28-Jun-2021
Date: 2021-06-28
Publication information: European Journal of Cancer 2021; 153: 213-222
Abstract: Combination immunotherapy with nivolumab and ipilimumab has a high initial response rate in advanced melanoma; however, up to 55% of patients later progress. The efficacy and safety of ipilimumab re-induction in the setting of acquired resistance (AR) to combination immunotherapy is unknown. Patients with advanced melanoma who initially achieved a complete response, partial response or sustained stable disease to induction combination immunotherapy then progressed and were reinduced with ipilimumab (alone or in combination with anti-PD-1) and were analysed retrospectively. Demographics, disease characteristics, efficacy and toxicity were examined. Forty-seven patients were identified from 12 centres. The response rate to reinduction therapy was 12/47 (26%), and disease control rate was 21/47 (45%). Responses appeared more frequent in patients who developed AR after ceasing induction immunotherapy (30% vs. 18%, P = 0.655). Time to AR was 11 months (95% confidence interval [CI], 8-15 months). After a median follow-up of 16 months (95% CI, 10-25 months), responders to reinduction had a median progression-free survival of 14 months (95% CI, 13, NR months), and in the whole cohort, the median overall survival from reinduction was 17 months (95% CI, 12-NR months). Twenty-seven (58%) immune-related adverse events (irAEs) were reported; 18 (38%) were grade 3/4, and in 11 of 27 (40%), the same irAE observed during induction therapy recurred. Reinduction with ipilimumab ± anti-PD-1 has modest clinical activity. Clinicians should be attentive to the risk of irAEs, including recurrence of irAEs that occurred during induction therapy. Future studies are necessary to determine best management after resistance to combination immunotherapy.
URI: https://ahro.austin.org.au/austinjspui/handle/1/26911
DOI: 10.1016/j.ejca.2021.04.021
Journal: European Journal of Cancer
PubMed URL: 34214936
Type: Journal Article
Subjects: Immunotherapy
Ipilimumab
Melanoma
Programmed death-1
Appears in Collections:Journal articles

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