A Durable Response after the Discontinuation of Nivolumab in an Advanced Gastric Cancer Patient

Yatsuda, Yukino; Hirose, Suguru; Ito, Yoshimi; Onoda, Tsubasa; Sugiyama, Yuriko; Nagafuchi, Miho; Suzuki, H.; Niisato, Yusuke; Tange, Yoshitaka; Ikeda, Takafumi; Yamada, Takeshi; Yamamoto, Yoshiyuki; Osawa, Mariko Ohyama; Sakamoto, Noriaki; Moriwaki, Toshikazu; Mizokami, Yuji

doi:10.2169/internalmedicine.5893-20

Cited by 8 publications

(6 citation statements)

References 45 publications

(54 reference statements)

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“…Consistent with these reports, several studies have demonstrated prolonged remission in patients after the discontinuation of nivolumab therapy (8,17,18). Accordingly, a correlation may be present between long-term PD-1 occupancy and a prolonged treatment effect (9). In our study, two patients experienced disease recurrence after discontinuation of nivolumab.…”

Section: Discussionsupporting

confidence: 90%

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Transition of the PD‑1 occupancy of nivolumab on T cells after discontinuation and response of nivolumab re‑challenge

et al. 2022

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Although nivolumab is administered every two or four weeks, high programmed cell death-1 (PD-1) binding of nivolumab on T cells lasting for several months has been reported. A relationship between the PD-1 occupancy rate on T-cells and the efficacy of nivolumab is not yet fully understood. The present study used flow cytometric analyses to determine the time-dependence of PD-1 occupancy in five patients who discontinued nivolumab. The relationship between PD-1 occupancy at relapse and the efficacy of re-challenge was also studied. Occupancies after discontinuation were measured at a total of 32 points. The data indicated that it took 32.4 and 48.9 weeks to decrease occupancy by 50 and 70%, respectively. Subsequently, two patients had recurrence and were re-challenged with nivolumab. At that time, one patient had 70.8% occupancy while the other had 6.6%. Treatment was effective only for the patient with lower occupancy. Overall, the present study suggests that re-challenge with nivolumab may be efficacious in patients with low occupancy at recurrence.

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Section: Discussionsupporting

confidence: 90%

“…In some reports, long-lasting responses were observed in patients even after discontinuation of nivolumab treatment and no further anti-cancer treatment (8)(9)(10). Although the mechanisms of long-lasting response are not fully understood, prolonged binding of nivolumab on T cells is one possible explanation (11,12).…”

Section: Introductionmentioning

confidence: 99%

Transition of the PD‑1 occupancy of nivolumab on T cells after discontinuation and response of nivolumab re‑challenge

et al. 2022

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“…A durable response after ICI discontinuation has also been reported for various tumor entities (22,(26)(27)(28)(29). For R/M-HNSCC the broadly accepted concept is an ICI treatment until disease progression or unacceptable toxicity such as irAE.…”

Section: Discussionmentioning

confidence: 96%

Discontinuation of anti‑programmed cell death protein 1 immune checkpoint inhibition after complete remission in head and neck squamous cell carcinoma: A case report and literature review

Stöth,

Meyer,

Gehrke

et al. 2023

Oncol Lett

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Programmed cell death protein 1 (PD-1) inhibition plays a central role in the current treatment of recurrent or metastatic head and neck squamous cell carcinoma (R/M-HNSCC). Some patients achieve a durable response, and even complete remission (CR) is possible, though it occurs rarely. In cases of durable CR, there are no guidelines regarding a possible discontinuation of immunotherapy. Since clinical experience on this issue is limited, the present study reported on a case of a durable CR following discontinuation of PD-1 inhibition in R/M-HNSCC and additionally presented an overview on the current literature. The present study reported on a case of CR of recurrent oropharyngeal cancer after four cycles of PD-1 monotherapy with Nivolumab. The therapy was discontinued after overall 46 cycles. Even after 3 more years of follow-up, there was no sign of tumor recurrence. Overall, according to reports from the literature, CR seems to be an indicator for durable disease control after therapy discontinuation. Since data on therapy termination is rare, decisions about when to stop successful immunotherapy in R/M-HNSCC have to be made individually for each patient.

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“…Thus, we resumed nivolumab treatment, and QTc prolongation was not observed. Recent studies have also shown that the emergence of irAEs is reportedly associated with better outcomes for ICI treatment in several cancers 19–21 . However, the association between the types of irAEs and the response to ICIs in different cancer types remains unclear.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment with nivolumab in a patient with unresectable oral squamous cell carcinoma following ineffective chemoradiotherapy

Sekido,

Imaue,

Tachinami

et al. 2023

Clinical Case Reports

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Key clinical messageNivolumab has been clinically successful in prolonging the overall survival of patients with recurrent and metastatic head and neck cancer, complete remission is rare. Synergistic combinations of immunotherapy and conventional cancer treatments, such as radiotherapy or chemotherapy, are likely to be the most viable strategies for improving patient responses.AbstractImmune checkpoint inhibitors have revolutionized recurrent, metastatic oral cancer treatment; however complete remission in advanced stages is unusual. We present a case of complete remission of advanced oral squamous cell carcinoma for >4 years in a 64‐year‐old Japanese woman, that responded poorly to chemoradiotherapy but well to subsequent nivolumab treatment.

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A Durable Response after the Discontinuation of Nivolumab in an Advanced Gastric Cancer Patient

Cited by 8 publications

References 45 publications

Transition of the PD‑1 occupancy of nivolumab on T cells after discontinuation and response of nivolumab re‑challenge

Transition of the PD‑1 occupancy of nivolumab on T cells after discontinuation and response of nivolumab re‑challenge

Discontinuation of anti‑programmed cell death protein 1 immune checkpoint inhibition after complete remission in head and neck squamous cell carcinoma: A case report and literature review

Successful treatment with nivolumab in a patient with unresectable oral squamous cell carcinoma following ineffective chemoradiotherapy

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