Drastic Response of Rechallenge of Nivolumab in a Patient with NSCLC Who Progressed on the First Nivolumab Treatment

Hirano, Satoshi; Hayama, Nami; Tabeta, Hiroshi; Kuroki, Tsuguko; Shiraishi, Yuka; Fujita, Tetsuo; Amano, Hiroyuki; Nakamura, Makoto; Shimizu, Shinichiro; Nakamura, Sukeyuki

doi:10.1016/j.jtho.2019.10.012

Cited by 6 publications

(9 citation statements)

References 3 publications

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“…Although it remains unknown in which patients ICPI rechallenge might be effective, on the other hand, previous studies have suggested the predictive factors of the efficacy of the therapy [2][3][4][5][6][7]. Some of them were as follows: 1) high tumor PD-L1 expression [5], 2) good response to the first ICPI therapy [2,6,7], 3) radiation therapy before ICPI rechallenge [4,6], 4) short duration between the initial ICPI therapy and the rechallenge [3,6], 5) good response to prior chemotherapy [3], 6) presence of immune-related adverse events in initial ICPI therapy [6], and 7) prior therapy including vascular endothelial growth factor inhibitor [3]. Some of the factors were relevant to our patient.…”

Section: Discussionmentioning

confidence: 99%

“…This clinical situation may provide opportunities for ICPI rechallenge therapy in later lines after the recurrence on post-ICPI chemotherapy or driver gene targeted therapies. In some NSCLC patients, the effects of ICPI rechallenge therapy have become apparent [2][3][4][5][6][7]. We have encountered a NSCLC patient who showed pseudoprogression [8][9][10][11], which is very rare phenomenon in this therapy, during successful ICPI rechallenge treatment.…”

Section: Introductionmentioning

confidence: 96%

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Pseudoprogression during Successful Rechallenge of Immune Checkpoint Inhibitor in a NSCLC Patient

Kagohashi

Miyazaki²,

Shiozawa

et al. 2021

Advances in Respiratory Medicine

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Rechallenge of immune checkpoint inhibitors (ICPIs) is one of the attractive but unestablished treatment for recurrent non-small cell lung cancer (NSCLC) patients who have been treated with several lines of systemic chemotherapy. In some NSCLC patients, the effects of ICPI rechallenge therapy have become apparent. In ICPI treatment, although very rare, a phenomenon called pseudoprogression is known. We report the first case of pseudoprogression during successful rechallenge of ICPI in a NSCLC patient. Although not fully clarified, factors related to the onset of pseudoprogression and good response to ICPI rechallenge are being investigated. Our case showed that pseudoprogression could be developed even in patients with ICPI rechallenge therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 96%

Pseudoprogression during Successful Rechallenge of Immune Checkpoint Inhibitor in a NSCLC Patient

Kagohashi

Miyazaki²,

Shiozawa

et al. 2021

Advances in Respiratory Medicine

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“…3,4 Similarly, a few cases show the effectiveness of nivolumab against lung cancer; and we found three such case reports. [5][6][7] In the CheckMate 057 trial, nivolumab achieved four points of CR out of 292 cases. 8 In the OAK study, atezolizumab achieved CR in six out of 425 patients.…”

Section: Discussionmentioning

confidence: 99%

Complete response of squamous cell carcinoma of the lung following treatment with pembrolizumab in an elderly patient: A case report

et al. 2020

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Complete response of non-small cell lung cancer (NSCLC) with immune checkpoint inhibitor (ICI) monotherapy is rare. Here, we encountered an elderly patient who showed complete response of NSCLC following treatment with pembrolizumab. An 84-year-old man with a history of bloody sputum for several weeks visited a general physician. At that time, a chest X-ray revealed a tumor shadow in the left middle lung field, and the patient was referred to our hospital. Following transbronchial biopsy, he was diagnosed with squamous cell carcinoma of the lung. Expression of programmed death ligand 1 (PD-L1) in tumor cells was 80% or more by immunostaining. Based on the above, immunotherapy with pembrolizumab was performed as first-line therapy. The cancer cells completely disappeared at the end of the fifth cycle. There were no side effects during the therapeutic course. Treatment with pembrolizumab continued for two years and was then discontinued at the patient's request. Since then, no tumor recurrence has been detected for about one and a half years without treatment. There have been few reports of lung cancer disappearing after treatment with pembrolizumab. In conclusion, in elderly NSCLC patients with PD-L1 expression of 50% or more, pembrolizumab should be considered as first-line treatment with the treatment period, and mechanism suggested in this report.

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“…In these studies, the objective response rate (ORR) in primary use was 46.8%, the disease control rate (DCR) was 81.0%, and the median progression‐free survival (PFS) was 10.2 months. While in the rechallenge setting, the ORR and DCR were 15.6% and 58.4%, respectively, and the median PFS was 5.1 months 4–12 . It is obvious that the ORR and DCR in the primary treatment were higher than that in the rechallenge setting, and the PFS were also much longer.…”

Section: Expert Consensus 1: Whether To Rechallenge or Notmentioning

confidence: 91%

“…Several have researchers reported that the ORR, DCR and PFS of the primary and rechallenging ICIs use (both were nivolumab) were 57.6%, 87.9%, 11.5 months, and 42.7%, 58.3%, 6.5 months, respectively. 5,7,11,12 8,11 F I G U R E 1 Optimal response to initial treatment with immune checkpoint inhibitors (ICIs).…”

Section: Introductionmentioning

confidence: 99%

Rechallenge of immune checkpoint inhibitors in advanced non‐small cell lung cancer

Lin,

Wang,

Chu

et al. 2024

Thoracic Cancer

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Immune checkpoint inhibitor (ICI) rechallenge in non‐small cell lung cancer (NSCLC) is a promising therapeutic strategy. The situation for ICI rechallenge can be divided into three categories: adverse events (AEs); resistance to ICIs, and rechallenge becomes compulsive because of tumor relapse while the patients had completed a 2 year course of immunotherapy. However, these categories are still controversial and should be explored further. Through voting at the 6th Straits Summit Forum on Lung Cancer, in this study we summarize the consensus of 147 experts in ICI rechallenges. A total of 97.74% experts agreed to rechallenge; 48.87% experts rechallenge with the original drug, and the others rechallenge with a different drug; 40.3% agreed to rechallenge directly after progression; 88.06% experts agreed to ICI rechallenge with a combination regimen; and factors such as previous performance status score, PD‐1 expression, and age should also be considered. Understanding the the clinical studies in ICI rechallenge could bring us one step closer to understanding the consensus. In patients with advanced NSCLC who have suffered recurrent or distant metastasis after immunotherapy, the option of rechallenge with ICIs is a promising treatment option.

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Drastic Response of Rechallenge of Nivolumab in a Patient with NSCLC Who Progressed on the First Nivolumab Treatment

Cited by 6 publications

References 3 publications

Pseudoprogression during Successful Rechallenge of Immune Checkpoint Inhibitor in a NSCLC Patient

Pseudoprogression during Successful Rechallenge of Immune Checkpoint Inhibitor in a NSCLC Patient

Complete response of squamous cell carcinoma of the lung following treatment with pembrolizumab in an elderly patient: A case report

Rechallenge of immune checkpoint inhibitors in advanced non‐small cell lung cancer

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