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Immunotherapy Resumption/Rechallenge in Melanoma Patients after Toxicity: Do We Have Another Chance?

Sofia España Fernandez1,2, Chen Sun3, Carme Solé-Blanch2

  • 1Medical Oncology Department, Catalan Institute of Oncology Badalona, 08916 Badalona, Spain.

Pharmaceutics
|March 29, 2023
PubMed
Abstract

Insights

Resuming or rechallenging immune checkpoint inhibitors (ICIs) after toxicity in metastatic melanoma patients is possible. Careful multidisciplinary evaluation is crucial to weigh the risks and benefits for each individual case.

Area of Science:

  • Oncology
  • Immunology
  • Pharmacology

Background:

  • Immune checkpoint inhibitors (ICIs) have transformed metastatic melanoma treatment.
  • ICIs introduce a novel spectrum of toxicities requiring clinical management strategies.
  • Managing treatment interruption and re-initiation due to adverse events is a common clinical challenge.

Purpose of the Study:

  • To review the available literature on resuming or rechallenging ICI therapy in melanoma patients post-toxicity.
  • To understand the incidence and implications of immune-related adverse events (irAEs) upon treatment re-initiation.

Main Methods:

  • A comprehensive literature search was conducted using PubMed.
  • The review focused on studies reporting on ICI treatment resumption or rechallenge in melanoma.

Main Results:

  • Data on ICI resumption/rechallenge in melanoma is limited and varied.
  • Recurrence rates for severe (grade 3-4) immune-related adverse events (irAEs) ranged significantly from 18% to 82% across studies.

Conclusions:

  • Resuming or rechallenging ICI therapy is feasible in select melanoma patients.
  • Individualized assessment by a multidisciplinary team is essential to evaluate the risk/benefit ratio before re-initiating treatment.
Keywords:
immune checkpointsimmunotherapyrechallengeresumptiontoxicity

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