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Rechallenge with Anti-PD-1 Inhibitors in Patients with Recurrent Gynecologic Malignancies

Migang Kim1, Chi-Son Chang2, Min Chul Choi3

  • 1Comprehensive Gynecologic Cancer Center, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea.

Yonsei Medical Journal
|September 20, 2023
PubMed
Abstract

Insights

Immune checkpoint inhibitor (ICI) rechallenge in recurrent gynecologic cancers showed some response, with fewer severe adverse events (AEs) upon re-exposure. Further data is needed before routine use outside clinical trials.

Area of Science:

  • Oncology
  • Immunotherapy

Background:

  • Recurrent gynecologic cancers pose treatment challenges.
  • Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy.
  • Rechallenge with ICIs after initial treatment is an emerging strategy.

Purpose of the Study:

  • To investigate the treatment outcomes of immune checkpoint inhibitor (ICI) rechallenge in patients with recurrent gynecologic cancers.
  • To evaluate the safety and efficacy of PD-1 inhibitor rechallenge.

Main Methods:

  • Retrospective review of 20 patients with recurrent gynecologic cancers treated with PD-1 inhibitors.
  • Data collected from January 2018 to September 2022 at two tertiary centers.
  • Analysis of treatment responses, progression-free survival (PFS), and adverse events (AEs).

Main Results:

  • Patients received pembrolizumab or nivolumab for rechallenge.
  • Initial ICI treatment showed complete response (CR) in 5% and partial response (PR) in 20%.
  • Second ICI treatment resulted in CR in 5%, PR in 10%, and stable disease in 25%; median PFS was 1.8 months.
  • No AE relapse occurred in patients who previously discontinued ICI due to AEs.

Conclusions:

  • ICI rechallenge in recurrent gynecologic cancers can yield responses.
  • Rechallenge appears to be less intolerable than initial ICI treatment regarding AEs.
  • Further research is warranted to establish routine clinical practice for ICI rechallenge.
Keywords:
Gynecologic malignancyimmune checkpoint inhibitorrechallengerecurrence

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