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Re-Exposure of a PD-1 Inhibitor After Previous Immune-Related Adverse Events

Jana Burghaus-Zhang1, Carsten Schulz1, Egle Ramelyte2

  • 1Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, 69115 Heidelberg, Germany.

Current Oncology (Toronto, Ont.)
|April 27, 2026
PubMed
Abstract

Insights

Retreating patients with dermatological tumors using the same or different Programmed cell death protein 1 (PD-1) inhibitors after immune-related adverse events (irAEs) can be safe. This approach offers a viable option for improving therapy tolerance in these patients.

Area of Science:

  • Oncology
  • Immunology
  • Dermatology

Background:

  • Programmed cell death protein (ligand) 1 (PD-(L)1) inhibitors are standard treatments for skin cancers.
  • While generally safe, 9-21% of patients experience severe immune-related adverse events (irAEs).
  • Limited alternative treatments necessitate evaluating the safety of re-administering PD-(L)1 inhibitors post-irAEs.

Purpose of the Study:

  • To assess the safety and efficacy of re-challenging patients with PD-(L)1 inhibitors after irAEs.
  • To compare outcomes between re-exposure to the same PD-(L)1 inhibitor versus switching to a different one.

Main Methods:

  • A multicenter, retrospective study involving patients with metastatic dermatological tumors.
  • Patients received either the same or a different PD-(L)1 inhibitor following prior irAEs.
  • Data collected from centers in Heidelberg, Zurich, and Frankfurt.

Main Results:

  • 22 patients (median age 71) were analyzed.
  • 13 patients (59%) were re-exposed to the same PD-(L)1 inhibitor; 6 (46%) developed irAEs (67% identical to prior).
  • 9 patients (41%) received a different PD-(L)1 inhibitor; 4 (44%) developed irAEs (75% identical to prior).

Conclusions:

  • Re-exposure to the same PD-(L)1 inhibitor after irAEs is a safe option.
  • Switching to a different PD-(L)1 inhibitor is also a viable strategy post-irAEs.
  • Both strategies offer a reasonable chance of improved therapeutic tolerance.
Keywords:
immune-related adverse eventsimmunotherapyskin cancer

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