Prolonged benefit from ipilimumab correlates with improved outcomes from subsequent pembrolizumab

Amanda Shreders, Richard W Joseph, Chengwei Peng, Fei Ye, Shilin Zhao, Igor Puzanov, Jeffrey A. Sosman, Douglas B. Johnson

Research output: Contribution to journalReview article

9 Scopus citations

Abstract

Patients with metastatic melanoma whose disease progresses on ipilimumab can clearly derive benefit from subsequent anti- programmed death-1 (PD-1). However, patients experience heterogeneous outcomes with ipilimumab, including rapid or delayed progression, and it is unclear whether patterns of ipilimumab progression influence subsequent clinical responses to anti-PD-1. We retrospectively reviewed data from 116 patients with metastatic melanoma who progressed on ipilimumab and were subsequently treated with pembrolizumab. The study objectives were to determine whether progression-free survival (PFS) with ipilimumab was associated with PFS, objective response rate (ORR), and clinical benefit rate (CBR; ORR stable disease) with pembrolizumab. Patients with PFS ≥90 days after treatment with ipilimumab generally had superior outcomes with subsequent pembrolizumab treatment compared with patients with PFS <90 days (ORR, 49% vs. 35%, P = 0.12; CBR, 66% vs. 46%, P = 0.03). Patients with prolonged ipilimumab benefit (PFS ≥ 180 days) had excellent outcomes with pembrolizumab compared with rapid progressors (PFS < 45 days; ORR, 55% vs. 25%; CBR, 80% vs. 25%; median PFS, 249 vs. 50 days). Using logistic regression models, PFS with ipilimumab was independently correlated with response to pembrolizumab (odds ratio, 1.22; 95% CI, 1.02-1.51). This study shows that prolonged PFS with ipilimumab predicts excellent outcomes with subsequent pembrolizumab treatment, offering valuable prognostic information for clinicians.

Original languageEnglish (US)
Pages (from-to)569-573
Number of pages5
JournalCancer immunology research
Volume4
Issue number7
DOIs
StatePublished - Jul 1 2016

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ASJC Scopus subject areas

  • Cancer Research
  • Immunology

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