Prolonged benefit from ipilimumab correlates with improved outcomes from subsequent pembrolizumab

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

Research output: Contribution to journalReview articlepeer-review

12 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 2016

ASJC Scopus subject areas

  • Immunology
  • Cancer Research

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