A Single Dose of a PD-1 Inhibitor Before Surgery Predicts Outcomes in Melanoma Patients

[D.ap]

PHILADELPHIA – A single dose of a PD-1 inhibitor before surgery for melanoma can put patients in remission. Researchers from the Abramson Cancer Center at the University of Pennsylvania, who documented this finding in the largest cohort of patients to be treated with anti-PD-1 drugs before surgery, also showed that immune responses brought on by this therapy can peak as early as seven days after treatment – much earlier than previous studies have shown. Patients in this study completed up to a year of anti-PD-1 therapy after surgery, and those with complete responses after the initial dose have remained cancer free for more than two years – the longest follow-up data to date for a trial evaluating this treatment approach for patients with melanoma. Further, researchers also identified patterns in the way melanoma that comes back after surgery adapts to develop resistance to PD-1 inhibitors, potentially paving the way for greater understanding of how best to help these patients. The findings appear in Nature Medicine today.


https://www.pennmedicine.org/news/news- ... a-patients

[Olga]

After reading what they say about the resistance mechanisms, I am wondering if actually having ICI longer would facilitate the resistance development versus having it initially and stopping at the sign of the durable response (i.e. when there is a reasonable hope the tumor specific killer cells with memory have already developed). We already knew that the excellent response to K can be had with only few doses even smaller than recommended.

[D.ap]

Interesting thought Olga .
I wonder too if the continuing of an ICI could be circumvented by the advent of studies of just these particular folks, who were good responders to the one dose .
Also looked up metronomic dosing of ICIs, but to no avail. Lots of chemo (metronomic) studies along with ICIs.
But none on just ICIs.

Found this article written in 2016 and the challenges of figuring out the responses in taking ICIs.

“The Where, the When, and the How of Immune Monitoring for Cancer Immunotherapies in the Era of Checkpoint Inhibition”

http://clincancerres.aacrjournals.org/content/22/8/1865