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Evaluation of readministration of immune checkpoint inhibitors after immune-related adverse events in patients with cancer

JAMA Sep 19, 2019

Simonaggio A, Michot JM, Voisin AL, et al. - Via a cohort study of 93 French adults who were referred to the ImmunoTOX assessment board at the Gustave Roussy cancer center in Villejuif, France, between August 1, 2015, and December 31, 2017, researchers examined the safety of a rechallenge with anti–PD-1 (programmed cell death 1) or anti–PD-L1 (programmed cell death 1 ligand 1) immunotherapies following an immune-related adverse events (irAEs). Melanoma, lung, colorectal, and lymphomas were chief cancer types or tumor sites. For the initial irAE, 43 grade 2 events, 36 grade 3 events, and 14 grade 4 events were discovered, manifesting primarily as hepatitis, skin toxic effect, pneumonitis, colitis, or arthralgia. With the same anti–PD-1 or anti–PD-L1 agent, 40 patients were rechallenged. In terms of the median (range) age, time to initial irAE, irAE severity, or steroid use, the rechallenged and non-rechallenged groups did not vary. With a median follow-up period of 14 months, the same irAE or a distinctive irAE happened in 22 patients. Shorter time to the initial irAE was associated with the occurrence of a second irAE. The second irAEs were not observed to be more severe vs the first. Thus, the risk-reward ratio for an anti–PD-1 or anti–PD-L1 rechallenge seems to be fair, though these patients need close monitoring.
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