title: Reinduction of PD1-inhibitor therapy: first experience in eight patients with metastatic melanoma.
abstract: Significant progress has been made in the treatment of metastatic melanoma during the last years. Approval of immune-checkpoint inhibitors and targeted therapies has been achieved recently. The sequencing of these therapies is an important issue. Here, we report our experience with the treatment and retreatment with PD1-inhibitors (PD1i) in eight patients. The patients (two female and seven male with a median age of 70 years, all melanoma stage IV, M1c) underwent a first treatment period with PD1i for a median of 5.5 months. Three (37.5%) patients had a stable disease as best response, two (25%) showed progression, two (25%) showed partial response, and one (12.5%) achieved complete remission. PD1i was discontinued due to disease progression in seven patients and due to side effects (pancreatitis) in one patient. Patients were subsequently treated with ipilimumab (n=2), or chemotherapy (n=4), or no other medical treatment (n=2). All eight patients were subsequently retreated with PD1i for a median of 2.5 months. One (12.5%) developed a partial response, whereas in three patients (37.5%) the disease was stabilized. PD1i have shown a high and durable response rate in the first-line treatment of metastatic melanoma. Our study suggests PD1i retreatment as a reasonable option for selected patients. Further investigations are needed to verify the value of PD1i re-exposure and to identify subgroups of patients who can benefit.
authors.affiliation: aDepartment of Dermatology and Allergy Hannover Medical School, Skin Cancer Center Hannover, Hannover bDepartment of Dermatology, University Hospital Heidelberg, Heidelberg cDepartment of Dermatology, University Hospital Tuebingen, Tuebingen dDepartment of Dermatology, Phlebology and Allergology, Hospital Bremerhaven-Reinkenheide, Bremerhaven, Germany.
authors.forename: Hanna
authors.initials: H
authors.lastname: Blasig
authors.forename: Carolin
authors.initials: C
authors.lastname: Bender
authors.forename: Jessica C
authors.initials: JC
authors.lastname: Hassel
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Eigentler
authors.forename: Michael M
authors.initials: MM
authors.lastname: Sachse
authors.forename: Julia
authors.initials: J
authors.lastname: Hiernickel
authors.forename: Anika
authors.initials: A
authors.lastname: Koop
authors.forename: Imke
authors.initials: I
authors.lastname: Satzger
authors.forename: Ralf
authors.initials: R
authors.lastname: Gutzmer
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000473:pathology / Q000628:therapy*; D008875:Middle Aged; D061026:Programmed Cell Death 1 Receptor / Q000037:antagonists & inhibitors*; D012189:Retrospective Studies; D012878:Skin Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: C105992:PDCD1 protein, human; D061026:Programmed Cell Death 1 Receptor