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Treatment Duration for PD-1 Inhibitors in Melanoma

Panelists: Robert H.I. Andtbacka, MD, Huntsman; Omid Hamid, MD, The Angeles Clinic; Richard W. Joseph, MD, Mayo Clinic; Howard L. Kaufman, MD, FACS,
Published: Sunday, Mar 29, 2015
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The optimal duration of treatment with the PD-1 inhibitors nivolumab and pembrolizumab for patients with metastatic melanoma remains an unanswered question and an important goal for randomized trials. In the absence of progression or side effects, patients in currently ongoing clinical trials have stayed on these agents indefinitely, notes Richard Joseph, MD. 

In many situations, patients who achieve a complete remission seek to discontinue therapy at some point. The risk of discontinuing treatment seems to be low, particularly since many patients can be retreated with the PD-1 inhibitor if there is a recurrence, Joseph adds. 

Retreatment with immunotherapy is a proven strategy, with success demonstrated using ipilimumab and interleukin-2, notes Howard Kaufman, MD. However, until more data is available, it may be ideal to administer a different therapy for a patient whose disease progresses after anti-PD-1 therapy. At this time, the impact of constantly stimulating the immune system for an extended duration is unknown, Anna C. Pavlick, DO, adds.


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For High-Definition, Click
The optimal duration of treatment with the PD-1 inhibitors nivolumab and pembrolizumab for patients with metastatic melanoma remains an unanswered question and an important goal for randomized trials. In the absence of progression or side effects, patients in currently ongoing clinical trials have stayed on these agents indefinitely, notes Richard Joseph, MD. 

In many situations, patients who achieve a complete remission seek to discontinue therapy at some point. The risk of discontinuing treatment seems to be low, particularly since many patients can be retreated with the PD-1 inhibitor if there is a recurrence, Joseph adds. 

Retreatment with immunotherapy is a proven strategy, with success demonstrated using ipilimumab and interleukin-2, notes Howard Kaufman, MD. However, until more data is available, it may be ideal to administer a different therapy for a patient whose disease progresses after anti-PD-1 therapy. At this time, the impact of constantly stimulating the immune system for an extended duration is unknown, Anna C. Pavlick, DO, adds.
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Online CME Activities
TitleExpiration DateCME Credits
Medical Crossfire®: Evolving Roles for Targeted Melanoma Therapies: Assessing Rapid Progress in the Field and Looking Toward Future CombinationsFeb 28, 20191.5
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