Safety and Tolerability in an Older Patient Population

Dr In reviews the safety and tolerability profile of cosibelimab in the updated locally advanced cohort, an older patient population in which tolerability carries particular weight. Immune-related adverse events occurred in 34% of patients, but grade 3 immune-related adverse events were reported in only 2%, reflecting a single patient with maculopapular rash. No grade 4 or grade 5 events and no deaths were reported, and the discontinuation rate was 5%. Dr Dunn describes the profile as very favorable and a potential distinguishing feature relative to anti–PD-1 inhibition, particularly for patients with comorbidities. She observes that response rate ordinarily correlates with treatment-related adverse events, making the combination of comparable efficacy and lower immune-related toxicity notable. Both faculty discuss the mechanistic hypothesis that preserved PD-L2 signaling may leave a checkpoint in place and limit autoimmune toxicity, while emphasizing that head-to-head comparisons are needed.