Treatment Duration for PD-1 Inhibitors in Melanoma

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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.