Programmed cell death protein-1 (PD-1) inhibitor therapy in patients with advanced melanoma and preexisting autoimmunity or ipilimumab-triggered autoimmunity
Gutzmer R, Koop A, Meier F, Hassel JC, Terheyden P, Zimmer L, Heinzerling L, Ugurel S, Pfoehler C, Gesierich A, Livingstone E, Satzger I, Kaehler KC (2017)
Publication Type: Journal article
Publication year: 2017
Journal
Book Volume: 75
Pages Range: 24-32
DOI: 10.1016/j.ejca.2016.12.038
Abstract
AIM: Programmed cell death protein 1 (PD-1) inhibitors are a common treatment strategy for metastatic melanoma and other tumour entities. Clinical trials usually exclude patients with preexisting autoimmune diseases, thus experience with PD-1 inhibitor (PD-1i) in this patient population is limited. PATIENTS AND METHODS: Metastatic melanoma patients with preexisting autoimmune disorders or previous ipilimumab-triggered immune-related adverse events (irAE) undergoing treatment with PD-1i from seven German skin cancer centres were evaluated retrospectively with regard to flare of the preexisting autoimmunity and development of new, not preexisting irAE as well as response to PD-1i therapy. RESULTS: In total, 41 patients had either preexisting autoimmunity (n=19, group A, including two patients with additional ipilimumab-triggered autoimmune colitis) or ipilimumab-triggered irAE (n=22, group B). At PD-1i therapy initiation, six patients in group A and two patients in group B required immunosuppressive therapy. In group A, a flare of preexisting autoimmune disorders was seen in 42% of patients, new irAE in 16%. In group B, 4.5% of patients showed a flare of ipilimumab-triggered irAE and 23% new irAE. All flares of preexisting autoimmune disorders or irAE were managed by immunosuppressive and/or symptomatic therapy and did not require termination of PD-1i therapy. tumour responses (32% in group A and 45% in group B) were unrelated to occurrence of autoimmunity. CONCLUSION: While preexisting autoimmunity commonly showed a flare during PD-1i therapy, a flare of ipilimumab-triggered irAE was rare. Response rates were above 30% and unrelated to irAE. PD-1i therapy can be considered in patients with autoimmune disorders depending on severity and activity of autoimmunity.
Authors with CRIS profile
Involved external institutions
Universitätsklinikum Schleswig-Holstein (UKSH)
Germany (DE)
Technische Universität Dresden
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
Universität Duisburg-Essen (UDE)
Germany (DE)
Universität des Saarlandes (UdS)
Germany (DE)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
Universitätsklinikum Heidelberg
Germany (DE)
Universität zu Lübeck
Germany (DE)
Germany (DE)
Technische Universität Dresden
Germany (DE)
Universitätsklinikum Würzburg
Germany (DE)
Universität Duisburg-Essen (UDE)
Germany (DE)
Universität des Saarlandes (UdS)
Germany (DE)
Medizinische Hochschule Hannover (MHH) / Hannover Medical School
Germany (DE)
Universitätsklinikum Heidelberg
Germany (DE)
Universität zu Lübeck
Germany (DE)
How to cite
APA:
Gutzmer, R., Koop, A., Meier, F., Hassel, J.C., Terheyden, P., Zimmer, L.,... Kaehler, K.C. (2017). Programmed cell death protein-1 (PD-1) inhibitor therapy in patients with advanced melanoma and preexisting autoimmunity or ipilimumab-triggered autoimmunity. European Journal of Cancer, 75, 24-32. https://doi.org/10.1016/j.ejca.2016.12.038
MLA:
Gutzmer, Ralf, et al. "Programmed cell death protein-1 (PD-1) inhibitor therapy in patients with advanced melanoma and preexisting autoimmunity or ipilimumab-triggered autoimmunity." European Journal of Cancer 75 (2017): 24-32.
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