Department of Surgery UZ Brussel, Laarbeeklaan 101, 1090, Jette, Belgium.
Department of Medical Oncology and Radiology & Nuclear Medicine, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Curr Oncol Rep. 2022 Jul;24(7):905-915. doi: 10.1007/s11912-022-01264-6. Epub 2022 Mar 26.
Emerging data indicate that immune checkpoint blockade (ICB) in patients with metastatic melanoma can be stopped electively or at the time of toxicity with an acceptable risk for progression. However, the optimal treatment duration remains to be defined. We review published data on treatment duration, outcome after treatment discontinuation, and treatment re-introduction in patients with metastatic melanoma.
Published studies indicate that disease control can be maintained after discontinuation of ICB therapy. Discontinuation of therapy in responders decreases the risk for treatment-related adverse events and lowers the financial burden of ICB. With the limitation of the limited and heterogenous available published data, elective treatment discontinuation after 1 year of treatment appears safe with an acceptable risk of disease progression. The depth of response is currently the best predictor of prolonged response. The metabolic response on 18F-FDG-PET/CT is expected to gain importance, especially for partial responders.
新出现的数据表明，转移性黑色素瘤患者的免疫检查点阻断 (ICB) 可以在出现毒性时或在可接受的进展风险时选择性地停止。然而，最佳治疗持续时间仍有待确定。我们回顾了转移性黑色素瘤患者的治疗持续时间、停药后结果和重新引入治疗的数据。
已发表的研究表明，ICB 治疗停药后可维持疾病控制。应答者停药可降低治疗相关不良事件的风险，并降低 ICB 的经济负担。由于可用的已发表数据有限且存在异质性，在治疗 1 年后选择性停药似乎是安全的，疾病进展的风险可接受。目前，反应深度是预测延长反应的最佳指标。18F-FDG-PET/CT 的代谢反应预计将变得更加重要，特别是对于部分应答者。
