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Clin Cancer Res. 2019 Feb 1;25(3):946-956. doi: 10.1158/1078-0432.CCR-18-0793. Epub 2018 Oct 8.

Long-Term Survival in Patients Responding to Anti-PD-1/PD-L1 Therapy and Disease Outcome upon Treatment Discontinuation.

Author information

1
Gustave Roussy, Université Paris-Saclay, Département d'Innovation Thérapeutique et d'Essais Précoces, Villejuif, France.
2
Gustave-Roussy, Université Paris-Saclay, Service de Biostatistique et d'Epidémiologie, Villejuif, France.
3
Université Paris-Saclay, Univ. Paris-Sud, UVSQ, CESP, INSERM, Villejuif, France.
4
INSERM U981, Villejuif, France.
5
Gustave-Roussy, Université Paris-Saclay, Service de Radiologie, Villejuif, France.
6
Gustave Roussy, Université Paris-Saclay, Département de Médecine Oncologique, Unité de Dermatologie, Villejuif, France.
7
Gustave Roussy, Université Paris-Saclay, Département d'Innovation Thérapeutique et d'Essais Précoces, Villejuif, France. aurelien.marabelle@gustaveroussy.fr.
8
Gustave-Roussy, Université Paris-Saclay, INSERM U1015, Villejuif, France.

Abstract

PURPOSE:

Anti-PD-(L)1 can provide overall survival (OS) benefits over conventional treatments for patients with many different cancer types. However, the long-term outcome of cancer patients responding to these therapies remains unknown. This study is an exploratory study that aimed to describe the long-term survival of patients responding to anti-PD-(L)1 monotherapy across multiple cancer types.Patients and Methods: Data from patients treated with an anti-PD-(L)1 monotherapy in a phase I trial at Gustave Roussy were retrospectively analyzed over a period of 5 years. All cancer types (n = 19) were included. Clinical and biological factors associated with response, long-term survival, and secondary refractory disease were studied.

RESULTS:

Among 262 eligible patients, the overall objective response rate was 29%. The median progression-free survival of responder patients (RP) at 3 months was 30 months, and the median OS of RP was not reached after a median follow-up of 34 months. In RPs, 3- and 5-year OS percentages were 84% and 64%, respectively. No death occurred in the 21 complete responders (CR) during the overall follow-up. However, many partial responders (PR) showed subsequent tumor relapses to treatment. Long responders (response ≥2 years) represented 11.8% of the overall population. These findings should be validated in further prospective studies.

CONCLUSIONS:

There are currently no differences in therapeutic strategies between CRs and PRs to anti-PD-(L)1. We found a striking difference in OS between these two types of responses. Our results are in favor of evaluating patient stratification strategies and intensification of treatments when tumor lesions of a partial responder to immunotherapy stop improving.See related commentary by Cohen and Flaherty, p. 910.

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