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Cured or Not? Long-term Outcomes of Immunotherapy Responders. Focus on Melanoma

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Abstract

Purpose of Review

Immune checkpoint inhibitors (ICIs) demonstrated robust antitumor activity and tolerable safety in advanced melanoma. Data on long-term outcome of patients who benefited from this therapy and who are still free of progression despite ICI discontinuation is now available. We review here the characteristics of long-term ICI responders and address the critical question of cure.

Recent Findings

Long-term outcome of patients with metastatic melanoma enrolled in large phase 2 and phase 3 clinical trials evaluating ICI in metastatic melanoma is now available. Durable responses, with more than 6 years of median follow-up, may persist after discontinuation. They occur more frequently in patients who achieved a complete response rather than in patients who had partial response or stable disease. Although long-term clinical benefit is more frequent in patients with high PDL-1 expression and smaller tumor burden, durable response may also be observed regardless of baseline characteristics. In patients with asymptomatic brain metastasis, combined immunotherapy (ipilimumab plus nivolumab) may also lead to long-term remission.

Summary

Clinical trials confirm the durable antitumor activity of ICI. Although the hope for cure seems reasonable for many patients in this situation, late relapses may occur and no relapse-predictive biomarkers have been identified yet. Long-term responders who relapse can respond to a rechallenge of ICI although data are limited concerning the rate and the duration of this new response.

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Authors and Affiliations

  1. Dermatology Unit, Department of Medicine, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, 94805, Villejuif, France

    Céline Boutros, Djaouida Belkadi-Sadou, Antoine Marchand, Séverine Roy, Emilie Routier & Caroline Robert

  2. Outpatient Clinic, Department of Medicine, Gustave Roussy Cancer Campus, Villejuif, France

    Céline Boutros

  3. University Paris-Saclay, Faculty of Medicine, Kremlin-Bicêtre, France

    Caroline Robert

  4. INSERM Unit U981, Villejuif, France

    Caroline Robert

Authors
  1. Céline Boutros
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  2. Djaouida Belkadi-Sadou
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  6. Caroline Robert
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Corresponding author

Correspondence to Caroline Robert.

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Conflict of Interest

Djaouida Belkadi-Sadou, Antoine Marchand, and Severine Roy declare no conflict of interest. Celine Boutros has received travel fees from Pierre Fabre, Amgen, and MSD, and has received compensation from MSD for participation in conferences, and from BMS for participation to advisory boards. Emilie Routier has received compensation from BMS, Novartis, and Pierre Fabre, and conference fees from BMS, Novartis, and Pierre Fabre. Caroline Robert reports consultancy for BMS, Roche, Novartis, Pierre Fabre, MSD, Sanofi, AstraZeneca, and Merck, and is cofounder of Ribonexus.

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Boutros, C., Belkadi-Sadou, D., Marchand, A. et al. Cured or Not? Long-term Outcomes of Immunotherapy Responders. Focus on Melanoma. Curr Oncol Rep 25, 989–996 (2023). https://doi.org/10.1007/s11912-023-01429-x

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  • DOI: https://doi.org/10.1007/s11912-023-01429-x

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