Neurology

PD-1 inhibition has only limited clinical benefit in patients with recurrent high-grade glioma

Objective

To investigate the question of whether salvage therapy with the programmed cell death protein 1 (PD-1)–blocking antibodies nivolumab or pembrolizumab with or without bevacizumab offers clinical or survival benefit in patients with recurrent high-grade gliomas (HGGs).

Methods

This was a single-institution retrospective observational study in 31 adult patients who received pembrolizumab (Keytruda) or nivolumab (Opdivo) with or without concurrent bevacizumab for recurrent high-grade glioma.

Results

Median progression-free survival (mPFS) from first anti–PD-1 dose was 3.2 months (95% confidence interval [CI] 2.2–4.2), and there was no difference in patients receiving nivolumab (mPFS 3.8 months, 95% CI 1.7–5.8) compared to patients receiving pembrolizumab (mPFS 2.3 months, 95% CI 1.7–2.8, log rank 3.1, p = 0.08). There was also no difference in mPFS if patients had previously received bevacizumab (mPFS 3.2 months, 95% CI 2–4.3) or were bevacizumab naive (mPFS 3.7, 95% CI 0–7.9, log rank 1.3, p = 0.3). The median survival from date of first anti–PD-1 dose was 6.6 months (95% CI 4.2–9.1).

Conclusion

Salvage therapy with nivolumab or pembrolizumab with or without bevacizumab does not confer a survival benefit in this heavily pretreated unselected patient population. Until the results of the currently ongoing clinical trials become available, the use of PD-1–blocking antibodies should be considered in selected individuals only.

Classification of evidence

This retrospective observational study provides Class IV evidence that for patients with recurrent HGGs, salvage therapy with nivolumab or pembrolizumab does not significantly improve survival.

Source link




Related posts

Advanced white matter mapping in the subconcussive brain

Newsemia

Reader response: To harvest?: A reality-based ethical dilemma and fictional dialogue

Newsemia

Author response: Idiopathic intracranial hypertension: The veno glymphatic connections

Newsemia

This website uses cookies to improve your experience. We'll assume you're ok with this, but you can opt-out if you wish. Accept Read More

Privacy & Cookies Policy