Re-immunotherapy with nivolumab plus ipilimumab in advanced non-small cell lung cancer patients previously treated with anti-programmed death-1 and/or anti-programmed death ligand-1 antibodies

Takuma Imakita; Kohei Fujita; Takanori Ito; Zentaro Saito; Issei Oi; Osamu Kanai; Hiromasa Tachibana; Satoru Sawai; Tadashi Mio

doi:10.1007/s12672-023-00781-5

Re-immunotherapy with nivolumab plus ipilimumab in advanced non-small cell lung cancer patients previously treated with anti-programmed death-1 and/or anti-programmed death ligand-1 antibodies

Discov Oncol. 2023 Aug 31;14(1):163. doi: 10.1007/s12672-023-00781-5.

Authors

Takuma Imakita¹, Kohei Fujita², Takanori Ito², Zentaro Saito², Issei Oi², Osamu Kanai², Hiromasa Tachibana², Satoru Sawai³, Tadashi Mio²

Affiliations

¹ Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, 1-1, Fukakusa-Mukaihata, Fushimi, Kyoto, 612-8555, Japan. imakita-kyt@umin.ac.jp.
² Division of Respiratory Medicine, Center for Respiratory Diseases, National Hospital Organization Kyoto Medical Center, 1-1, Fukakusa-Mukaihata, Fushimi, Kyoto, 612-8555, Japan.
³ Division of Thoracic Surgery, Center for Respiratory Diseases, National Hospital Organization, Kyoto Medical Center, 1-1, Fukakusa-Mukaihata, Fushimi, Kyoto, 612-8555, Japan.

Abstract

Background: The role of re-immunotherapy in advanced non-small cell lung cancer (NSCLC) remains unclear. No studies have evaluated the re-immunotherapy regimen including anti-cytotoxic T-lymphocyte antigen-4 antibody for lung cancer treatment. This study aimed to investigate the efficacy and safety of re-immunotherapy with nivolumab plus ipilimumab in patients with advanced NSCLC previously treated with anti-programmed death-1 (PD-1) and/or anti-programmed death ligand-1 (PD-L1) antibodies.

Methods: We retrospectively reviewed patients with advanced or recurrent NSCLC who received immunotherapy with nivolumab plus ipilimumab (without concomitant cytotoxic chemotherapy) between November 2020 and November 2022 at the National Hospital Organization Kyoto Medical Center, Kyoto, Japan. Data were extracted from patients who had previously received immunotherapies with anti-PD-1 and/or anti-PD-L1 antibodies. Treatment responses and adverse events were evaluated.

Results: Of the 67 patients who received immunotherapy with nivolumab plus ipilimumab, 23 were included in final analysis. The objective response rate was 17%, and the disease control rate was 48% for nivolumab plus ipilimumab therapy. The highest grade of immune-related adverse events was grade 3, occurring in 11% of cases.

Conclusion: Re-immunotherapy with nivolumab plus ipilimumab after anti-PD-1 and/or anti-PD-L1 immunotherapy may be feasible and provide clinical benefit in selected patients. Further prospective studies are warranted to identify the patient population that may benefit from re-immunotherapy.

Keywords: Cytotoxic T-lymphocyte-associated protein-4; Immune checkpoint inhibitor; Immune-related adverse event; Objective response rate; Tumor proportion score.