Immunotherapy Resumption/Rechallenge in Melanoma Patients after Toxicity: Do We Have Another Chance?

Pharmaceutics. 2023 Mar 2;15(3):823. doi: 10.3390/pharmaceutics15030823.

Abstract

Introduction: Immune checkpoint inhibitors (ICIs) have radically changed the prognosis of several neoplasias, among them metastatic melanoma. In the past decade, some of these new drugs have appeared together with a new toxicity spectrum previously unknown to clinicians, until now. A common situation in daily practice is that a patient experiences toxicity due to this type of drug and we need to resume or rechallenge treatment after resolving the adverse event.

Methods: A PubMed literature review was carried out.

Results: The published data regarding the resumption or rechallenge of ICI treatment in melanoma patients is scarce and heterogeneous. Depending on the study reviewed, the recurrence incidence of grade 3-4 immune-related adverse events (irAEs) ranged from 18% to 82%.

Conclusion: It is possible to resume or rechallenge, but each patient should be evaluated by a multidisciplinary team for close monitoring and assessment of the risk/benefit ratio before initiating treatment.

Keywords: immune checkpoints; immunotherapy; rechallenge; resumption; toxicity.

Publication types

  • Review

Grants and funding

The authors have not declared a specific grant for this research from any funding agency in the public, commercial, or not-for-profit sectors.