Treatment beyond progression with anti-PD-1/PD-L1 based regimens in advanced solid tumors: a systematic review

Abstract Background Treatment beyond progression with immunotherapy may be appropriate in selected patients based on the potential for late responses. The aim of this systematic review was to explore the impact of treatment beyond progression in patients receiving an anti-PD-1/PD-L1 based regimen fo...

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Main Authors: Francesco Spagnolo, Andrea Boutros, Federica Cecchi, Elena Croce, Enrica Teresa Tanda, Paola Queirolo
Format: Article
Language:English
Published: BMC 2021-04-01
Series:BMC Cancer
Subjects:
Online Access:https://doi.org/10.1186/s12885-021-08165-0
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author Francesco Spagnolo
Andrea Boutros
Federica Cecchi
Elena Croce
Enrica Teresa Tanda
Paola Queirolo
author_facet Francesco Spagnolo
Andrea Boutros
Federica Cecchi
Elena Croce
Enrica Teresa Tanda
Paola Queirolo
author_sort Francesco Spagnolo
collection DOAJ
description Abstract Background Treatment beyond progression with immunotherapy may be appropriate in selected patients based on the potential for late responses. The aim of this systematic review was to explore the impact of treatment beyond progression in patients receiving an anti-PD-1/PD-L1 based regimen for an advanced solid tumor. Methods A systematic literature search was performed to identify prospective clinical trials reporting data on overall response rate by immune-related criteria and/or the number of patients treated beyond conventional criteria-defined PD and/or the number of patients achieving a clinical benefit after an initial PD with regimens including an anti-PD-1/PD-L1 agent which received the FDA approval for the treatment of an advanced solid tumor. Results 254 (4.6%) responses after an initial RECIST-defined progressive disease were observed among 5588 patients, based on 35 trials included in our analysis reporting this information. The overall rate of patients receiving treatment beyond progressive disease was 30.2%, based on data on 5334 patients enrolled in 36 trials, and the rate of patients who achieved an unconventional response among those treated beyond progressive disease was 19.7% (based on 25 trials for a total of 853 patients). Conclusion The results of our systematic review support the clinical relevance of unconventional responses to anti-PD-1/PD-L1-based regimens; however, most publications provided only partial information regarding immune-related clinical activity, or did not provide any information at all, highlighting the need of a more comprehensive report of such data in trials investigating immunotherapy for the treatment of patients with advanced tumors.
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spelling doaj.art-0969a343b3cb44a082488578006189e82022-12-21T18:01:54ZengBMCBMC Cancer1471-24072021-04-0121111410.1186/s12885-021-08165-0Treatment beyond progression with anti-PD-1/PD-L1 based regimens in advanced solid tumors: a systematic reviewFrancesco Spagnolo0Andrea Boutros1Federica Cecchi2Elena Croce3Enrica Teresa Tanda4Paola Queirolo5Medical Oncology 2, IRCCS Ospedale Policlinico San MartinoMedical Oncology 2, IRCCS Ospedale Policlinico San MartinoMedical Oncology 2, IRCCS Ospedale Policlinico San MartinoMedical Oncology 2, IRCCS Ospedale Policlinico San MartinoMedical Oncology 2, IRCCS Ospedale Policlinico San MartinoMelanoma, Sarcoma & Rare Tumors Division, European Institute of Oncology (IEO)Abstract Background Treatment beyond progression with immunotherapy may be appropriate in selected patients based on the potential for late responses. The aim of this systematic review was to explore the impact of treatment beyond progression in patients receiving an anti-PD-1/PD-L1 based regimen for an advanced solid tumor. Methods A systematic literature search was performed to identify prospective clinical trials reporting data on overall response rate by immune-related criteria and/or the number of patients treated beyond conventional criteria-defined PD and/or the number of patients achieving a clinical benefit after an initial PD with regimens including an anti-PD-1/PD-L1 agent which received the FDA approval for the treatment of an advanced solid tumor. Results 254 (4.6%) responses after an initial RECIST-defined progressive disease were observed among 5588 patients, based on 35 trials included in our analysis reporting this information. The overall rate of patients receiving treatment beyond progressive disease was 30.2%, based on data on 5334 patients enrolled in 36 trials, and the rate of patients who achieved an unconventional response among those treated beyond progressive disease was 19.7% (based on 25 trials for a total of 853 patients). Conclusion The results of our systematic review support the clinical relevance of unconventional responses to anti-PD-1/PD-L1-based regimens; however, most publications provided only partial information regarding immune-related clinical activity, or did not provide any information at all, highlighting the need of a more comprehensive report of such data in trials investigating immunotherapy for the treatment of patients with advanced tumors.https://doi.org/10.1186/s12885-021-08165-0MelanomaImmunotherapyImmune-related response criteriaTreatment beyond progressionAnti-PD-1
spellingShingle Francesco Spagnolo
Andrea Boutros
Federica Cecchi
Elena Croce
Enrica Teresa Tanda
Paola Queirolo
Treatment beyond progression with anti-PD-1/PD-L1 based regimens in advanced solid tumors: a systematic review
BMC Cancer
Melanoma
Immunotherapy
Immune-related response criteria
Treatment beyond progression
Anti-PD-1
title Treatment beyond progression with anti-PD-1/PD-L1 based regimens in advanced solid tumors: a systematic review
title_full Treatment beyond progression with anti-PD-1/PD-L1 based regimens in advanced solid tumors: a systematic review
title_fullStr Treatment beyond progression with anti-PD-1/PD-L1 based regimens in advanced solid tumors: a systematic review
title_full_unstemmed Treatment beyond progression with anti-PD-1/PD-L1 based regimens in advanced solid tumors: a systematic review
title_short Treatment beyond progression with anti-PD-1/PD-L1 based regimens in advanced solid tumors: a systematic review
title_sort treatment beyond progression with anti pd 1 pd l1 based regimens in advanced solid tumors a systematic review
topic Melanoma
Immunotherapy
Immune-related response criteria
Treatment beyond progression
Anti-PD-1
url https://doi.org/10.1186/s12885-021-08165-0
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