open access

Vol 16, No 2 (2020)
Review paper
Published online: 2020-03-13
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Summary of immunotherapy efficacy ordered in accordance with drug reimbursement program in melanoma patients

Anna M Czarnecka, Piotr Rutkowski
DOI: 10.5603/OCP.2020.0004
·
Oncol Clin Pract 2020;16(2):56-68.

open access

Vol 16, No 2 (2020)
REVIEW ARTICLES
Published online: 2020-03-13

Abstract

Nivolumab and pembrolizumab are monoclonal antibodies of the IgG4 class, which target the cell death receptor (PD-1) found on T cells. The binding of the anti-PD-1 drug to the receptor therefore prevents the inhibition of these T cells and increases the immune response against melanoma cells. Pembrolizumab and nivolumab monotherapy has similar efficacy, including PFS and OS. Nivolumab and pembrolizumab immunotherapy are effective regardless of the BRAF mutation status. Currently, the choice between nivolumab and pembrolizumab is primarily dependent on to the frequency of infusions (every 3 weeks for pembrolizumab vs. every 2 weeks for nivolumab or every 6 weeks vs. every 4 weeks). Based on the available data, it can be concluded that autoimmune disease is not an absolute contraindication to the use of immunotherapy, but close clinical monitoring of these patients and specialist consultations (e.g. rheumatologist, dermatologist) must be provided. Patients with severe autoimmune disease who are treated with biologicals or have a history of life-threatening autoimmune disease complications (e.g. severe Crohn’s disease) should not be qualified for immunotherapy, as opposed to patients with minimally symptomatic autoimmune disease (e.g., mild dermal psoriasis).

Abstract

Nivolumab and pembrolizumab are monoclonal antibodies of the IgG4 class, which target the cell death receptor (PD-1) found on T cells. The binding of the anti-PD-1 drug to the receptor therefore prevents the inhibition of these T cells and increases the immune response against melanoma cells. Pembrolizumab and nivolumab monotherapy has similar efficacy, including PFS and OS. Nivolumab and pembrolizumab immunotherapy are effective regardless of the BRAF mutation status. Currently, the choice between nivolumab and pembrolizumab is primarily dependent on to the frequency of infusions (every 3 weeks for pembrolizumab vs. every 2 weeks for nivolumab or every 6 weeks vs. every 4 weeks). Based on the available data, it can be concluded that autoimmune disease is not an absolute contraindication to the use of immunotherapy, but close clinical monitoring of these patients and specialist consultations (e.g. rheumatologist, dermatologist) must be provided. Patients with severe autoimmune disease who are treated with biologicals or have a history of life-threatening autoimmune disease complications (e.g. severe Crohn’s disease) should not be qualified for immunotherapy, as opposed to patients with minimally symptomatic autoimmune disease (e.g., mild dermal psoriasis).

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Keywords

melanoma; immunotherapy; nivolumab; pembrolizumab

About this article
Title

Summary of immunotherapy efficacy ordered in accordance with drug reimbursement program in melanoma patients

Journal

Oncology in Clinical Practice

Issue

Vol 16, No 2 (2020)

Article type

Review paper

Pages

56-68

Published online

2020-03-13

DOI

10.5603/OCP.2020.0004

Bibliographic record

Oncol Clin Pract 2020;16(2):56-68.

Keywords

melanoma
immunotherapy
nivolumab
pembrolizumab

Authors

Anna M Czarnecka
Piotr Rutkowski

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