Low-Dose Anti-PD(L)1 for the Treatment of Solid Malignancies
PURPOSEMounting data suggest that lower doses of anti-PD(L)1 agents can be as efficacious as label-approved doses at a fraction of its cost. We compare the outcomes of patients treated with low-dose (LD) and with conventional-dose (CD) anti-PD(L)1 agents.METHODSThis observational study evaluates the...
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American Society of Clinical Oncology
2024-11-01
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| Series: | JCO Global Oncology |
| Online Access: | https://ascopubs.org/doi/10.1200/GO.24.00122 |
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| author | Iza Andrade de A. Souza Beatriz de M. Dobbert Barbara G. Sao Jose Joao Pedro Homse-Netto Larissa L. Furlan Maira S. Abreu Camila Ferrari Bruno Uchoa Kathia Abdallah Stephano N. Lucio Joao A. Soler Fabio L.C. Fernandez Luiza Ferreira Joao D. Guedes Aline F. Fares Daniel V. Araujo |
| author_facet | Iza Andrade de A. Souza Beatriz de M. Dobbert Barbara G. Sao Jose Joao Pedro Homse-Netto Larissa L. Furlan Maira S. Abreu Camila Ferrari Bruno Uchoa Kathia Abdallah Stephano N. Lucio Joao A. Soler Fabio L.C. Fernandez Luiza Ferreira Joao D. Guedes Aline F. Fares Daniel V. Araujo |
| author_sort | Iza Andrade de A. Souza |
| collection | DOAJ |
| description | PURPOSEMounting data suggest that lower doses of anti-PD(L)1 agents can be as efficacious as label-approved doses at a fraction of its cost. We compare the outcomes of patients treated with low-dose (LD) and with conventional-dose (CD) anti-PD(L)1 agents.METHODSThis observational study evaluates the outcomes of patients with solid malignancies treated with anti-PD(L)1 agents (LD or CD) at Hospital de Base, Brazil. Patients were classified as receiving LD if the dose administered in the first cycle was below the label-approved dose. Efficacy outcomes, including best clinical overall response rate (cORR), clinical progression-free survival (cPFS), and overall survival (OS), were evaluated.RESULTSFrom January 2020 to May 2023, 71 patients were included: 49 (69%) with LD and 22 (31%) with CD agents. The most frequent tumor sites were the lung (41% LD, 22.9% CD) and skin (melanoma; 24.6% LD, 50% CD). Most of the patients were treated with pembrolizumab (65% LD and 72% CD). The mean dose of pembrolizumab was 95.3 mg (1.5 mg/kg) in LD and 168.7 mg (2.12 mg/kg) in CD groups, once a day, q21d (every 21 days). After a median follow-up of 10.9 months, there were no significant differences between LD versus CD in cORR (38.1% v 35.2%, P = .31), cPFS (5.3 m v 7 m, P = .36), and OS (12.8 m v not reached, P = .17). A subgroup analysis with patients receiving pembrolizumab was performed, and similar results were obtained.CONCLUSIONOur study found no differences in cORR, cPFS, and OS between patients treated with LD and CD anti-PD(L)1. LD anti-PD(L)1 could be an alternative to promote accessibility, which warrants further investigation in randomized trials. |
| format | Article |
| id | doaj-art-b1d064690de94f7a891e06ea352b2951 |
| institution | Kabale University |
| issn | 2687-8941 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | American Society of Clinical Oncology |
| record_format | Article |
| series | JCO Global Oncology |
| spelling | doaj-art-b1d064690de94f7a891e06ea352b29512025-01-09T20:59:17ZengAmerican Society of Clinical OncologyJCO Global Oncology2687-89412024-11-011010.1200/GO.24.00122Low-Dose Anti-PD(L)1 for the Treatment of Solid MalignanciesIza Andrade de A. Souza0Beatriz de M. Dobbert1Barbara G. Sao Jose2Joao Pedro Homse-Netto3Larissa L. Furlan4Maira S. Abreu5Camila Ferrari6Bruno Uchoa7Kathia Abdallah8Stephano N. Lucio9Joao A. Soler10Fabio L.C. Fernandez11Luiza Ferreira12Joao D. Guedes13Aline F. Fares14Daniel V. Araujo15Division of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilDivision of Medical Oncology, Hospital de Base—FUNFARME, São José do Rio Preto, BrazilPURPOSEMounting data suggest that lower doses of anti-PD(L)1 agents can be as efficacious as label-approved doses at a fraction of its cost. We compare the outcomes of patients treated with low-dose (LD) and with conventional-dose (CD) anti-PD(L)1 agents.METHODSThis observational study evaluates the outcomes of patients with solid malignancies treated with anti-PD(L)1 agents (LD or CD) at Hospital de Base, Brazil. Patients were classified as receiving LD if the dose administered in the first cycle was below the label-approved dose. Efficacy outcomes, including best clinical overall response rate (cORR), clinical progression-free survival (cPFS), and overall survival (OS), were evaluated.RESULTSFrom January 2020 to May 2023, 71 patients were included: 49 (69%) with LD and 22 (31%) with CD agents. The most frequent tumor sites were the lung (41% LD, 22.9% CD) and skin (melanoma; 24.6% LD, 50% CD). Most of the patients were treated with pembrolizumab (65% LD and 72% CD). The mean dose of pembrolizumab was 95.3 mg (1.5 mg/kg) in LD and 168.7 mg (2.12 mg/kg) in CD groups, once a day, q21d (every 21 days). After a median follow-up of 10.9 months, there were no significant differences between LD versus CD in cORR (38.1% v 35.2%, P = .31), cPFS (5.3 m v 7 m, P = .36), and OS (12.8 m v not reached, P = .17). A subgroup analysis with patients receiving pembrolizumab was performed, and similar results were obtained.CONCLUSIONOur study found no differences in cORR, cPFS, and OS between patients treated with LD and CD anti-PD(L)1. LD anti-PD(L)1 could be an alternative to promote accessibility, which warrants further investigation in randomized trials.https://ascopubs.org/doi/10.1200/GO.24.00122 |
| spellingShingle | Iza Andrade de A. Souza Beatriz de M. Dobbert Barbara G. Sao Jose Joao Pedro Homse-Netto Larissa L. Furlan Maira S. Abreu Camila Ferrari Bruno Uchoa Kathia Abdallah Stephano N. Lucio Joao A. Soler Fabio L.C. Fernandez Luiza Ferreira Joao D. Guedes Aline F. Fares Daniel V. Araujo Low-Dose Anti-PD(L)1 for the Treatment of Solid Malignancies JCO Global Oncology |
| title | Low-Dose Anti-PD(L)1 for the Treatment of Solid Malignancies |
| title_full | Low-Dose Anti-PD(L)1 for the Treatment of Solid Malignancies |
| title_fullStr | Low-Dose Anti-PD(L)1 for the Treatment of Solid Malignancies |
| title_full_unstemmed | Low-Dose Anti-PD(L)1 for the Treatment of Solid Malignancies |
| title_short | Low-Dose Anti-PD(L)1 for the Treatment of Solid Malignancies |
| title_sort | low dose anti pd l 1 for the treatment of solid malignancies |
| url | https://ascopubs.org/doi/10.1200/GO.24.00122 |
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