Exceptional responses with sequential metronomic temozolomide after pembrolizumab failure in patients with metastatic melanoma

Autor: Aaron D. Bossler, Weizhou Zhang, Michele Freesmeier, Yousef Zakharia, Varun Monga, Umang Swami, Mohammed M. Milhem
Rok vydání: 2019
Předmět:
Zdroj: Melanoma Res
ISSN: 0960-8931
Popis: Pembrolizumab is an effective therapy for patients with metastatic melanoma. However, not all patients derive benefit. It is postulated that an increase in regulatory T cells in melanoma patients can impair the response to immunotherapies. Continuous low-dose temozolomide has shown to cause immunomodulatory effects resulting in CD4 + lymphopenia due to which Treg population can also decrease significantly. Herein, we present a case series of three patients with metastatic melanoma who after progression on pembrolizumab showed a radiological response after just one cycle of metronomic temozolomide (75 mg/m daily for 6 weeks on 8-week cycle). This suggests that temozolomide may be a useful alternative for patients with metastatic melanoma after disease progression on pembrolizumab. Further studies with biomarkers are warranted to elucidate which patients will derive benefit from this strategy.
Databáze: OpenAIRE