Case Series

Short-course treatment after complete response to pembrolizumab in metastatic urothelial bladder cancer: a case series

Department of Medical Oncology, Hôpital Saint-Louis, AP-HP Nord – Université Paris-Cité, Paris, 75010, France

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Clément Dumont

Department of Medical Oncology, Hôpital Saint-Louis, AP-HP Nord – Université Paris-Cité, Paris, 75010, France

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Hélène Gauthier

Department of Medical Oncology, Hôpital Saint-Louis, AP-HP Nord – Université Paris-Cité, Paris, 75010, France

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Stéphane Culine

*Author for correspondence: Tel.: +33 142 494 247;

E-mail Address: stephane.culine@aphp.fr

https://orcid.org/0000-0003-2568-2637

Department of Medical Oncology, Hôpital Saint-Louis, AP-HP Nord – Université Paris-Cité, Paris, 75010, France

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Published Online:4 May 2023https://doi.org/10.2217/imt-2022-0283

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Abstract

Background: The optimal duration of treatment for metastatic patients who achieve a complete response with immune checkpoint inhibitors is unknown. Methods: The outcome for six metastatic bladder cancer patients who received short course of pembrolizumab is reported. Results: A median number of seven cycles of pembrolizumab was given. After a median follow-up of 38 months, progressive disease was confirmed in three patients. All patients relapsed in lymph nodes and underwent pembrolizumab rechallenge: one achieved a complete response, another a partial response. Conclusion: Our case series paves the way for discontinuation of pembrolizumab in patients who achieve a complete response since three out of six patients remain free of disease after 3-year follow-up. Prospective studies are required to confirm our results.

Plain language summary

The rise of immunotherapy in oncology has provided significant gains in survival of metastatic patients. However, questions persist about the optimal use of immune checkpoint inhibitors. For now, treatment is supposed to be delivered until progression of disease. We report a case series of six patients who received a short course of treatment after achieving a complete response. Three of them remained free of recurrence after a median follow-up of 3 years. Our results suggest that a stop-and-go strategy might be appropriate for some patients, thereby sparing the potential toxicities associated with prolonged exposure.

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Papers of special note have been highlighted as: • of interest; •• of considerable interest

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Vol. 15, No. 10

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History

Received 15 November 2022

Accepted 11 April 2023

Published online 4 May 2023

Published in print July 2023

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Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Ethical conduct of research

The authors state that they have obtained verbal and written informed consent from the patient/patients for the inclusion of their medical and treatment history within this case report.

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