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. 2021 Dec;21(4):399-406.
doi: 10.1007/s40268-021-00362-3. Epub 2021 Sep 25.

Dissociated Responses in Patients with Metastatic Solid Tumors Treated with Immunotherapy

Pauline Vaflard  1 , Xavier Paoletti  2   3 , Vincent Servois  4 , Patricia Tresca  1 , Elvire Pons-Tostivint  5 , Marie-Paule Sablin  1 , Francesco Ricci  1 , Delphine Loirat  1 , Ségolène Hescot  1 , Nouritza Torossian  1 , Diana Bello Roufai  1 , Maud Kamal  1 , Edith Borcoman  1 , Christophe Le Tourneau  6   7   8
Affiliations

Dissociated Responses in Patients with Metastatic Solid Tumors Treated with Immunotherapy

Pauline Vaflard et al. Drugs R D. 2021 Dec.

Abstract

Background: Immune checkpoint inhibitors have been demonstrated to improve overall survival. Atypical patterns of response have been reported, including dissociated response (DR). We evaluated the prevalence of DR.

Patients and methods: Patients had to have a baseline computed tomography (CT) scan and at least one follow-up CT scan and two target lesions (TLs). Three types of DR were evaluated using RECIST1.1: DR1, defined as at least one progressive and one responding TL; DR2, defined as at least one progressive and one stable TL; and DR3, defined as at least one stable and one responding TL.

Results: A total of 1244 measurements of 272 TLs were performed in 100 patients. Forty-nine out of the 272 TLs (18%) had received old or recent radiotherapy, and 42 (15%) had been biopsied. An objective response was observed in 22 patients (22%) and on 52 TLs (19%). DR1 were observed in 8% of patients. At the tumor measurement level, the response rate was lower in the case of prior radiotherapy (29% vs 34%, p = 0.01) and higher in the case of prior biopsy (40% vs 32%, p = 0.02).

Conclusions: A DR was observed in 8% of patients. Response rate was lower in the case of prior radiotherapy and higher in the case of prior biopsy.

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Conflict of interest statement

Christophe Le Tourneau has participated in advisory boards from MSD, BMS, Merck Serono, Astra Zeneca, Roche, Amgen, Nanobiotix, GSK, Celgene, and Rakuten. Delphine Loirat has participated in advisory boards from MSD, Roche, BMS, Astra Zeneca, Novartis, and Nanobiotix. The other authors have declared no conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Types of dissociated response (DR). a DR1 was defined as at least one progressive target lesion and one responding tumor lesion according to RECIST1.1. b DR2 was defined as at least one progressive target lesion and one stable target lesion according to RECIST 1.1. c DR3 was defined as at least one stable target lesion and one responding target lesion according to RECIST1.1. TL1 target lesion 1, TL2 target lesion 2
Fig. 2.
Fig. 2.
Patient selection flow chart. CT computed tomography
Fig. 3.
Fig. 3.
Best response of target lesions according to the sites of metastases. CR complete response, PR partial response, SD stable disease, PD progressive disease
See this image and copyright information in PMC

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