Beautiful retrospective work suggesting the clone of melanoma that recurs after an initial complete response to checkpoint inhibitors is often different than the one that presented initially.
https://twitter.com/DrBetofMDPhD/status/1228072232641060865
Our group has taken these data to heart. I've changed a few things about my approach in clinic as a result:
1) When patients ask if we can just retry the same medicine if the disease comes back, I try to take time to say "yes, but it may not work the same way as before."
1) When patients ask if we can just retry the same medicine if the disease comes back, I try to take time to say "yes, but it may not work the same way as before."
2) This recurrence rate was a little higher than the clinical trial recurrence risks of 10-15%. While length of tx wasn't statistically associated with recurrence, I now am much more reticent to stop therapy if no toxicity and length of therapy is only 6 months.
3) This underscores the importance of calling on our talented friends in surgery and radiation oncology for particularly stubborn/scary sites of metastasis, especially if relatively isolated. We have published on this recently: link.springer.com/article/10.124…
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