Considerations When Switching Therapy

A variety of immunotherapeutic agents with differing mechanisms of action are now available for the treatment of cancer. Richard W. Joseph, MD, discusses considerations regarding switching therapy in patients who experience disease progression.

While studies have been conducted of patients placed on an anti-PD-1 therapy following disease progression on ipilimumab, Dr Joseph remarks, there is a lack of data regarding treating patients with ipilimumab following disease progression on anti-PD-1 therapy.

Among other factors, treatment toxicities need to be considered before switching therapy, he adds. “In my personal experience, I tend to see that some of the side effects that patients had from ipilimumab will be reaggravated with anti-PD-1 [therapy]. I have also seen that not happen as well,” he comments.

Dr Joseph also briefly discusses the use of combination therapy (ipilimumab and anti-PD-1 therapy), and describes how the tolerability of combination therapy further complicates the making of treatment decisions.