我们调查了免疫检查点抑制剂（ICI）重新挑战治疗对妇科癌症复发患者的治疗效果。回顾性研究了2018年1月至2022年9月期间，在两家三甲医疗中心进行了PD-1抑制剂重新挑战治疗的20名复发性妇科癌症患者的病历。患者的中位年龄为56岁（范围：35-79岁）。其中，分别有7例（35%）、1例（5%）、11例（55%）、1例（5%）患者患有宫颈癌、外阴癌、卵巢癌和子宫内膜癌。16名（80%）患者首次接受了帕博利珠单抗，4名（20%）患者接受了尼伐曼抗体作为第一线治疗。8例（40%）患者接受了帕博利珠单抗，12例（60%）患者接受了尼伐曼抗体作为第二线治疗。在初始ICI治疗中，观察到1例（5%）完全缓解（CR）和4例（20%）部分缓解（PR）的病例，中位无进展生存期（PFS）为2.8个月（范围：1.4-49.6个月）。初始ICI中断的原因包括疾病进展（n=16）、严重不良事件（AEs）（n=2）和治疗中止（n=2）。在第二次ICI治疗中，1例（5%）患者实现了CR，2例（10%）患者显示PR，5例（25%）患者经历稳定病情。第二次ICI的中位PFS为1.8个月（范围：0.4-10.4个月）。中位总生存期为21.3个月（范围：10.1-52.7个月）。在由于AEs而停用ICI治疗的患者中，没有患者在第二次ICI治疗期间出现AEs复发。这些结果表明，与之前ICI的应答相比，ICI复述的应答并不那么难以忍受。临床医生在临床试验获得充分数据支持之前应谨慎考虑PD-1抑制剂的重新挑战治疗。©版权所有：韩国延世大学医学院2023年。

We investigated the treatment outcomes of immune checkpoint inhibitor (ICI) rechallenge in patients with recurrent gynecologic cancers.We retrospectively reviewed the medical records of 20 patients who underwent rechallenge with PD-1 inhibitors for recurrent gynecologic cancers at two tertiary centers between January 2018 and September 2022.The median age of the patients was 56 years (range, 35-79). Seven (35%), 1 (5%), 11 (55%), and 1 (5%) patients presented with cervical, vulvar, ovarian, and endometrial cancers, respectively. Sixteen (80%) patients received pembrolizumab and 4 (20%) received nivolumab at first treatment. Eight (40%) and 12 (60%) patients received pembrolizumab and nivolumab, respectively, at second treatment. At initial ICI treatment, 1 (5%) and 4 (20%) cases of a complete response (CR) and a partial response (PR) were observed, respectively, with a median progression-free survival (PFS) of 2.8 months (range, 1.4-49.6). Reasons for first ICI discontinuation were disease progression (n=16), severe adverse events (AEs) (n=2), and treatment withdrawal (n=2). During second ICI treatment, 1 (5%) patient achieved CR, 2 (10%) showed PR, and 5 (25%) experienced stable disease. The median PFS to second ICI was 1.8 months (range, 0.4-10.4). The median overall survival was 21.3 months (range, 10.1-52.7). Neither patient who discontinued ICI treatment due to AEs experienced AE relapse during second ICI treatment.These results suggest that responses to ICI rechallenge are not as intolerable as responses to previous ICI. Clinicians should carefully consider rechallenge with PD-1 inhibitors outside of clinical trials until there are sufficient data to routinely support this practice.© Copyright: Yonsei University College of Medicine 2023.