{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T17:52:36Z","timestamp":1792691556322,"version":"4.5.0"},"reference-count":23,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T00:00:00Z","timestamp":1611619200000},"content-version":"unspecified","delay-in-days":25,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Immunother Cancer"],"accepted":{"date-parts":[[2020,12,29]]},"published-print":{"date-parts":[[2021,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Randomized trials evaluating programmed cell death protein 1 (PD-1) inhibitors in metastatic melanoma either permitted treatment for 2 years (pembrolizumab) or more (nivolumab). The optimal duration of therapy is currently unknown due to limited data, and shorter therapies may be effective.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data of patients with metastatic cutaneous melanoma treated with single-agent PD-1 inhibitors at Huntsman Cancer Institute from January 1, 2015, to December 31, 2018, was reviewed to identify a continuous series of patients who made the joint decision with their provider to electively discontinue therapy at 1\u2009year (&gt;6 months and &lt;18 months) in the setting of ongoing treatment response or disease stability. Patients were excluded if they received PD-1 inhibitors with other systemic therapy, had prior exposure to PD-1 therapy, or discontinued treatment due to disease progression or immune-related adverse event. Best objective response (BOR) per RECIST V.1.1 at treatment discontinuation, progression-free survival (PFS), and retreatment characteristics was analyzed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 480 patients who received PD-1 inhibitors, 52 met the inclusion criteria. The median treatment duration from first to the last dose was 11.1 months (95%\u2009CI 10.5 to 11.4). BOR was complete response in 13 (25%), partial response in 28 (53.8%), and stable disease in 11 (21.2%) patients. After a median follow-up of 20.5 months (range 3\u201349.2) from treatment discontinuation, 39 (75%) patients remained without disease progression, while 13 (25%) had progression (median PFS 3.9 months; range 0.7\u201330.9). On multivariable analysis, younger age, history of brain metastasis, and higher lactate dehydrogenase at the time of anti-PD-1 discontinuation were associated with recurrence. Patients with recurrent melanoma were managed with localized treatment, anti-PD-1 therapies, and BRAF-MEK inhibitors. All patients except one were alive at data cutoff.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In this large real-world, observational cohort study, the majority of patients with metastatic melanoma after 1\u2009year of anti-PD-1 therapy remained without progression on long-term follow-up. The risk of disease progression even in patients with residual disease on imaging was low. After prospective validation, elective PD-1 discontinuation at 1\u2009year may reduce financial and immunotherapy-related toxicity without sacrificing outcomes.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jitc-2020-001781","type":"journal-article","created":{"date-parts":[[2021,1,26]],"date-time":"2021-01-26T12:38:56Z","timestamp":1611664736000},"page":"e001781","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":35,"title":["Real-world experience with elective discontinuation of PD-1 inhibitors at 1 year in patients with metastatic melanoma"],"prefix":"10.1136","volume":"9","clinical-trial-number":[{"clinical-trial-number":"nct02821013","registry":"10.18810\/clinical-trials-gov"},{"clinical-trial-number":"isrctn15837212","registry":"10.18810\/isrctn"}],"author":[{"given":"Rebecca","family":"Pokorny","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordan P","family":"McPherson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Haaland","sequence":"additional","affiliation":[{"name":"Division of Oncology and Department of Population Health Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth F","family":"Grossmann","sequence":"additional","affiliation":[{"name":"Department of Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolyn","family":"Luckett","sequence":"additional","affiliation":[{"name":"Department of Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin Newell","family":"Voorhies","sequence":"additional","affiliation":[{"name":"Division of Oncology, Department of Medicine, Intermountain Healthcare, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel S","family":"Sageser","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jocelyn","family":"Wallentine","sequence":"additional","affiliation":[{"name":"Department of Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zachary","family":"Tolman","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siwen","family":"Hu-Lieskovan","sequence":"additional","affiliation":[{"name":"Department of Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3518-0411","authenticated-orcid":false,"given":"Umang","family":"Swami","sequence":"additional","affiliation":[{"name":"Department of Oncology, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,1,26]]},"reference":[{"key":"2025100314190224000_9.1.e001781.1","unstructured":"United States Food and Drug Administration . 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