Figure 4.

Individual clinical courses for patients with disease progression following treatment discontinuation. Data is presented from treatment discontinuation to last follow-up, second progression, or death. The best response to previous treatment is presented at the onset of the plot, followed by time to progression (time off-treatment), systemic re-treatment, and response. There was no significant correlation between time off-treatment and response to the subsequent treatment; median time off-treatment in patients who responded (PR/CR) to the subsequent treatment was 15 months, whereas for patients who maintained SD or developed PD, the median time to progression was 11.8 months (p = 0.95). ^Δ In patients 1, 3, 4, 6, 8, and 20–23, re-treatment was discontinued due to treatment-limiting toxicity. ^∞ Patient 12 was lost to follow-up after re-induction of anti-PD-1. ^ℇ Patients who were treated with local therapy: patients 2, 9, and 19 were treated with radiotherapy or surgery to subcutaneous and lung metastasis and are now free of disease; patients 24 and 29 had soft-tissue progression, which was treated with radiotherapy, and are currently planned to start systemic treatment; patient 28 had brain progression treated with SRS and achieved near-CR. Abbreviations: SRS—stereotactic radiosurgery; CR—complete response; PR—partial response; SD—stable disease; PD—progressive disease; PD-1—programmed cell death 1, IPI-NIVO—ipilimumab and nivolumab combination; IPI—ipilimumab.