What will happen if you stop taking Tislelizumab after two years?

Tislelizumab (Tislelizumab), as a PD-1 immune checkpoint inhibitor, has been widely used in the treatment of various cancers, such as non-small cell lung cancer, liver cancer, esophageal cancer, etc. Clinically, many patients are recommended to receive a fixed course of immunotherapy, usually about 2 years. The setting of this time point mainly refers to the results of existing research. It is found that most patients who respond within 2 years have established a certain memory response to the tumor in their immune system and may be able to maintain stable disease after drug withdrawal.

The outcomes for patients who stopped tislelizumab after two years were not uniform. A subset of patients can maintain long-term tumor remission or stable disease after discontinuation of treatment, especially those who achieve complete remission or sustained partial remission during treatment. However, some patients experience recurrence of the disease several months after stopping the drug. Factors that affect this result include cancer type, tumor burden, immune system activity, and whether it is combined with other treatments (such as targeted drugs or chemoradiotherapy).

For patients who have completed 2 years of immunotherapy, it is usually clinically recommended to enter a close follow-up phase, such as imaging examinations and blood tumor marker testing every 3 months. Once signs of recurrence or metastasis are detected, it may be possible to restart immunotherapy. Some studies are also exploring the "re-challenge strategy", that is, restarting PD-1 inhibitors after relapse, and have achieved certain efficacy. Therefore, even if the drug is stopped, monitoring must be maintained under the guidance of a doctor for timely intervention.

Currently there is no unified answer internationally to the question of “whether immunotherapy requires long-term maintenance.” Some doctors advocate individualized decision-making based on efficacy evaluation and stopping the drug if it is effective; while others believe that it is more prudent to maintain treatment for high-risk patients. In actual treatment, a scientific and reasonable treatment and discontinuation strategy should be formulated based on the patient's specific condition, medication response, side effect tolerance, financial ability and other factors. For most patients who have achieved stable disease control, it is a gradually recognized practice to safely stop taking the drug under the guidance of a doctor after two years of treatment.

Reference materials:https://www.drugs.com/donanemab.html