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It appears that the patient started on adjuvant nivolumab. Did the patient complete a full year of treatment, or did he progress while on adjuvant therapy? If the former, it is reasonable to restart nivolumab therapy, preferably together with ipilimumab. Even if the latter, there is some Phase II evidence that adding ipilimumab to PD-1 therapy after progression on PD1 may result in a response rate of up to 25%. The definitive trial, S1616, has yet to report out, but in the absence of this, it remains a reasonable option before embarking on more heroic therapies.
Pending Moderator approval.
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