Falchi Lorenzo, Sawas Ahmed, Deng Changchun, Amengual Jennifer E, Colbourn Donald S, Lichtenstein Emily A, Khan Karen A, Schwartz Lawrence H, O'Connor Owen A
Center for Lymphoid Malignancies, Division of Hematology/Oncology, Department of Medicine, Columbia University Medical Center, 51 West 51st Street, Suite 200, New York, NY, 10019, USA.
Department of Radiology, Columbia University Medical Center, 180 Fort Washington Avenue, New York, NY, 10032, USA.
J Hematol Oncol. 2016 Nov 30;9(1):132. doi: 10.1186/s13045-016-0363-1.
Options for patients with relapsed or refractory (R/R) classical Hodgkin lymphoma (cHL) after brentuximab vedotin (Bv) and autologous stem cell transplantation (ASCT) are limited. Immune checkpoint inhibitors (ICI) are active in this population but rarely induce complete response (CR). Ten patients with R/R cHL after ASCT and Bv received pembrolizumab (n = 8) or nivolumab (n = 2). Five had been previously exposed to 5-azacitidine on a phase 1 study. Among nine evaluable patients, seven (78%) achieved CR, one partial response, and one reduction of tumor burden. All five patients who had received 5-azacitidine prior to ICI achieved CR, while only two of four who did not receive prior 5-azacitidine achieved CR. At a median follow-up of 9.9 months [0.5-14.3], eight patients are alive and five are still receiving treatment. We documented an unprecedented CR rate after ICI in patients with R/R cHL. We hypothesize that hypomethylating agents might have an immune priming effect and enhance the efficacy of ICI.
对于接受过本妥昔单抗(Bv)和自体干细胞移植(ASCT)后复发或难治性(R/R)经典型霍奇金淋巴瘤(cHL)的患者,治疗选择有限。免疫检查点抑制剂(ICI)在该人群中具有活性,但很少能诱导完全缓解(CR)。10例接受过ASCT和Bv治疗的R/R cHL患者接受了帕博利珠单抗(n = 8)或纳武利尤单抗(n = 2)治疗。其中5例患者曾在1期研究中接受过阿扎胞苷治疗。在9例可评估的患者中,7例(78%)达到CR,1例部分缓解,1例肿瘤负荷减轻。在接受ICI治疗前接受过阿扎胞苷治疗的所有5例患者均达到CR,而在未接受过阿扎胞苷治疗的4例患者中只有2例达到CR。在中位随访9.9个月[0.5 - 14.3]时,8例患者存活,5例仍在接受治疗。我们记录了R/R cHL患者接受ICI治疗后前所未有的CR率。我们推测,低甲基化药物可能具有免疫启动作用并增强ICI的疗效。
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