Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA.
Department of Experimental, Diagnostic and Specialty Medicine, Institute of Hematology "Seràgnoli" University of Bologna, Bologna, Italy.
Blood. 2019 Oct 3;134(14):1144-1153. doi: 10.1182/blood.2019000324. Epub 2019 Aug 13.
Programmed death-1 inhibitors are approved for patients with relapsed or refractory classic Hodgkin lymphoma (RRcHL). We present the 2-year follow-up of the phase 2 KEYNOTE-087 study of pembrolizumab in 210 patients, based on HL progression after autologous stem cell transplantation (ASCT) and subsequent brentuximab vedotin (BV; cohort 1); salvage chemotherapy and BV, with ineligibility for SCT owing to chemorefractory disease (cohort 2); and progression after SCT without BV (cohort 3). With a median follow-up of 27.6 months, the objective response rate (ORR) by blinded independent central review was 71.9% (95% CI, 65.3-77.9), the complete response rate (CRR) was 27.6%, and the partial response (PR) rate was 44.3%. Median duration of response was 16.5 months (range, 0.0+ to 27.0+ [+, no progressive disease at last assessment]) in all patients, 22.1 months in cohort 1, 11.1 months in cohort 2, and 24.4 months in cohort 3. Median progression-free survival was not reached in all patients with CR: 13.8 months (95% CI, 12.0-22.1) for patients with PR and 10.9 months (95% CI, 5.6-11.1) for patients with stable disease. Median overall survival was not reached in all patients or in any cohort. Treatment-related adverse events (TRAEs) of any grade occurred in 153 (72.9%) patients; grades 3 and 4 occurred in 25 (12.0%) patients; none resulted in death. Results confirmed effective antitumor activity, durability of response, and manageable safety of pembrolizumab monotherapy in RRcHL, regardless of prior treatment and including chemoresistant cHL. This trial was registered at www.clinicaltrials.gov as #NCT02453594.
程序性死亡-1 抑制剂获批用于治疗复发或难治性经典霍奇金淋巴瘤(RRcHL)患者。我们报告了 pembrolizumab 在 210 例患者中的 2 年随访结果,这些患者来自于自体干细胞移植(ASCT)后经典霍奇金淋巴瘤进展(队列 1)、挽救性化疗和 brentuximab vedotin(BV),但由于疾病对化疗耐药而不适合 SCT(队列 2),以及 SCT 后无 BV 进展(队列 3)。中位随访时间为 27.6 个月,经盲法独立中心评估的客观缓解率(ORR)为 71.9%(95%CI,65.3-77.9),完全缓解率(CRR)为 27.6%,部分缓解(PR)率为 44.3%。所有患者的中位缓解持续时间为 16.5 个月(范围,0.0+至 27.0+[+,上次评估时无疾病进展]),队列 1 为 22.1 个月,队列 2 为 11.1 个月,队列 3 为 24.4 个月。所有达到 CR 的患者均未达到无进展生存期:PR 患者为 13.8 个月(95%CI,12.0-22.1),疾病稳定患者为 10.9 个月(95%CI,5.6-11.1)。所有患者或任何队列的中位总生存期均未达到。153 例(72.9%)患者发生任何级别的治疗相关不良事件(TRAEs);25 例(12.0%)患者发生 3 级或 4 级 TRAEs;无 TRAE 导致死亡。结果证实,在 RRcHL 中,无论先前的治疗情况如何,包括对化疗耐药的 cHL,pembrolizumab 单药治疗具有有效的抗肿瘤活性、持久的缓解和可管理的安全性。该试验在 www.clinicaltrials.gov 上注册,编号为 #NCT02453594。