Kuruvilla John, Armand Philippe, Hamadani Mehdi, Kline Justin, Moskowitz Craig H, Avigan David, Brody Joshua D, Ribrag Vincent, Herrera Alex F, Morschhauser Franck, Kanate Abraham, Zinzani Pier Luigi, Bitran Jacob, Ghesquieres Herve, Schuster Stephen J, Farooqui Mohammed, Marinello Patricia, Bartlett Nancy L
Princess Margaret Cancer Centre, Toronto, Canada.
Dana-Farber Cancer Institute, Boston, MA, USA.
Leuk Lymphoma. 2023 Jan;64(1):130-139. doi: 10.1080/10428194.2022.2136956. Epub 2022 Nov 18.
The multicohort phase 1b KEYNOTE-013 study (NCT01953692) evaluated the safety and efficacy of pembrolizumab in patients with relapsed or refractory NHL who were ineligible for or failed hematopoietic cell transplantation (HCT). Patients received pembrolizumab (cohort 4) or pembrolizumab plus lenalidomide (cohort 5). Primary end points were safety and objective response rate (ORR) per IWG 2007 criteria. Cohort 4 included 89 patients. ORR was 22% (19/86; 90% CI 15-31; 10 CR, nine PR); ORRs by disease type were 48% (10/21), 10% (2/20), 12% (5/41), and 50% (2/4), for PMBCL, FL, DLBCL, and 'other' NHL, respectively. Toxicity was as predicted. Cohort 5 included 19 patients. ORR was 39% (90% CI 20-61; four CR, three PR). Hematologic toxicities were the most common treatment-related AEs. In conclusion, pembrolizumab following HCT ineligibility/failure confirms prior experience in PMBCL but not with NHL subtypes in this study. Additional analyses in DLBCL may not be warranted.
多队列1b期KEYNOTE-013研究(NCT01953692)评估了帕博利珠单抗在不符合造血细胞移植(HCT)条件或造血细胞移植失败的复发或难治性非霍奇金淋巴瘤(NHL)患者中的安全性和疗效。患者接受帕博利珠单抗(队列4)或帕博利珠单抗联合来那度胺(队列5)治疗。主要终点是根据2007年国际工作组(IWG)标准评估的安全性和客观缓解率(ORR)。队列4纳入了89例患者。ORR为22%(19/86;90%CI 15-31;10例完全缓解,9例部分缓解);按疾病类型划分的ORR分别为:原发性纵隔大B细胞淋巴瘤(PMBCL)48%(10/21)、滤泡性淋巴瘤(FL)10%(2/20)、弥漫性大B细胞淋巴瘤(DLBCL)为12%(5/41)、“其他”NHL为50%(2/4)。毒性反应与预期一致。队列5纳入了19例患者。ORR为39%(90%CI 20-61;4例完全缓解,3例部分缓解)。血液学毒性是最常见的治疗相关不良事件。总之,在不符合HCT条件/移植失败后使用帕博利珠单抗证实了之前在PMBCL中的经验,但在本研究的NHL亚型中并非如此。可能无需对DLBCL进行额外分析。