Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, 100142, China.
School of Mathematical Sciences, Peking University, Beijing, 100871, China.
Signal Transduct Target Ther. 2023 Sep 20;8(1):356. doi: 10.1038/s41392-023-01600-7.
Anti-programmed cell death-1 (anti-PD-1) therapies have shown a favorable efficacy and good tolerance for relapsed or refractory (r/r) classical Hodgkin lymphoma (cHL). However, there are limited data on long-term outcomes among patients with r/r cHL who achieve an objective response to anti-PD-1 therapies. A total of 260 responders from four, phase 2 clinical trials were included in this study. The median age was 32 years with a male/female ratio of 1.3:1. After a median follow-up period of 31.1 months, 116 (44.6%) responders experienced disease progression and 18 (6.9%) died. The 3-year progression-free survival (PFS) and overall survival (OS) rates were 55.1% and 89.7% overall. Patients with partial remission (PR) had inferior outcomes compared with those who achieved complete remission (3-year PFS, 29.5% vs. 72.3%, P < 0.001; 3-year OS, 81.5% vs. 94.4%, P = 0.017). Moreover, the survival outcome was inferior for patients with refractory disease compared with those with relapsed disease. Multivariate Cox regression analysis showed PR and refractory disease were independent risk factors for PFS. In conclusion, PR and refractory disease have a negative impact on the survival benefit of anti-PD-1 therapeutics in patients with r/r cHL, which highlights the need for multimodal treatment strategies.
抗程序性细胞死亡蛋白-1（抗 PD-1）疗法在复发或难治性（r/r）经典型霍奇金淋巴瘤（cHL）患者中显示出良好的疗效和耐受性。然而，对于对抗 PD-1 治疗有客观反应的 r/r cHL 患者的长期结果数据有限。本研究共纳入了四项 2 期临床试验的 260 名应答者。中位年龄为 32 岁，男女比例为 1.3:1。中位随访 31.1 个月后，116 名（44.6%）应答者疾病进展，18 名（6.9%）死亡。3 年无进展生存（PFS）和总生存（OS）率分别为 55.1%和 89.7%。部分缓解（PR）患者的结局不如完全缓解（CR）患者，3 年 PFS 分别为 29.5%和 72.3%（P<0.001）；3 年 OS 分别为 81.5%和 94.4%（P=0.017）。此外，难治性疾病患者的生存结局不如复发性疾病患者。多变量 Cox 回归分析显示 PR 和难治性疾病是 PFS 的独立危险因素。总之，PR 和难治性疾病对抗 PD-1 治疗 r/r cHL 患者的生存获益有负面影响，这突出了需要采用多模式治疗策略。
