Yi Jun Ho, Kim Seok Jin, Kim Sang-A, Jung Jongheon, Yoon Dok Hyun
Division of Hematology-Oncology, Department of Medicine, Chung-Ang University, Seoul, Korea.
Division of Hematology and Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Cancer Res Treat. 2025 Apr;57(2):590-596. doi: 10.4143/crt.2024.531. Epub 2024 Aug 16.
Given that 40%-50% of primary central nervous system lymphoma (PCNSL) tissues exhibit aberrancy on 9p24.1, immune checkpoint inhibitors (ICI) may work for the disease.
To define the role of ICIs in PCNSL, we carried out a nationwide retrospect analysis for 22 patients who had been treated with nivolumab monotherapy for relapsed or refractory PCNSL.
The median age at diagnosis was 66, and male: female ratio was 1:1. Patients received nivolumab after a median of 3 lines (range, 2 to 6) of therapy and at the median age of 67 years (range, 37 to 82 years). Eleven patients (50%) were refractory to the last treatment prior to nivolumab. With a median follow-up duration of 22.3 months (95% confidence interval [CI], 13.1 to 31.5), nine patients (41%) had an objective response (6 complete responses, 3 partial responses), and the median duration of response was 20.9 months (95% CI, 1.7 to 40.0). The median progression-free survival and overall survival were 2.1 months (95% CI, 0.2 to 4.0) and 18.9 months (95% CI, 5.0 to 32.8), respectively. Nivolumab was generally well-tolerated as no patients required dose reduction and only two patients required delay of treatment.
Our study suggests that nivolumab can be a reasonable option with the durable response for RR PCNSL.
鉴于40%-50%的原发性中枢神经系统淋巴瘤(PCNSL)组织在9p24.1上存在异常,免疫检查点抑制剂(ICI)可能对该疾病有效。
为了明确ICI在PCNSL中的作用,我们对22例接受纳武单抗单药治疗复发或难治性PCNSL的患者进行了一项全国性回顾性分析。
诊断时的中位年龄为66岁,男女比例为1:1。患者在接受中位3线(范围2至6线)治疗后,于中位年龄67岁(范围37至82岁)时接受纳武单抗治疗。11例患者(50%)对纳武单抗治疗前的最后一次治疗无效。中位随访时间为22.3个月(95%置信区间[CI],13.1至31.5),9例患者(41%)有客观缓解(6例完全缓解,3例部分缓解),中位缓解持续时间为20.9个月(95%CI,1.7至40.0)。中位无进展生存期和总生存期分别为2.1个月(95%CI,0.2至4.0)和18.9个月(95%CI,5.0至32.8)。纳武单抗总体耐受性良好,因为没有患者需要减量,只有2例患者需要延迟治疗。
我们的研究表明,纳武单抗对于复发/难治性PCNSL可产生持久反应,可能是一个合理的选择。