Department of Hematology, The Second Affiliated Hospital, College of Medicine, ZhejiangUniversity, Hangzhou, China.
Department of Hematology, Affiliated Hospital of Shaoxing University(Shaoxing Municipal Hospital), Shaoxing, Zhejiang, People's Republic of China.
J Cancer Res Clin Oncol. 2024 Sep 19;150(9):425. doi: 10.1007/s00432-024-05956-3.
The retrospective study was to explore the effectiveness and safety of GemOx (gemcitabine, oxaliplatin) plus sintilimab (belongs to the class of drugs known as immune checkpoint inhibitors, particularly targeting the PD-1 receptor) in relapse or refractory nodal PTCLs.
Patients with nodal PTCL who initiated salvage therapy with sintilimab and GemOx between January 2020 to September 2021 were identified from the database of the hematology department of the Second Affiliated Hospital of Zhejiang University School of Medicine. All patients received 2-4 cycles (3 weeks/cycle) of treatment of sintilimab (200 mg, I.V, D1) in combination with GemOx. Treatment response was assessed every six weeks during the salvage treatment phase. Eligible patients received maintenance therapy according to the investigator's decision. Follow-ups were routinely conducted every three months.
31 patients with r/r nodal PTCLs were enrolled, including 23 PTCL-NOS, 4 AITL, and 4 ALCL. 21 (67.7%) patients received at least two lines of therapy. 71.0% (95% CI, 53.4%-83.9%) of patients documented objective response of 2-4 cycles of sintilimab plus GemOx therapy, including 9 complete response and 13 partial response. 21 (67.7%) patients received consolidation therapy, including 5 autologous stem-cell transplantation and 12 histone deacetylase inhibitors. After a median 25.6 months follow-up, the median PFS was 22.0 (95% CI,11.8-24.7) months, and the median OS was 26.2 (95% CI, 24.4 -NA) months. 29 (93.5%) patients experienced at least one adverse event, and 26 (83.9% patients only had mild (grade 1-2) AEs.Univariable Cox regression showed the progression risk of AITL is 22.7 (3.9- 131.0, p < 0.01) times of PTCL-NOS, while the HR of ALCL was 1.14 (0.33-3.96,p = 0.833).
Sintilimab plus GemOx showed encouraging activity and manageable toxicity for patients with r/r PTCL.
本回顾性研究旨在探索吉西他滨(gemcitabine,健择)联合替雷利珠单抗(属于免疫检查点抑制剂类药物,尤其靶向 PD-1 受体)在复发或难治性结外 T 细胞淋巴瘤(PTCL)患者中的疗效和安全性。
本研究从浙江大学医学院附属第二医院血液科数据库中筛选出 2020 年 1 月至 2021 年 9 月期间接受替雷利珠单抗联合吉西他滨奥沙利铂(GemOx)挽救治疗的复发或难治性结外 T 细胞淋巴瘤患者。所有患者均接受替雷利珠单抗(200mg,静脉输注,第 1 天)联合 GemOx 治疗 2-4 个周期(每 3 周 1 个周期)。在挽救治疗阶段,每 6 周评估 1 次治疗反应。根据研究者的决定,有资格的患者接受维持治疗。常规每 3 个月进行 1 次随访。
共纳入 31 例复发或难治性结外 T 细胞淋巴瘤患者,包括 23 例结外 NK/T 细胞淋巴瘤,NOS 型(PTCL-NOS)、4 例血管免疫母细胞性 T 细胞淋巴瘤(AITL)和 4 例间变大细胞淋巴瘤(ALCL)。21 例(67.7%)患者接受了至少 2 线治疗。替雷利珠单抗联合 GemOx 治疗 2-4 个周期后,71.0%(95%CI,53.4%-83.9%)的患者有客观缓解,包括 9 例完全缓解和 13 例部分缓解。21 例(67.7%)患者接受了巩固治疗,包括 5 例自体造血干细胞移植和 12 例组蛋白去乙酰化酶抑制剂。中位随访 25.6 个月后,中位无进展生存期(PFS)为 22.0 个月(95%CI,11.8-24.7),中位总生存期(OS)为 26.2 个月(95%CI,24.4-N/A)。29 例(93.5%)患者至少发生 1 次不良事件,26 例(83.9%)患者仅发生轻微(1-2 级)AE。单因素 Cox 回归分析显示,AITL 的进展风险是 PTCL-NOS 的 22.7(3.9-131.0,p<0.01)倍,而 ALCL 的 HR 为 1.14(0.33-3.96,p=0.833)。
替雷利珠单抗联合吉西他滨奥沙利铂治疗复发难治性结外 T 细胞淋巴瘤具有良好的疗效和可管理的毒性。