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PD-1抑制剂治疗复发或难治性经典型霍奇金淋巴瘤的疗效和安全性分析

OBJECTIVE: This retrospective, single-center study aimed to evaluate the efficacy and safety of programmed death-1(PD-1)inhibitors, either as monotherapy or in combination with chemotherapy, in the management of relapse/refractory classical Hodgkin's lymphoma(R/R cHL). METHODS: A total of 35 pa...

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Formato: Online Artículo Texto
Lenguaje:English
Publicado: Editorial office of Chinese Journal of Hematology 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509629/
https://www.ncbi.nlm.nih.gov/pubmed/37749034
http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2023.07.005
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description OBJECTIVE: This retrospective, single-center study aimed to evaluate the efficacy and safety of programmed death-1(PD-1)inhibitors, either as monotherapy or in combination with chemotherapy, in the management of relapse/refractory classical Hodgkin's lymphoma(R/R cHL). METHODS: A total of 35 patients with R/R cHL who received treatment at the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College from September 2016 to December 2020 were enrolled in this study. Among them, 17 patients received PD-1 inhibitor monotherapy(PD-1 inhibitor group), while 18 patients received a combination of PD-1 inhibitor and chemotherapy(PD-1 inhibitor + chemotherapy group). Clinical data and follow-up information were retrospectively analyzed, and survival analysis was conducted using the Kaplan-Meier method and Cox proportional hazards model. RESULTS: The median age of the 35 patients with R/R cHL was 29 years(range: 11–61 years), with 54.3% being male. According to the Ann Arbor staging system, 62.9% of patients presented with advanced(stage Ⅲ/Ⅳ)disease, and 48.6% had extranodal involvement. Before PD-1 inhibitor therapy, the median number of prior lines of therapy was 2(range: 1–3). Objective responses were observed in 28 patients, including 22 complete response(CR)cases, resulting in an overall response rate(ORR)of 80.0% and a CR rate of 62.9%. Specifically, the ORR and CR rates were 64.7% and 58.8%, respectively, in the PD-1 inhibitor group and 94.4% and 66.7%, respectively, in the PD-1 inhibitor + chemotherapy group. Among the 18 patients who underwent sequential autologous hematopoietic stem cell transplantation(auto-HSCT)[13 CR and five partial response(PR)cases], eight patients received PD-1 inhibitor therapy after auto-HSCT as consolidation therapy. All patients maintained a CR status after transplantation, and they exhibited significantly improved progression-free survival(PFS)rates compared with those who did not undergo sequential auto-HSCT(4-year PFS rates: 100% vs 53.5%; P=0.041). The incidence of immune-related adverse events was 29%, with only one patient experiencing grade≥3 adverse reactions, which indicated a favorable safety profile for the treatment approach. CONCLUSION: PD-1 inhibitor monotherapy demonstrates notable efficacy and sustained response in patients with R/R cHL. PD-1 inhibitors combined with chemotherapy significantly improve response rates. Additionally, for salvage therapy-sensitive patients, consolidation treatment with PD-1 inhibitors after auto-HSCT exhibits the potential for prolonging PFS.
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spelling pubmed-105096292023-09-21 PD-1抑制剂治疗复发或难治性经典型霍奇金淋巴瘤的疗效和安全性分析 Zhonghua Xue Ye Xue Za Zhi 论著 OBJECTIVE: This retrospective, single-center study aimed to evaluate the efficacy and safety of programmed death-1(PD-1)inhibitors, either as monotherapy or in combination with chemotherapy, in the management of relapse/refractory classical Hodgkin's lymphoma(R/R cHL). METHODS: A total of 35 patients with R/R cHL who received treatment at the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College from September 2016 to December 2020 were enrolled in this study. Among them, 17 patients received PD-1 inhibitor monotherapy(PD-1 inhibitor group), while 18 patients received a combination of PD-1 inhibitor and chemotherapy(PD-1 inhibitor + chemotherapy group). Clinical data and follow-up information were retrospectively analyzed, and survival analysis was conducted using the Kaplan-Meier method and Cox proportional hazards model. RESULTS: The median age of the 35 patients with R/R cHL was 29 years(range: 11–61 years), with 54.3% being male. According to the Ann Arbor staging system, 62.9% of patients presented with advanced(stage Ⅲ/Ⅳ)disease, and 48.6% had extranodal involvement. Before PD-1 inhibitor therapy, the median number of prior lines of therapy was 2(range: 1–3). Objective responses were observed in 28 patients, including 22 complete response(CR)cases, resulting in an overall response rate(ORR)of 80.0% and a CR rate of 62.9%. Specifically, the ORR and CR rates were 64.7% and 58.8%, respectively, in the PD-1 inhibitor group and 94.4% and 66.7%, respectively, in the PD-1 inhibitor + chemotherapy group. Among the 18 patients who underwent sequential autologous hematopoietic stem cell transplantation(auto-HSCT)[13 CR and five partial response(PR)cases], eight patients received PD-1 inhibitor therapy after auto-HSCT as consolidation therapy. All patients maintained a CR status after transplantation, and they exhibited significantly improved progression-free survival(PFS)rates compared with those who did not undergo sequential auto-HSCT(4-year PFS rates: 100% vs 53.5%; P=0.041). The incidence of immune-related adverse events was 29%, with only one patient experiencing grade≥3 adverse reactions, which indicated a favorable safety profile for the treatment approach. CONCLUSION: PD-1 inhibitor monotherapy demonstrates notable efficacy and sustained response in patients with R/R cHL. PD-1 inhibitors combined with chemotherapy significantly improve response rates. Additionally, for salvage therapy-sensitive patients, consolidation treatment with PD-1 inhibitors after auto-HSCT exhibits the potential for prolonging PFS. Editorial office of Chinese Journal of Hematology 2023-07 /pmc/articles/PMC10509629/ /pubmed/37749034 http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2023.07.005 Text en 2023年版权归中华医学会所有 https://creativecommons.org/licenses/by/3.0/This work is licensed under a Creative Commons Attribution 3.0 License.
spellingShingle 论著
PD-1抑制剂治疗复发或难治性经典型霍奇金淋巴瘤的疗效和安全性分析
title PD-1抑制剂治疗复发或难治性经典型霍奇金淋巴瘤的疗效和安全性分析
title_full PD-1抑制剂治疗复发或难治性经典型霍奇金淋巴瘤的疗效和安全性分析
title_fullStr PD-1抑制剂治疗复发或难治性经典型霍奇金淋巴瘤的疗效和安全性分析
title_full_unstemmed PD-1抑制剂治疗复发或难治性经典型霍奇金淋巴瘤的疗效和安全性分析
title_short PD-1抑制剂治疗复发或难治性经典型霍奇金淋巴瘤的疗效和安全性分析
title_sort pd-1抑制剂治疗复发或难治性经典型霍奇金淋巴瘤的疗效和安全性分析
topic 论著
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10509629/
https://www.ncbi.nlm.nih.gov/pubmed/37749034
http://dx.doi.org/10.3760/cma.j.issn.0253-2727.2023.07.005
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