Early Response to First-Line Anti-PD-1 Treatment in Hodgkin Lymphoma: A PET-Based Analysis from the Prospective, Randomized Phase II NIVAHL Trial.
Adult
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Dacarbazine
/ administration & dosage
Doxorubicin
/ administration & dosage
Female
Hodgkin Disease
/ diagnostic imaging
Humans
Immune Checkpoint Inhibitors
/ administration & dosage
Male
Middle Aged
Nivolumab
/ administration & dosage
Outcome Assessment, Health Care
/ methods
Positron-Emission Tomography
/ methods
Prospective Studies
Survival Analysis
Vinblastine
/ administration & dosage
Journal
Clinical cancer research : an official journal of the American Association for Cancer Research
ISSN: 1557-3265
Titre abrégé: Clin Cancer Res
Pays: United States
ID NLM: 9502500
Informations de publication
Date de publication:
15 01 2021
15 01 2021
Historique:
received:
23
08
2020
revised:
08
10
2020
accepted:
26
10
2020
pubmed:
31
10
2020
medline:
11
1
2022
entrez:
30
10
2020
Statut:
ppublish
Résumé
A primary analysis of the ongoing NIVAHL trial demonstrated unexpectedly high interim complete response rates to nivolumab-based first-line treatment in early-stage unfavorable Hodgkin lymphoma. However, biomarkers such as metabolic tumor volume (MTV) or total lesion glycolysis (TLG) and their change under treatment (ΔMTV and ΔTLG), measured on PET, might provide additional relevant information for response assessment in this setting. Hence, the current analysis aimed to investigate early response to checkpoint inhibitor therapy beyond conventional criteria. NIVAHL is a prospective, randomized phase II trial that recruited between April 2017 and October 2018. Patients in arms A and B were assessed for early treatment response after two courses of doxorubicin, vinblastine, and dacarbazine with two concomitant nivolumab infusions per cycle (2 × N-AVD) and 4 × nivolumab, respectively. In the current analysis, we included all 59 individuals with PET images available to the central review panel for quantitative analysis before April 30, 2019. At interim restaging, we determined a mean ΔMTV and ΔTLG of -99.8% each in arm A after 2 × N-AVD, compared with -91.4% and -91.9%, respectively, for treatment group B undergoing 4 × nivolumab. This high decrease in MTV and TLG was observed regardless of the initial lymphoma burden. Our study showed that nivolumab-based first-line treatment leads to rapid, near-complete reduction of tumor metabolism in early-stage unfavorable Hodgkin lymphoma. Thus, PET-derived biomarkers might allow reduction or even omission of chemotherapy and radiotherapy. Furthermore, MTV and TLG could be also used to optimize immune checkpoint-targeting treatments in other cancers.
Identifiants
pubmed: 33122344
pii: 1078-0432.CCR-20-3303
doi: 10.1158/1078-0432.CCR-20-3303
doi:
Substances chimiques
Immune Checkpoint Inhibitors
0
Nivolumab
31YO63LBSN
Vinblastine
5V9KLZ54CY
Dacarbazine
7GR28W0FJI
Doxorubicin
80168379AG
Types de publication
Clinical Trial, Phase II
Journal Article
Randomized Controlled Trial
Langues
eng
Sous-ensembles de citation
IM
Pagination
402-407Informations de copyright
©2020 American Association for Cancer Research.
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