Immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed/refractory classical Hodgkin lymphoma: A retrospective analysis in 12 patients.
Hodgkin lymphoma
ICI-RT
Nivolumab
pembrolizumab
radiotherapy
Journal
Hematology reports
ISSN: 2038-8322
Titre abrégé: Hematol Rep
Pays: Switzerland
ID NLM: 101556723
Informations de publication
Date de publication:
09 Jun 2021
09 Jun 2021
Historique:
received:
23
01
2021
accepted:
30
04
2021
entrez:
5
7
2021
pubmed:
6
7
2021
medline:
6
7
2021
Statut:
epublish
Résumé
The rate of complete remission (CR) with the anti-PD1 immune checkpoint inhibitors (ICI) nivolumab (N) and pembrolizumab (P) in patients with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL) is low (20-30%), and the majority of patients eventually relapse. One strategy to improve their outcome is to combine ICI with radiotherapy (ICI-RT), taking advantage of a supposed synergistic effect. We retrospectively collected data of 12 adult patients with R/R cHL treated with ICI-RT delivered during or within 8 weeks from the start or after the end of ICI. Median age at ICI-RT was 37 years, 50% had previously received an autologous stem cell transplantation (SCT) and 92% brentuximab vedotin. RT was given concurrently, before or after ICI in 4, 1 and 7 patients. Median RT dose was 30Gy, for a median duration of 22 days. Median number of ICI administrations was 15. Overall response and CR rate were 100% and 58%. Nine patients received subsequent SCT consolidation (7 allogeneic and 2 autologous). After a median follow-up of 18 months, 92% of patients were in CR. No major concerns about safety were reported. ICI-RT combination appears to be a feasible and highly active bridge treatment to transplant consolidation.
Identifiants
pubmed: 34221295
doi: 10.4081/hr.2021.9080
pmc: PMC8215529
doi:
Types de publication
Journal Article
Langues
eng
Pagination
9080Informations de copyright
©Copyright: the Author(s).
Déclaration de conflit d'intérêts
Conflict of interest: CR: advisory board MSD (2017 and 2018). All the other authors have no conflict of interest to declare.
Références
J Clin Oncol. 2018 May 10;36(14):1428-1439
pubmed: 29584546
Int J Radiat Oncol Biol Phys. 2018 Apr 1;100(5):1100-1118
pubmed: 29722655
N Engl J Med. 2018 Dec 13;379(24):2342-2350
pubmed: 30280658
Br J Haematol. 2009 Jul;146(2):158-63
pubmed: 19438504
Radiat Oncol. 2020 Mar 12;15(1):62
pubmed: 32164700
Biol Blood Marrow Transplant. 2006 Oct;12(10):1065-72
pubmed: 17084370
Radiat Res. 2018 Sep;190(3):322-329
pubmed: 29949442
Nat Immunol. 2015 Oct;16(10):1005-7
pubmed: 26343538
Annu Rev Immunol. 2008;26:677-704
pubmed: 18173375
Cancer Radiother. 2019 Apr;23(2):132-137
pubmed: 30733172
Cancer Radiother. 2019 Jun;23(3):232-239
pubmed: 31147173
J Clin Oncol. 2014 Sep 20;32(27):3059-68
pubmed: 25113753
Blood. 2016 Nov 24;128(21):2489-2496
pubmed: 27574190
Int J Radiat Oncol Biol Phys. 2014 Jul 15;89(4):854-62
pubmed: 23790512
Crit Rev Oncol Hematol. 2017 May;113:63-70
pubmed: 28427523
J Clin Oncol. 2012 Jun 20;30(18):2183-9
pubmed: 22454421
Int J Radiat Oncol Biol Phys. 2018 Mar 15;100(4):916-925
pubmed: 29485071
Lancet Oncol. 2019 Aug;20(8):e434-e442
pubmed: 31364595
J Clin Oncol. 2005 Mar 1;23(7):1522-9
pubmed: 15632410
Blood. 2019 Oct 3;134(14):1144-1153
pubmed: 31409671
J Exp Med. 2006 May 15;203(5):1259-71
pubmed: 16636135
Lancet Oncol. 2015 Oct;16(13):e498-509
pubmed: 26433823
Oncotarget. 2014 Jan 30;5(2):403-16
pubmed: 24480782