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Nivolumab for relapsed or refractory Hodgkin lymphoma: real-life experience
Nivolumab for relapsed or refractory Hodgkin lymphoma: real-life experience
- Source :
- Annals of Oncology. 28:2496-2502
- Publication Year :
- 2017
- Publisher :
- Elsevier BV, 2017.
-
Abstract
- WOS: 000411827200025<br />PubMed ID: 28961828<br />Background: Reed-Sternberg cells of classical Hodgkin's lymphoma (cHL) are characterized by genetic alterations at the 9p24.1 locus, leading to over-expression of programmed death-ligand 1 and 2. In a phase 1b study, nivolumab, a PD-1-blocking antibody, produced a high response in patients with relapsed or refractory cHL, with an acceptable safety profile. Patients and methods: We present a retrospective analysis of 82 patients (median age: 30 years; range: 18-75) with relapsed/refractory HL treated with nivolumab in a named patient program from 24 centers throughout Turkey. The median follow-up was 7 months, and the patients had a median of 5 (2-11) previous lines of therapy. Fifty-seven (70%) and 63 (77%) had been treated by stem-cell transplantation and brentuximab vedotin, respectively. Results: Among 75 patients evaluated after 12 weeks of nivolumab treatment, the objective response rate was 64%, with 16 complete responses (CR; 22%); after 16 weeks, it was 60%, with 16 (26%) patients achieving CR. Twenty patients underwent subsequent transplantation. Among 11 patients receiving allogeneic stem-cell transplantation, 5 had CR at the time of transplantation and are currently alive with ongoing response. At the time of analysis, 41 patients remained on nivolumab treatment. Among the patients who discontinued nivolumab, the main reason was disease progression (n = 19). The safety profile was acceptable, with only four patients requiring cessation of nivolumab due to serious adverse events (autoimmune encephalitis, pulmonary adverse event, and two cases of graft-versus-host disease aggravation). The 6-month overall and progression-free survival rates were 91.2% (95% confidence interval: 0.83-0.96) and 77.3% (0.66-0.85), respectively. Ten patients died during the follow-up; one of these was judged to be treatment-related. Conclusions: Nivolumab represents a novel option for patients with cHL refractory to brentuximab vedotin, and may serve as a bridge to transplantation; however, it may be associated with increased toxicity.
- Subjects :
- cancer pain
allograft
Hypophosphatemia
retrospective study
thrombocytopenia
Septic shock
middle aged
immunopathology
Medicine
Disease free survival
catheter infection
progression free survival
Hematology
adult
steroid
clinical trial
Chronic graft versus host disease
nausea
Allografts
Survival Rate
Clinical trial
aged
priority journal
Oncology
drug withdrawal
Photopheresis
030220 oncology & carcinogenesis
medicine.medical_specialty
gynecomastia
muscle cramp
Major clinical study
visual disorder
Article
03 medical and health sciences
Hypothyroidism
brentuximab vedotin
neutropenia
Cancer recurrence
Retrospective Studies
Aged
hypophosphatemia
treatment response
Upper respiratory tract infection
major clinical study
Resistant
drug efficacy
multicenter study
Pancreatitis
monoclonal antibody
fatigue
drug safety
peripheral neuropathy
Immunoconjugates
drug response
pancreatitis
PD-1 blockade
rash
hypocalcemia
allogeneic stem cell transplantation
immune system diseases
hemic and lymphatic diseases
Monoclonal
Edema
pain
Overall survival
Visual disorder
Cancer pain
appetite disorder
Fatigue
Priority journal
treatment withdrawal
Hodgkin Disease
Programmed death 1 receptor
photopheresis
arthritis
scrotal pain
young adult
Gynecomastia
medicine.drug
Adult
Abdominal pain
Neutropenia
chronic graft versus host disease
side effect
Adolescent
overall survival
Drug response
Pain
overall response rate
macromolecular substances
Relapsed Disease
Rash
Refractory Hodgkin Lymphoma
hyperthyroidism
pneumonia
Stomatitis
Hypocalcemia
business.industry
Pruritus
allergic encephalitis
mycophenolate mofetil
hypercalcemia
programmed death 1 receptor
pruritus
Cancer survival
Allogeneic stem cell transplantation
Surgery
Drug efficacy
Graft versus host reaction
cancer recurrence
classical Hodgkin lymphoma
septic shock
edema
Hodgkin lymphoma
030215 immunology
Male
encephalitis
diarrhea
Agent
sepsis
phlebitis
0302 clinical medicine
infusion related reaction
cancer survival
Drug safety
Brentuximab vedotin
disease free survival
Antibody conjugate
autoimmune liver disease
Stem cell transplantation
Headache
Antibodies, Monoclonal
Scrotal pain
General Medicine
cohort analysis
anemia
Antineoplastic
Multicenter study
Retrospective study
Nivolumab
named patient program
Infection
Human
Diarrhea
resistant/relapsed disease
heart infarction
Antineoplastic Agents
Cancer mortality
Disease-Free Survival
cancer growth
multiple cycle treatment
Humans
human
autoimmune pneumonitis
Adverse effect
cystitis
Steroid
nivolumab
cancer immunotherapy
Brentuxımab vedotın
Chlorambucil
Arthritis
abdominal pain
Pneumonia
medicine.disease
mortality
infection
Retrospective studies
Graft-versus-host disease
lymphocytopenia
upper respiratory tract infection
Hypercalcemia
Muscle cramp
drug hypersensitivity
lung disease
Peripheral neuropathy
antibody conjugate
Turkey (republic)
cancer mortality
Middle aged
antineoplastic agent
fever
Allergic encephalitis
Mycophenolate mofetil
Antibodies, Monoclonal/*therapeutic use
Antineoplastic Agents/therapeutic use
Brentuximab Vedotin
Female
Hodgkin Disease/*drug therapy/therapy
Immunoconjugates/therapeutic use
Middle Aged
Stem Cell Transplantation
Young Adult
Anemia
female
Decreased appetite
Encephalitis
headache
Hodgkin's Disease
Refractory Materials
Monoclonal antibody
Hodgkin disease
Fever
Disease-free survival
stem cell transplantation
Hypertransaminasemia
Antibodies
programmed death 1 (PD-1) blocker
Internal medicine
follow up
controlled study
decreased appetite
dermatitis
graft versus host reaction
Lymphocytopenia
hypertransaminasemia
Agents
Thrombocytopenia
stomatitis
Transplantation
Young adult
Lung disease
Progression free survival
Infusion related reaction
hypothyroidism
business
Controlled study
Follow-Up Studies
Subjects
Details
- ISSN :
- 09237534
- Volume :
- 28
- Database :
- OpenAIRE
- Journal :
- Annals of Oncology
- Accession number :
- edsair.doi.dedup.....724de343bc2ead3c22e0218984e89226
- Full Text :
- https://doi.org/10.1093/annonc/mdx341