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Efficacy of chemotherapy or chemo‐anti‐PD‐1 combination after failed anti‐PD‐1 therapy for relapsed and refractory hodgkin lymphoma: A series from lysa centers
Author(s) -
Rossi Cédric,
Gilhodes Julia,
Maerevoet Marie,
Herbaux Charles,
Morschhauser Franck,
Brice Pauline,
Garciaz Sylvain,
Borel Cécile,
Ysebaert Loïc,
Obéric Lucie,
Lazarovici Julien,
Deau Bénédicte,
Dupuis Jehan,
Chauchet Adrien,
Abraham Julie,
Bijou Fontanet,
StamatoullasBastard Aspasia,
Malfuson JeanValère,
Golfier Camille,
Laurent Camille,
Pericart Sarah,
TraverseGlehen Alexandra,
Kanoun Salim,
Filleron Thomas,
Casasnovas RenéOlivier,
Ghesquières Hervé
Publication year - 2018
Publication title -
american journal of hematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.456
H-Index - 105
eISSN - 1096-8652
pISSN - 0361-8609
DOI - 10.1002/ajh.25154
Subject(s) - medicine , refractory (planetary science) , brentuximab vedotin , salvage therapy , chemotherapy , autologous stem cell transplantation , lymphoma , progressive disease , gastroenterology , surgery , oncology , hodgkin lymphoma , physics , astrobiology
Anti‐PD‐1 therapy provides high response rates in Hodgkin lymphoma (HL) patients who have relapsed or are refractory (R/R) to autologous stem cell transplantation (ASCT) and brentuximab vedotin (BV), but median progression free survival (PFS) is only one year. The efficacy of treatment following anti‐PD‐1 is not well known. We retrospectively investigated the efficacy of salvage therapies for unsatisfactory response to anti‐PD‐1 therapy, assessed by PET‐CT according to the Lugano criteria, in 30 R/R HL patients. Patients were highly pretreated before anti‐PD‐1 (70% received ASCT and 93% BV). Unsatisfactory responses to anti‐PD1 therapy were progressive disease (PD) ( n = 24) and partial response (PR) ( n = 6). For the 24 PD patients, median anti‐PD‐1 related PFS was 7.5 months (95%CI, 5.7‐11.6); 17 received subsequent CT alone (Group 1) and 7 received CT in addition to anti‐PD‐1 (Group 2). 16/24 patients (67%) obtained an objective response. In the 15 patients treated with the same CT, twelve obtained PR or complete response (CR). In Group 1, there were 7 CR (41%), 3 PR (18%), and 7 PD (41%). In Group 2, there were 4 CR (57%), 2 PR (29%), and 1 SD (14%). No unexpected toxicity was observed. Six patients who achieved response proceeded to allogeneic SCT. With a median follow‐up of 12.1 months (7‐14.7), the median PFS following the initiation of CT was 11 months (95% CI 6.3‐not reached) and the median of overall survival was not reached. These observations in highly pretreated HL patients suggest that anti‐PD‐1 therapy might re‐sensitize tumor cells to CT.