Open AccessCheckpoint Inhibitors and Classical Hodgkin’s Lymphoma: Efficacy and Safety of Pembrolizumab in Relapsed/Refractory Tumor (Experience at the NI Pirogov Russian National Medical Center of Surgery)
Author(s) -
Vladislav Olegovich Sarzhevskii,
Е. А. Демина,
Н Е Мочкин,
Анна Анатольевна Спорник,
А. А. Мамедова,
Е Г Смирнова,
А Е Банникова,
A.A. Samoilova,
VS Bogatyrev,
Vladimir Melnichenko
Publication year - 2021
Publication title -
kliničeskaâ onkogematologiâ
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.116
H-Index - 2
eISSN - 2500-2139
pISSN - 1997-6933
DOI - 10.21320/2500-2139-2021-14-1-53-62
Subject(s) - pembrolizumab , medicine , refractory (planetary science) , immunotherapy , adverse effect , expanded access , complete response , oncology , surgery , chemotherapy , cancer , physics , astrobiology
Background. Checkpoint inhibitors contribute to improving the treatment outcomes in patients with relapsed/refractory classical Hodgkin's lymphoma (cHL). The paper describes the first generalized experience with pembrolizumab-induc-ing cHL immunotherapy in Russia. The hallmark of the study is a long follow-up period. Aim. To retrospectively assess efficacy and safety of pem-brolizumab-inducing immunotherapy of relapsed/refractory cHL. Materials & Methods. The study enrolled 14 cHL patients: 3 men and 11 women aged 24-57 years (median 33 years). Pembrolizumab 200 mg or 2 mg/kg was intravenously administered every 3 weeks. Median pembrolizumab administration number was 27 (max. 52 administrations), median follow-up after immunotherapy onset was 31 months. Results. Complete response (as best response) was achieved in 8 (57 %) patients, 3 (21 %) patients showed partial response (as best response). Overall objective response was 78 %. Median number of pembrolizumab administrations resulting in better responses to immunotherapy was 4, which corresponded to 3 months of treatment. Maximum number of pembrolizumab administrations before achieving best response was 32. Best response duration (the period from achieving it to disease progression/relapse or to the end-point of data collection in case of sustained response) varied from 3 to 56 months (median 15 months). Most common severe adverse events of grade 3-4 were pulmonary complications. Overall survival for 12, 24, and 36 months was 92.9 %, 85.7 %, and 85.7 %, respectively, and progression-free survival was 76.9 %, 59.3 %, and 37.1 %, respectively; median time before progression was 27.7 months. Conclusion. The experience with pembrolizumab-inducing immunotherapy of relapsed/refractory cHL in Russia proves the efficacy and relative safety of this treatment approach. Due to long follow-up period a series of crucial practical immunotherapy-related issues were raised, which will need to be dealt with in future studies.