Blood:ASCT后采用Pembrolizumab巩固治疗可提高经典霍奇金淋巴瘤患者的预后

2019-04-09 MedSci MedSci原创

中心点:在自体干细胞移植后,采用Pembrolizumab(Keytruda,一种抗癌药)阻断PD-1具有可接受的安全性。该治疗方案可使经典霍奇金淋巴瘤患者(包括高危患者)获得较高的无进展存活率(PFS)。摘要:自体干细胞移植(ASCT)仍是复发性/难治性经典霍奇金淋巴瘤(RR cHL)患者的标准疗法。但ASCT后,淋巴瘤复发也仍是导致失败最常见的原因。鉴于cHL对PD-1阻断具有独特的敏感性,A

中心点:

在自体干细胞移植后,采用Pembrolizumab(Keytruda,一种抗癌药)阻断PD-1具有可接受的安全性。

该治疗方案可使经典霍奇金淋巴瘤患者(包括高危患者)获得较高的无进展存活率(PFS)。

摘要:

自体干细胞移植(ASCT)仍是复发性/难治性经典霍奇金淋巴瘤(RR cHL)患者的标准疗法。但ASCT后,淋巴瘤复发也仍是导致失败最常见的原因。

鉴于cHL对PD-1阻断具有独特的敏感性,ASCT后进行PD-1封闭作为巩固或可提高ASCT的预后。

Philippe Armand等人开展一多队列的2期研究,评估RR cHL患者在ASCT后的采用Pembrolizumab进行巩固治疗对预后的影响,研究人员假定可将ASCT后18个月时的无进展存活率(PFS)从60%提高至80%。

Pembrolizumab,每2周予以200mg(IV),从ASCT后21天内开始用药,长达8个疗程。

共招募了30位患者,中位年龄33岁,90%的患者为临床高危型。77%的患者完成8个疗程。毒副作用可控,30%的患者至少出现一次3级及以上的副反应(AE),40%的患者至少发生1次2级及以上的免疫相关的AE。随访12个月时,有2位患者失访。18个月时,28位可评估的患者的PFS为82%,符合预期。18个月时的整体存活率为100%。

综上所述,RR cHL患者在ASCT后可采用Pembrolizumab巩固治疗,有助于提高高危患者的PFS,值得进一步在开展随机试验评估这一疗法。

原始出处:

Philippe Armand, et al.
PD-1 Blockade with Pembrolizumab for Classical Hodgkin Lymphoma after Autologous Stem Cell Transplantation.Blood 2019 :blood.2019000215; doi: https://doi.org/10.1182/blood.2019000215 

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    2019-12-13 snf701207

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