Blood:派姆单抗序贯AVD化疗可有效治疗经典霍奇金淋巴瘤

2020-10-05 星云 MedSci原创

Pembrolizumab(派姆单抗)是一种针对程序性死亡-1蛋白的人源化IgG4单克隆抗体,已证明对复发/难治性经典型霍奇金淋巴瘤(cHL)有效。

Pembrolizumab(派姆单抗)是一种针对程序性死亡-1蛋白的人源化IgG4单克隆抗体,已证明对复发/难治性经典型霍奇金淋巴瘤(cHL)有效。

为了评估派姆单抗单药治疗新诊断的cHL的完全代谢缓解(CMR)率和安全性,Allen等进行了一项多中心、单臂、II期的派姆单抗联合阿霉素、长春新碱和达卡巴嗪(AVD)序贯化疗的试验。招募年龄≥18岁、早期未治疗、病情不利或晚期的患者。

不同结点获得缓解患者比例

共纳入30例早期不良(n=12)或晚期(n=18)cHL患者接受派姆单抗单药治疗3个周期,然后根据分期和体积进行4~6个周期的AVD治疗。12例纵隔肿块较大和/或肿块较大(>10 cm)。经派姆单抗单一治疗后,11位患者(37%)出现了CMR,28位接受正电子发射断层扫描/计算机断层扫描(PET-CT)的患者中,另有7位(25%)的代谢性肿瘤体积缩小了90%以上。

两例大肿块患者经三个疗程派姆单抗治疗后的肿瘤体积变化(A→B,C→D)

所有患者在2个AVD周期后均获得CMR,并在治疗结束时维持其缓解状态。中位随访了22.5个月(范围:14.2-30.6个月),在治疗、进展或死亡方面没有变化。没有患者接受巩固放疗,包括那些大块头疾病的患者。治疗耐受性良好。最常见的免疫相关不良事件为1级皮疹(6例)和2级输液反应(4例)。一位患者患有可逆性4级转氨酶升高,另一位患者患有可逆性贝尔氏麻痹(面神经麻痹)。

综上,在新诊断的cHL患者(包括大肿块患者)中,短暂的派姆单抗治疗和AVD治疗被证明是高效和安全的。

原始出处:

Pamela Blair Allen, et al. Pembrolizumab followed by AVD in untreated early unfavorable and advanced stage classical Hodgkin lymphoma. Blood. September 29, 2020.

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    2020-10-07 zhaojie88
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    2020-10-05 健康达人

    肿瘤免疫是大家关心的话题,K药与其它药对比,值得关注!

    0

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