par Rossi, Cédric;Gilhodes, Julia;Maerevoet, Marie ;Herbaux, Charles;Morschhauser, Franck;Brice, Pauline;Garciaz, Sylvain;Borel, Cécile;Ysebaert, Loic;Obéric, Lucie;Lazarovici, Julien;Deau, Bénédicte;Dupuis, Jehan;Chauchet, Adrien;Abraham, Julie;Bijou, Fontanet;Stamatoullas-Bastard, Aspasia;Malfuson, Jean Valère;Golfier, Camille;Laurent, Camille;Pericart, Sarah;Traverse-Glehen, Alexandra;Kanoun, Salim;Filleron, Thomas;Casasnovas, René Olivier;Ghesquieres, Hervé
Référence American journal of hematology, 93, 8, page (1042-1049)
Publication Publié, 2018-08
Référence American journal of hematology, 93, 8, page (1042-1049)
Publication Publié, 2018-08
Article révisé par les pairs
Résumé : | 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. |