Chemotherapy after PD-1 inhibitors in relapsed/refractory Hodgkin lymphoma: Outcomes and clonal evolution dynamics.

Autor: Calabretta E; Department of Biomedical Sciences, Humanitas University, Milan, Italy.; Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy., Guidetti A; Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.; University of Milano, Milan, Italy., Ricci F; Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy., Di Trani M; Department of Biomedical Sciences, Humanitas University, Milan, Italy., Monfrini C; Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy., Magagnoli M; Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy., Bramanti S; Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy., Maspero D; Dipartimento di Informatica, Sistemistica e Comunicazione, Università degli Studi di Milano-Bicocca, Milan, Italy.; Institute of Molecular Bioimaging and Physiology, Consiglio Nazionale delle Ricerche (IBFM-CNR), Segrate, Milan, Italy., Morello L; Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy., Merli M; Department of Hematology, University Hospital 'Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi', University of Insubria, Varese, Italy., Di Rocco A; Department of Translational and Precision Medicine, La Sapienza University, Rome, Italy., Graudenzi A; Institute of Molecular Bioimaging and Physiology, Consiglio Nazionale delle Ricerche (IBFM-CNR), Segrate, Milan, Italy.; Bicocca Bioinformatics, Biostatistics and Bioimaging Centre (B4), Università degli Studi di Milano-Bicocca, Milan, Italy., Derenzini E; IEO European Institute of Oncology IRCCS, Milan, Italy.; Department of Health Sciences, University of Milan, Italy., Antoniotti M; Dipartimento di Informatica, Sistemistica e Comunicazione, Università degli Studi di Milano-Bicocca, Milan, Italy.; Bicocca Bioinformatics, Biostatistics and Bioimaging Centre (B4), Università degli Studi di Milano-Bicocca, Milan, Italy., Rossi D; Clinic of Hematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.; Institute of Oncology Research, Bellinzona, Switzerland.; Faculty of Biomedical Sciences, USI, Lugano, Switzerland., Corradini P; Division of Hematology and Bone Marrow Transplantation, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.; University of Milano, Milan, Italy., Santoro A; Department of Biomedical Sciences, Humanitas University, Milan, Italy.; Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy., Carlo-Stella C; Department of Biomedical Sciences, Humanitas University, Milan, Italy.; Department of Oncology and Hematology, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Milan, Italy.
Jazyk: angličtina
Zdroj: British journal of haematology [Br J Haematol] 2022 Jul; Vol. 198 (1), pp. 82-92. Date of Electronic Publication: 2022 Apr 25.
DOI: 10.1111/bjh.18183
Abstrakt: Checkpoint inhibitors (CPIs) are routinely employed in relapsed/refractory classical Hodgkin lymphoma. Nonetheless, persistent long-term responses are uncommon, and one-third of patients are refractory. Several reports have suggested that treatment with CPIs may re-sensitize patients to chemotherapy, however there is no consensus on the optimal chemotherapy regimen and subsequent consolidation strategy. In this retrospective study we analysed the response to rechallenge with chemotherapy after CPI failure. Furthermore, we exploratively characterized the clonal evolution profile of a small sample of patients (n = 5) by employing the CALDER approach. Among the 28 patients included in the study, 17 (71%) were primary refractory and 26 (92%) were refractory to the last chemotherapy prior to CPIs. Following rechallenge with chemotherapy, response was recorded in 23 (82%) patients experiencing complete remission and 3 (11%) patients experiencing partial remission. The tumour evolution of the patients inferred by CALDER seemingly occurred prior to the first cycle of therapy and was characterized either by linear or branching evolution patterns. Twenty-five patients proceeded to allogeneic stem cell transplantation. At a median follow-up of 21 months, median PFS and OS were not reached. In conclusion, patients who fail CPIs can be effectively rescued by salvage chemotherapy and bridged to allo-SCT/auto-SCT.
(© 2022 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.)
Databáze: MEDLINE
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