Immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed/refractory classical Hodgkin lymphoma: A retrospective analysis in 12 patients
The rate of complete remission (CR) with the anti-PD1 immune checkpoint inhibitors (ICI) nivolumab (N) and pembrolizumab (P) in patients with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL) is low (20-30%), and the majority of patients eventually relapse. One strategy to improve their out...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-06-01
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| Series: | Hematology Reports |
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| Online Access: | https://www.pagepress.org/journals/index.php/hr/article/view/9080 |
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| author | Elisa Lucchini Chiara Rusconi Mario Levis Francesca Ricci Armando Santoro Umberto Ricardi Stefano Volpetti Fabio Matrone Anna Di Russo Manuela Caizzi Anna Schiattarella Francesco Zaja |
| author_facet | Elisa Lucchini Chiara Rusconi Mario Levis Francesca Ricci Armando Santoro Umberto Ricardi Stefano Volpetti Fabio Matrone Anna Di Russo Manuela Caizzi Anna Schiattarella Francesco Zaja |
| author_sort | Elisa Lucchini |
| collection | DOAJ |
| description | The rate of complete remission (CR) with the anti-PD1 immune checkpoint inhibitors (ICI) nivolumab (N) and pembrolizumab (P) in patients with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL) is low (20-30%), and the majority of patients eventually relapse. One strategy to improve their outcome is to combine ICI with radiotherapy (ICI-RT), taking advantage of a supposed synergistic effect. We retrospectively collected data of 12 adult patients with R/R cHL treated with ICI-RT delivered during or within 8 weeks from the start or after the end of ICI. Median age at ICI-RT was 37 years, 50% had previously received an autologous stem cell transplantation (SCT) and 92% brentuximab vedotin. RT was given concurrently, before or after ICI in 4, 1 and 7 patients. Median RT dose was 30Gy, for a median duration of 22 days. Median number of ICI administrations was 15. Overall response and CR rate were 100% and 58%. Nine patients received subsequent SCT consolidation (7 allogeneic and 2 autologous). After a median follow-up of 18 months, 92% of patients were in CR. No major concerns about safety were reported. ICI-RT combination appears to be a feasible and highly active bridge treatment to transplant consolidation. |
| first_indexed | 2024-04-10T18:34:56Z |
| format | Article |
| id | doaj.art-35964a569f1b49e1b155084f149ad497 |
| institution | Directory Open Access Journal |
| issn | 2038-8322 2038-8330 |
| language | English |
| last_indexed | 2024-04-10T18:34:56Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hematology Reports |
| spelling | doaj.art-35964a569f1b49e1b155084f149ad4972023-02-02T01:46:43ZengMDPI AGHematology Reports2038-83222038-83302021-06-0113210.4081/hr.2021.9080Immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed/refractory classical Hodgkin lymphoma: A retrospective analysis in 12 patientsElisa Lucchini0Chiara Rusconi1Mario Levis2Francesca Ricci3Armando Santoro4Umberto Ricardi5Stefano Volpetti6Fabio Matrone7Anna Di Russo8Manuela Caizzi9Anna Schiattarella10Francesco Zaja11Department of Hematology, Azienda Sanitaria Universitaria Giuliano- Isontina, TriesteDivision of Hematology and Stem Cell Transplantation Fondazione IRCCS Istituto Nazionale dei Tumori, MilanoDepartment of Oncology, University of TorinoDepartment of Oncology and Hematology, Humanitas Clinical and Research Center - IRCCS, Rozzano, MilanoDepartment of Oncology and Hematology, Humanitas Clinical and Research Center - IRCCS, Rozzano, MilanoDepartment of Oncology, University of TorinoDepartment of Hematology, Azienda Sanitaria Universitaria Friuli Centrale, UdineDepartment of Radiation Oncology, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, PordenoneDivision of Radiotherapy Oncology Fondazione IRCCS Istituto Nazionale dei Tumori, MilanoDepartment of Hematology, Azienda Sanitaria Universitaria Giuliano- Isontina, TriesteDepartment of Radiotherapy, Azienda Sanitaria Universitaria Giuliano-Isontina, TriesteDepartment of Hematology, Azienda Sanitaria Universitaria Giuliano- Isontina, Trieste; Department of Medical, Surgical and Health Sciences, University of TriesteThe rate of complete remission (CR) with the anti-PD1 immune checkpoint inhibitors (ICI) nivolumab (N) and pembrolizumab (P) in patients with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL) is low (20-30%), and the majority of patients eventually relapse. One strategy to improve their outcome is to combine ICI with radiotherapy (ICI-RT), taking advantage of a supposed synergistic effect. We retrospectively collected data of 12 adult patients with R/R cHL treated with ICI-RT delivered during or within 8 weeks from the start or after the end of ICI. Median age at ICI-RT was 37 years, 50% had previously received an autologous stem cell transplantation (SCT) and 92% brentuximab vedotin. RT was given concurrently, before or after ICI in 4, 1 and 7 patients. Median RT dose was 30Gy, for a median duration of 22 days. Median number of ICI administrations was 15. Overall response and CR rate were 100% and 58%. Nine patients received subsequent SCT consolidation (7 allogeneic and 2 autologous). After a median follow-up of 18 months, 92% of patients were in CR. No major concerns about safety were reported. ICI-RT combination appears to be a feasible and highly active bridge treatment to transplant consolidation.https://www.pagepress.org/journals/index.php/hr/article/view/9080Nivolumab; pembrolizumab; radiotherapy; Hodgkin lymphoma; ICI-RT |
| spellingShingle | Elisa Lucchini Chiara Rusconi Mario Levis Francesca Ricci Armando Santoro Umberto Ricardi Stefano Volpetti Fabio Matrone Anna Di Russo Manuela Caizzi Anna Schiattarella Francesco Zaja Immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed/refractory classical Hodgkin lymphoma: A retrospective analysis in 12 patients Hematology Reports Nivolumab; pembrolizumab; radiotherapy; Hodgkin lymphoma; ICI-RT |
| title | Immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed/refractory classical Hodgkin lymphoma: A retrospective analysis in 12 patients |
| title_full | Immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed/refractory classical Hodgkin lymphoma: A retrospective analysis in 12 patients |
| title_fullStr | Immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed/refractory classical Hodgkin lymphoma: A retrospective analysis in 12 patients |
| title_full_unstemmed | Immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed/refractory classical Hodgkin lymphoma: A retrospective analysis in 12 patients |
| title_short | Immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed/refractory classical Hodgkin lymphoma: A retrospective analysis in 12 patients |
| title_sort | immune checkpoint inhibitors in combination with radiotherapy as salvage treatment for relapsed refractory classical hodgkin lymphoma a retrospective analysis in 12 patients |
| topic | Nivolumab; pembrolizumab; radiotherapy; Hodgkin lymphoma; ICI-RT |
| url | https://www.pagepress.org/journals/index.php/hr/article/view/9080 |
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