Journal article
Pembrolizumab followed by AVD in untreated early unfavorable and advanced-stage classical Hodgkin lymphoma
Blood, Vol.137(10), pp.1318-1326
03/11/2021
DOI: 10.1182/blood.2020007400
PMCID: PMC7955404
PMID: 32992341
Abstract
Pembrolizumab, a humanized IgG4 monoclonal antibody targeting programmed death-1 protein, has demonstrated efficacy in relapsed/refractory classical Hodgkin lymphoma (cHL). To assess the complete metabolic response (CMR) rate and safety of pembrolizumab monotherapy in newly diagnosed cHL, we conducted a multicenter, single-arm, phase 2 investigator-initiated trial of sequential pembrolizumab and doxorubicin, vinblastine, and dacarbazine (AVD) chemotherapy. Patients >= 18 years of age with untreated, early, unfavorable, or advanced-stage disease were eligible for treatment. Thirty patients (early unfavorable stage, n = 12; advanced stage, n = 18) were treated with 3 cycles of pembrolizumab monotherapy followed by AVD for 4 to 6 cycles, depending on stage and bulk. Twelve had either large mediastinal masses or bulky disease (>10 cm). After pembrolizumab monotherapy, 11 patients (37%) demonstrated CMRs, and an additional 7 of 28 (25%) patients with quantifiable positron emission tomography computed tomography scans had >90% reduction in metabolic tumor volume. All patients achieved CMR after 2 cycles of AVD and maintained their responses at the end of treatment. With a median follow-up of 22.5 months (range, 14.2-30.6) there were no changes in therapy, progressions, or deaths. No patients received consolidation radiotherapy, including those with bulky disease. Therapy was well tolerated. The most common immune-related adverse events were grade 1 rash (n = 6) and grade 2 infusion reactions (n = 4). One patient had reversible grade 4 transaminitis and a second had reversible Bell's palsy. Brief pembrolizumab monotherapy followed by AVD was both highly effective and safe in patients with newly diagnosed cHL, including those with bulky disease.
Details
- Title: Subtitle
- Pembrolizumab followed by AVD in untreated early unfavorable and advanced-stage classical Hodgkin lymphoma
- Creators
- Pamela B. Allen - Emory UniversityHatice Savas - Northwestern UniversityAndrew M. Evens - Rutgers, The State University of New JerseyRanjana H. Advani - Stanford Cancer Institute, Palo Alto, CA; and.Brett Palmer - Northwestern UniversityBarbara Pro - Northwestern UniversityReem Karmali - Northwestern UniversityEric Mou - Stanford Cancer Institute, Palo Alto, CA; and.Jeffrey Bearden - Northwestern UniversityGary Dillehay - Northwestern UniversityRobert A. Bayer - Northwestern UniversityRobert M. Eisner - Northwestern UniversityJoan S. Chmiel - Northwestern UniversityKaitlyn O'Shea - Northwestern UniversityLeo I. Gordon - Northwestern UniversityJane N. Winter - Northwestern University
- Resource Type
- Journal article
- Publication Details
- Blood, Vol.137(10), pp.1318-1326
- Publisher
- Amer Soc Hematology
- DOI
- 10.1182/blood.2020007400
- PMID
- 32992341
- PMCID
- PMC7955404
- ISSN
- 0006-4971
- eISSN
- 1528-0020
- Number of pages
- 9
- Grant note
- P30 CA060553 / National Institutes of Health, National Cancer Institute Cancer Center Support Grant Merck Co, Inc; Merck & Company
- Language
- English
- Date published
- 03/11/2021
- Academic Unit
- Hematology, Oncology, and Blood & Marrow Transplantation; Internal Medicine
- Record Identifier
- 9984359913402771
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