Nivolumab for relapsed or refractory Hodgkin lymphoma: real-life experience
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ORIGINAL ARTICLE
Nivolumab for relapsed or refractory Hodgkin lymphoma: real-life experience Huseyin Bekoz 1 & Murat Ozbalak 2 & Nuri Karadurmus 3 & Semra Paydas 4 & Alev Turker 5 & Tayfur Toptas 6 & Tülin Firatli Tuglular 6 & Fevzi Altuntas 7 & Merih Kizil Cakar 7 & Mehmet Sonmez 8 & Zafer Gulbas 9 & Nazlı Demir 10 & Leylagul Kaynar 11 & Rahsan Yildirim 12 & Ihsan Karadogan 13 & Mutlu Arat 14 & Irem Kapucu 15 & Nevin Alayvaz Aslan 16 & Vildan Ozkocaman 17 & Mehmet Turgut 18 & Meltem Kurt Yuksel 19 & Muhit Ozcan 19 & Sibel Kabukcu Hacioglu 20 & Ibrahim Barista 5 & Metin Demirkaya 21 & Guray Saydam 22 & Selami K. Toprak 19 & Mehmet Yilmaz 23 & Onur Demirkol 24 & Burhan Ferhanoglu 25 Received: 4 August 2019 / Accepted: 4 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Classical Hodgkin lymphoma (cHL) is considered a curable disease; however, in approximately one-third of the responding patients, the disease relapses following completion of therapy. One of the drugs that have been approved for the treatment of relapsed/refractory cHL is nivolumab, an immune check point inhibitor that shows its effects by blocking the programmed death 1 (PD-1) receptor. In this study, we present a retrospective “real-life” analysis of the usage of nivolumab in patients with relapsed/ refractory cHL that have joined the named patient program (NPP) for nivolumab, reflecting 4 years of experience in the treatment of relapsed/refractory cHL. We present a retrospective analysis of 87 patients (median age, 30) that participated in the NPP in 24 different centers, who had relapsed/refractory cHL and were consequently treated with nivolumab. The median follow-up was 29 months, and the median number of previous treatments was 5 (2–11). In this study, the best overall response rate was 70% (CR, 36%; PR, 34%). Twenty-eight of the responding patients underwent subsequent stem cell transplantation (SCT). Among 15 patients receiving allogeneic stem cell transplantation, 9 patients underwent transplantation with objective response, of which 8 of them are currently alive with ongoing response. At the time of analysis, 23 patients remained on nivolumab treatment and the rest discontinued therapy. The main reason for discontinuing nivolumab was disease progression (n = 23). The safety profile was acceptable, with only nine patients requiring cessation of nivolumab due to serious adverse events. The 24-month progressionfree and overall survival rates were 58.5% (95% CI, 0.47–0.68) and 78.7% (95% CI, 0.68–0.86), respectively. Eighteen patients died during the follow-up and only one of these was regarded to be treatment-related. With its efficacy and its safety profile, PD-1 blockers became an important treatment option in the heavily pretreated cHL patients. Keywords Hodgkin lymphoma . Resistant/relapsed disease . Programmed death 1 (PD-1) blocker . Nivolumab
Introduction Classical Hodgkin lymphoma (cHL) is considered a curable disease, with durable remission achieved in about 80% of patients after first-line treatment [1
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