Efficacy and tolerability of nivolumab after allogeneic transplantation for relapsed Hodgkin lymphoma.

Abstract : Allogeneic hematopoietic cell transplantation (allo-HCT) is indicated for patients with relapsed or refractory Hodgkin lymphoma (HL). Although long-term disease control can be achieved, relapse is still frequent. The programmed cell death protein 1 (PD-1) pathway-blocking antibody nivolumab has shown substantial therapeutic activity and an acceptable safety profile in patients with relapsed or refractory HL who did not receive allo-HCT. However, PD-1 blocking strategy can increase the risk of graft-versus-host disease (GVHD) in murine models. We retrospectively assessed the efficacy and toxicity of nivolumab as a single agent in 20 HL patients relapsing after allo-HCT. GVHD occurred in 6 patients (30%) after nivolumab initiation. All 6 patients had prior history of acute GVHD. The patients with nivolumab-induced GVHD were managed by standard treatment for acute GVHD. Two patients died as a result of GVHD, 1 of progressive disease and 1 of complications related to a second allo-HCT. Overall response rate was 95%. At a median follow-up of 370 days, the 1-year progression-free survival rate was 58.2% (95% CI, 33.1%-76.7%) and the overall survival rate was 78.7% (95% CI, 52.4%-91.5%). Among 13 patients still in response, 6 received a single dose of nivolumab and 7 remain on nivolumab. Compared with standard options for this indication, our results show that nivolumab is effective with an acceptable safety profile.
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Submitted on : Wednesday, May 31, 2017 - 3:26:02 PM
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Charles Herbaux, Jordan Gauthier, Pauline Brice, Elodie Drumez, Loic Ysebaert, et al.. Efficacy and tolerability of nivolumab after allogeneic transplantation for relapsed Hodgkin lymphoma.. Blood, American Society of Hematology, 2017, 129 (18), pp.2471-2478. ⟨10.1182/blood-2016-11-749556⟩. ⟨hal-01529931⟩



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