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• W4380080811 abstract "Introduction: Programmed death-1 (PD1) blockade is an efficient and safe therapeutic option in patients with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL). However, many patients progress or lose the response to immune checkpoint inhibitors (CPIs). In this setting, two options can be explored to improve patients outcomes: 1) salvage chemotherapies (CHT) for those patients with an unsatisfactory response to anti-PD1 treatment (less than a partial response), and 2) autologous stem-cell transplantation (ASCT) as a consolidation treatment in those HL patients who obtained at least a partial response (PR) after CPI. Methods: We retrospectively investigated the effectiveness of both salvage therapies for unsatisfactory response to anti-PD1 therapy (cohort 1) and ASCT as consolidation (cohort 2) in patients with R/R cHL treated with pembrolizumab or nivolumab at our Institution. Overall response rates (ORR) were chosen as primary endpoint in the two settings, whereas progression-free survival (PFS), disease-free survival (DFS) and overall survival (OS) were analyzed as secondary endpoints starting from the first dose of CHT (intended as a conditioning regimen for consolidation pathway or other drugs in the case of salvage treatments after CPIs failure). Adverse events (especially cumulative toxicities) were also assessed. Results: Forty-eight heavily pre-treated patients were eligible for this retrospective analysis (median of previous therapies 4, range 3–9; 77% primary refractory). Thirty-one patients underwent further CHT (cohort 1) after a median time of 1.4 months from last CPI dose. Specifically, 21 patients received a single-agent treatment and 10 received a multi-agent regimen. Seventeen patients underwent ASCT to consolidate the response (15 in complete response [CR]) obtained with CPIs (cohort 2) with a median time to last CPI dose of 2 months days. In cohort 1, the final ORR was 32.3% (6 CR and 4 PR), while in cohort 2, we observed an ORR of 88.2% (all CR). After a median follow-up of 5 years, in cohort, median OS and DFS were still not reached, while median PFS was 11.6 months. In cohort 2, for OS, PFS, and DFS the median was not reached. No unexpected or cumulative toxicity was observed. Conclusions: Our results indicated that ASCT can be considered an effective consolidation strategy in patients with cHL who have achieved at least a partial response after CPI, despite a large number of prior lines of therapy. In addition, treatment with CPI, regardless of its success, appears to promote sensitization to subsequent chemotherapy regimen in a setting of heavily pretreated and chemorefractory patients. In this context, post CPI chemo-sensitization may pave the way for eventual subsequent transplant consolidation, increasing the chances of cure. Keywords: Chemotherapy, Immunotherapy, Stem Cell Transplant No conflicts of interests pertinent to the abstract." @default.
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• W4380080811 date "2023-06-01" @default.
• W4380080811 modified "2023-10-16" @default.
• W4380080811 title "Role of autologous stem cell transplantation or salvage chemotherapy in relapsed/refractory classical Hodgkin lymphoma patients after immune checkpoint inhibitors" @default.
• W4380080811 doi "https://doi.org/10.1002/hon.3164_265" @default.
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