Low-dose pembrolizumab or nivolumab therapy may be effective and safe for patients with relapsed/refractory classical Hodgkin lymphoma (cHL), according to research published in Hematological Oncology.
In a retrospective, single-center study conducted by researchers affiliated with Queen Mary Hospital in Hong Kong, patients with relapsed/refractory cHL were given either pembrolizumab (11 patients; 100 mg every 3 weeks), or nivolumab (6 patients; 40 mg every 2 weeks). Responses and other outcomes were assessed.
Patients in both treatment groups had a median of 3 previous therapies; patients treated with pembrolizumab had a minimum of 1 prior therapy and patients treated with nivolumab had minimum of 2 prior therapies. Brentuximab vedotin and autologous or allogeneic hematopoietic stem cell transplantation were the most common prior therapies across the 2 groups.
The median age in the pembrolizumab group was 34 years, 40.5 years in the nivolumab group. At the start of the study treatment, 91% of patients and 67% of patients in the pembrolizumab group and nivolumab group, respectively, had stage III or IV disease.
The overall response rate (ORR) with pembrolizumab was 100%. This included a metabolic complete response (mCR) rate of 73% and a partial response (PR) rate of 27%. The nivolumab group had an ORR of 100%, with 67% in mCR, 17% in PR, and indeterminate response in 17%. Best response was achieved at median cumulative doses of 400 mg for pembrolizumab and 160 mg for nivolumab.
Pembrolizumab was associated with a median progression-free survival (PFS) of 35 months. The median PFS for the nivolumab group was 33 months. Median overall survival was not reached with either treatment.
Grade 1 to 2 adverse events were reported in 3 patients from the pembrolizumab group and in 4 patients from the nivolumab group. There was 1 case of grade 4 immune thrombocytopenia in the nivolumab group, which occurred in a patient with a history of this condition, which became exacerbated during the study and responded to corticosteroid treatment.
“In conclusion, low‐dose anti‐PD1 antibodies were highly efficacious and safe in relapsed/refractory cHL,” the researchers stated in their report.
Chan TSY, Hwang Y, Khong P, et al. Low‐dose pembrolizumab and nivolumab were efficacious and safe in relapsed and refractory classical Hodgkin lymphoma: experience in a resource‐constrained setting. Hematol Oncol. Published online August 12, 2020. doi:10.1002/hon.2787