Post-transplantation consolidation with pembrolizumab is feasible, with a favorable safety profile and promising efficacy, in patients with peripheral T-cell lymphoma (PTCL), according to research published in Blood.
Investigators conducted a nonrandomized, open-label, investigator-initiated, multicenter, phase 2 study of the anti-PD-1 monoclonal antibody pembrolizumab after autologous stem cell transplantation (ASCT) in patients with PTCL in first remission (ClinicalTrials.gov Identifier: NCT02362997).
Patients were administered pembrolizumab, 200 mg intravenously, every 3 weeks for up to 8 cycles within 21 days of post-ASCT discharge and within 60 days of stem cell infusion. The primary endpoint was progression-free survival (PFS) at 18 months following ASCT.
Continue Reading
A total of 21 patients (median age, 58 years; range, 33-73 years; 57% male) were treated on study. The most common subtypes were PTCL-not otherwise specified (52%), angioimmunoblastic T-cell lymphoma (19%), and extranodal natural killer cell/T-cell lymphoma, nasal type (14%). Most (67%) patients completed 8 cycles of treatment.
The study met its primary efficacy endpoint, with 13 of 21 achieving PFS at 18 months post-ASCT. The estimated 18-month PFS and overall survival (OS) were 83.6% (95% CI, 68-100) and 94.4% (95% CI, 84-100), respectively. The investigators observed no significant difference in PFS or OS among PTCL subtypes.
The toxicity profile was consistent with that known for pembrolizumab. The most common severe adverse event was grade 3 transaminitis (10%); no grade 5 toxicities occurred.
“In conclusion, [post-transplantation] consolidation with pembrolizumab is feasible in patients with PTCL, with a favorable safety profile. The efficacy is promising, justifying future studies, especially in subtypes known to be sensitive to this therapy,” the study authors wrote in their report. “PD-1 blockade may be combined with other immunotherapies (or [brentuximab vedotin] for CD30+ disease including [ALK+ anaplastic large-cell lymphoma]), which could be deployed in the pre- or post-ASCT setting, as has been done in [Hodgkin lymphoma].”
Disclosure: This research was supported by Merck Sharp & Dohme LLC. Please see the original reference for a full list of disclosures.
Reference
Merrill MH, Dahi PB, Redd RA, et al. A phase 2 study of pembrolizumab after autologous stem cell transplantation in patients with T-cell non-Hodgkin lymphoma. Blood. 2023;142(7):621-628. doi:10.1182/blood.2023020244
