PD-1–based combinations before autologous transplant are associated with improved outcomes in classical Hodgkin lymphoma
Abstract
Abstract Combination therapy incorporating programmed cell death protein 1 (PD-1) blockade results in unprecedented response rates in both frontline and relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL). Previous retrospective studies have suggested benefit for PD-1 blockade before autologous stem cell transplant (ASCT) but included few patients receiving PD-1 blockade with cytotoxic chemotherapy. To explore the impact of anti–PD-1 based salvage on outcomes for patients with R/R cHL, we retrospectively reviewed 1280 patients with R/R cHL who underwent ASCT from 2010 to 2022 at 6 transplant centers, none of whom received PD-1 blockade as part of frontline therapy. Overall, 25% received a PD-1 inhibitor at any point before ASCT (10% in conjunction with chemotherapy), 28% received salvage brentuximab vedotin (BV) without PD-1 blockade, and the rest received salvage chemotherapy alone. Patients who received PD-1 inhibitors at any point before ASCT had a significantly higher 2-year progression-free survival than those who received BV without PD-1 inhibitors or patients receiving chemotherapy alone (88.2%, 70.2%, and 67.4%, respectively; P< .0001). When restricted to patients in complete response before ASCT, the benefit of PD-1 blockade remained significant. PD-1 blockade before ASCT is independently associated with superior post-ASCT outcomes and patients proceeding to ASCT should be treated with PD-1–based salvage.
Article Details
Authors (24)
Sanjal H. Desai
1Division of Hematology, Mayo Clinic, Rochester, MN
Alison J. Moskowitz
3Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
Reid W. Merryman
4Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
Harsh Shah
Levi D. Pederson
1Division of Hematology, Mayo Clinic, Rochester, MN
Susan M. Geyer
1Division of Hematology, Mayo Clinic, Rochester, MN
Nivetha Ganesan
3Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
Tiffany Chang
Tamer Othman
36Hematology, Blood and Marrow Transplantation, and Cellular Therapy Program, University of California San Francisco, San Francisco, CA
Ayo S. Falade
1Division of Hematology, Mayo Clinic, Rochester, MN
Gunjan L. Shah
Cellular Therapy Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York
Urshila Durani
1Division of Hematology, Mayo Clinic, Rochester, MN
Nuttavut Sumransub
2Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN
Lay She Ng
Indiana University School of Medicine, Indianapolis, Indiana, United States
Kelsey Baron
5Division of Hematology, Department of Medicine, Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT
Shin Yeu Ong
7Department of Hematology, Singapore General Hospital, Singapore, Singapore
Kevin Yoon
8Department of Medical Oncology and Therapeutics Research, City of Hope Comprehensive Cancer Center, Duarte, CA
Stephen M. Ansell
3Department of Hematology/Oncology, Mayo School of Graduate Medicine, Mayo Clinic, Rochester, MN
Philippe Armand
4Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
Siddharth Iyengar
9Division of Medical Oncology, Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA
Ivana Micallef
1Division of Hematology, Mayo Clinic, Rochester, MN
Robert Stuver
3Lymphoma Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
Alex F. Herrera
10Duarte Cancer Center, City of Hope Medical Center, Duarte, CA
Matthew Mei
10Division of Lymphoma, Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA