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Patterns of progression after immune checkpoint inhibitors for Hodgkin lymphoma: implications for radiation therapy.
Burlile, Jessica F; Frechette, Kelsey M; Breen, William G; Hwang, Steven R; Higgins, Alexandra S; Nedved, Adrienne N; Harmsen, William S; Pulsipher, Sydney D; Witzig, Thomas E; Micallef, Ivana N; Hoppe, Bradford S; Habermann, Thomas M; Thanarajasingam, Gita; Johnston, Patrick B; Inwards, David J; Bennani, N Nora; Peterson, Jennifer L; Stish, Bradley J; Rule, William G; Ansell, Stephen M; Lester, Scott C.
Afiliação
  • Burlile JF; Department of Radiation Oncology, Mayo Clinic, Rochester, MN.
  • Frechette KM; Department of Radiation Oncology, Mayo Clinic, Rochester, MN.
  • Breen WG; Department of Radiation Oncology, Mayo Clinic, Rochester, MN.
  • Hwang SR; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Higgins AS; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Nedved AN; Department of Pharmacy, Mayo Clinic, Rochester, MN.
  • Harmsen WS; Department of Biostatistics and Health Sciences Research, Mayo Clinic, Rochester, MN.
  • Pulsipher SD; Department of Biostatistics and Health Sciences Research, Mayo Clinic, Rochester, MN.
  • Witzig TE; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Micallef IN; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Hoppe BS; Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL.
  • Habermann TM; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Thanarajasingam G; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Johnston PB; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Inwards DJ; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Bennani NN; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Peterson JL; Department of Radiation Oncology, Mayo Clinic, Jacksonville, FL.
  • Stish BJ; Department of Radiation Oncology, Mayo Clinic, Rochester, MN.
  • Rule WG; Department of Radiation Oncology, Mayo Clinic, Phoenix, AZ.
  • Ansell SM; Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, MN.
  • Lester SC; Department of Radiation Oncology, Mayo Clinic, Rochester, MN.
Blood Adv ; 8(5): 1250-1257, 2024 Mar 12.
Article em En | MEDLINE | ID: mdl-38206755
ABSTRACT
ABSTRACT Immune checkpoint inhibitors (ICIs) have demonstrated remarkable response rates in relapsed or refractory Hodgkin lymphoma (HL). Still, most patients eventually progress. Patterns of progression after ICIs are not well described and are essential to defining the role of local therapies in combination with ICIs. We identified patients who received ICIs for HL between 2013 and 2022. Fludeoxyglucose-18 positron emission tomography (FDG-PET) before initiating ICI and at progression on/after ICI were reviewed, and areas of active HL were recorded. An exploratory analysis of treatable progression included patients with ≤5 sites of disease on pre-ICI FDG-PET and progression only at pre-ICI sites. Ninety patients were identified; 69 had complete records, and of these, 32 (52%) had relapsed at ICI initiation, 17 (25%) were refractory, and 16 (23%) received ICI as first-line therapy. Forty-five of 69 patients had ≤5 sites of disease (limited) on pre-ICI FDG-PET. Patients with >5 sites of disease had a higher risk of progression, and every site of disease >5 sites conferred an additional 1.2x higher chance of progression. At a median follow-up of 4.0 years, 41 of 69 patients had progressed on/after ICIs (cumulative incidence 66.4%), and of these, 22 of 41 patients progressed only at pre-ICI sites (cumulative incidence 39.4%). In an exploratory analysis, the cumulative incidence of a treatable progression among 45 patients with limited disease was 34%. The cumulative incidence of any progression among this cohort was 58.9%. More than one-third of patients with limited disease before ICIs experienced progression only at pre-ICI sites of disease. These patients could be candidates for radiation during or after ICIs.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença de Hodgkin / Inibidores de Checkpoint Imunológico Limite: Humans Idioma: En Revista: Blood Adv Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Mongólia

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença de Hodgkin / Inibidores de Checkpoint Imunológico Limite: Humans Idioma: En Revista: Blood Adv Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Mongólia