Anti-PD-1 therapy after CAR T-cell therapy shows efficacy in Hodgkin lymphoma
ORLANDO — Researchers demonstrated the clinical efficacy of anti-PD-1 mAb therapy following treatment with chimeric receptor modified T cells targeting the CD30 molecule, known as CD30.CAR-T, in a small sample of patients with relapsed/refractory Hodgkin lymphoma, according to a study presented at ASH Annual Meeting and Exposition.
In a retrospective cohort review, Timothy Voorhees, MD, clinical fellow, division of hematology/oncology, University of North Carolina School of Medicine, and colleagues examined the safety and efficacy of anti-PD-1 mAb therapy (CPI) post CD30.CAR-T cell therapy in five patients with relapsed/refractory Hodgkin lymphoma who later received CPI to treat relapsed disease after CD30.CAR-T progression. They determined clinical responses during the follow-up period.
“While the majority of patients with relapse had prior anti-PD-1 exposure, rechallenging with anti-PD-1 therapy was attempted,” Voorhees told HemOnc Today.
Voorhees reported that all patients treated with anti-PD-1 therapy following CD30 directed CAR T-cell therapy exhibited clinical response. Four patients achieved a complete response and one achieved a partial response.
Clinical responses seemed to be improved after CD30 directed CAR T-cell therapy compared with before in patients with prior anti-PD-1 exposure, according to Voorhees.
All five patients were heavily pre-treated with a median of eight therapies prior to CD30.CAR-T, according to the abstract. After CD30.CAR-T infusion, all patients subsequently developed progressive disease. The median time from CD30.CAR-T to CPI was 132 days.
Data showed the median duration of response was 212 days, with ongoing response observed in three patients. One patient developed neuropathy, another developed grade 3 colitis, and a third developed pneumonitis; however, all patients were still alive at last follow up with a median OS of 2.44 years from first CD30.CAR-T cell therapy, per the abstract.
“While these results are encouraging, prospective confirmation of both clinical response and immunophenotype characterization during treatment with anti-PD-1 therapy after CD30 directed CAR T-cell therapy are needed to confirm these findings,” Voorhees told HemOnc Today. “Plans for this treatment are being discussed at our institution.” – by Savannah Demko
Voorhees TJ, et al. Abstract 3233. Presented at: ASH Annual Meeting and Exposition; December 7-10, 2019; Orlando, Florida.
Disclosures: Voorhees reports no relevant financial disclosures.