The cancer immunotherapy strategy known as programmed cell death 1 (PD-1) has generated great excitement for its ability to help the immune system recognize and attack cancer. Now according to researchers at the American Society of Hematology (ASH) 56th Annual Meeting, PD-1 blockade has demonstrated efficacy in patients with Hodgkin lymphoma (HL).
Hodgkin’s lymphoma is a cancer of the lymph system. It typically begins in the lymph nodes in one region of the body and then spreads throughout the lymph system. Hodgkin’s lymphoma is one of the more curable cancers with effective treatments available at several stages of disease. First-line treatment of HL typically involves chemotherapy, often with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine). One problem with this regimen is the toxicity associated with bleomycin. In fact, older patients may develop bleomycin-related lung toxicity—and some die from this. Some patients with relapsed or refractory HL may also be cured with high doses of chemotherapy and stem cell transplant. For patients that fail stem cell transplant additional treatment options are limited.
Keytruda® (pembrolizumab) belongs to a new class of medicines called PD-1 inhibitors that help the immune system recognize and attack cancer. PD-1 is a protein that inhibits certain types of immune responses. Drugs that block PD-1 may enhance the ability of the immune system to fight cancer. Keytruda® works by blocking PD-1. This treatment strategy has previously produced impressive results in melanoma and other cancer types.1
Doctors reported the results of a phase 1 clinical study performed in 29 heavily pretreated patients with HL. All of the patients in the study had experienced failure with previous treatment with brentuximab vedotin, and most had relapsed after a stem cell transplant.
Patients were administered Keytruda® intravenously every 2 weeks until disease progression, excessive side effects, or completion of 2 years of therapy. Overall 66% of HL patients refractory to treatment responded, and 21% achieving a complete disappearance of their lymphoma. Importantly Keytruda® appeared to be well tolerated with minimal side effects. Keytruda® is is now being evaluated in later phase clinical trials for the purpose of submission to the U. S. Food and Drug Administration for use in HL.
1. Ribas A, Hodi FS, Kefford R, et al. Efficacy and safety of the anti-PD-1 monoclonal antibody MK-3475 in 411 patients (pts) with melanoma (MEL). J Clin Oncol 32:5s, 2014
2. Moskowitz C, Ribrag V, Michot J-M, et al. PD-1 Blockade with the Monoclonal Antibody Pembrolizumab (MK-3475) in Patients with Classical Hodgkin Lymphoma after Brentuximab Vedotin Failure: Preliminary Results from a Phase 1b Study (KEYNOTE-013). Presented at the 56th Annual Meeting of the American Society of Hematology. December 6-9, 2014. Abstract 290.
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