PD-1 blockade combined with ICE regimen in relapsed/refractory diffuse large B-cell lymphoma.
Liqin PingYan GaoYanxia HeBing BaiCheng HuangLina ShiXiaoxiao WangHui-Qiang HuangPublished in: Annals of hematology (2023)
The prognosis of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) is poor. The efficacy of salvage therapy with ICE (ifosfamide, carboplatin, and etoposide) is limited. DLBCL can evade immune surveillance by upregulating programmed cell death ligand 1 (PD-L1). The purpose of this study was to explore the efficacy and safety of programmed cell death 1 (PD-1) blockade combined with ICE regimen (P-ICE) in the treatment of R/R DLBCL patients. In this study, we retrospectively explored efficacy and toxicity in R/R DLBCL patients treated with P-ICE. Prognostic biomarkers, including clinical features and molecular markers related to efficacy, were explored. From February 2019 to May 2020, a total of 67 patients treated with the P-ICE regimen were analyzed. The median follow-up time was 24.7 months (range: 1.4-39.6 months), with an objective response rate (ORR) of 62.7% and a complete response rate (CRR) of 43.3%. The 2-year progression-free survival (PFS) and overall survival (OS) rates were 41.1% (95% CI: 35.0-47.2%) and 65.6% (95% CI: 59.5-71.7%), respectively. Age, Ann Arbor stage, international prognostic index (IPI) score, and response to first-line chemotherapy were correlated with the ORR. Grade 3 and 4 adverse events (AEs) related to the P-ICE regimen were reported in 21.5% of patients. The most common AE was thrombocytopenia (9.0%). No treatment-related deaths occurred. In patients with R/R DLBCL, the P-ICE regimen has promising efficacy and mild toxicity.
Keyphrases
- diffuse large b cell lymphoma
- epstein barr virus
- ejection fraction
- free survival
- end stage renal disease
- newly diagnosed
- prognostic factors
- peritoneal dialysis
- clinical trial
- acute lymphoblastic leukemia
- randomized controlled trial
- bone marrow
- chronic kidney disease
- squamous cell carcinoma
- acute myeloid leukemia
- smoking cessation
- combination therapy
- hodgkin lymphoma
- drug induced