PD-1 inhibitors plus chemotherapy for refractory EBV-positive DLBCL:a retrospective analysis
10.1007/s44313-024-00042-6
- Author:
Youli LI
1
;
Yonghe WU
;
Sufen CAO
;
Baohua YU
;
Qunling ZHANG
;
Zuguang XIA
;
Junning CAO
;
Fangfang LV
;
Guang‑Liang CHEN
Author Information
1. Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China
- Publication Type:RESEARCH
- From:Blood Research
2024;59():36-
- CountryRepublic of Korea
- Language:English
-
Abstract:
Background:Immunochemotherapy has demonstrated a promising efficacy for a variety of B-cell lymphoma but has limited efficacy for Epstein–Barr virus-positive (EBV +) diffuse large B-cell lymphoma (DLBCL) that is refractory or relapsed to conventional chemotherapy regimens. Considering higher programmed death-ligand 1 (PD-L1) expres‑ sion in the subset of patients with DLBCL with positive EBV, we speculated that PD-1 inhibitors plus chemotherapy may be an alternative regimen in patients with refractory/relapsed EBV + DLBCL.
Methods:This retrospective study included six adult patients diagnosed with refractory EBV + DLBCL resistant to first-line immunochemotherapy regimens (R-CHOP). These patients received PD-1 inhibitors plus chemotherapy as second-line treatment.
Results:The final analysis included six patients (four men and two women (median age, 50 years; range, 39–83 years)). Four patients were diagnosed with Epstein–Barr virus (EBV) + DLBCL, and two had DLBCL associated with chronic inflammation. Over a median follow-up of 20 months (range, 2–31 months), the objective response rate was 83% (5/6) and the complete remission rate was 67% (4/6). No severe immune-related adverse reactions occurred, and only a mild rash was reported, which did not necessitate the discontinuation of therapy.
Conclusion:The combination of PD-1 inhibitors and chemotherapy offers promising results as a second-line treat‑ ment for patients with refractory EBV + DLBCL that is resistant to first-line immunochemotherapy regimens. These preliminary findings warrant further investigation in larger clinical trials to validate the efficacy and safety of this therapeutic approach.