Voltin, Conrad-Amadeus ORCID: 0000-0002-5437-3959, Mettler, Jasmin, van Heek, Lutz, Goergen, Helen, Mueller, Horst, Baues, Christian, Keller, Ulrich, Meissner, Julia, Trautmann-Grill, Karolin, Kerkhoff, Andrea, Fuchs, Michael, Sasse, Stephanie, von Tresckow, Bastian, Dietlein, Markus, Borchmann, Peter, Engert, Andreas, Kobe, Carsten and Broeckelmann, Paul J. (2021). Early Response to First-Line Anti-PD-1 Treatment in Hodgkin Lymphoma: A PET-Based Analysis from the Prospective, Randomized Phase II NIVAHL Trial. Clin. Cancer Res., 27 (2). S. 402 - 408. PHILADELPHIA: AMER ASSOC CANCER RESEARCH. ISSN 1557-3265

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Abstract

Purpose: A primary analysis of the ongoing NIVAHL trial demonstrated unexpectedly high interim complete response rates to nivolumab-based first-line treatment in early-stage unfavorable Hodgkin lymphoma. However, biomarkers such as metabolic tumor volume (MTV) or total lesion glycolysis (TLG) and their change under treatment (Delta MTV and Delta TLG), measured on PET, might provide additional relevant information for response assessment in this setting. Hence, the current analysis aimed to investigate early response to checkpoint inhibitor therapy beyond conventional criteria. Patients and Methods: NIVAHL is a prospective, randomized phase II trial that recruited between April 2017 and October 2018. Patients in arms A and B were assessed for early treatment response after two courses of doxorubicin, vinblastine, and dacarbazine with two concomitant nivolumab infusions per cycle (2 X N-AVD) and 4 X nivolumab, respectively. In the current analysis, we included all 59 individuals with PET images available to the central review panel for quantitative analysis before April 30, 2019. Results: At interim restaging, we determined a mean DMTV and DTLG of -99.8% each in arm A after 2 X N-AVD, compared with -91.4% and -91.9%, respectively, for treatment group B undergoing 4 X nivolumab. This high decrease in MTV and TLG was observed regardless of the initial lymphoma burden. Conclusions: Our study showed that nivolumab-based first-line treatment leads to rapid, near-complete reduction of tumor metabolism in early-stage unfavorable Hodgkin lymphoma. Thus, PETderived biomarkers might allow reduction or even omission of chemotherapy and radiotherapy. Furthermore, MTV and TLG could be also used to optimize immune checkpoint-targeting treatments in other cancers.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Voltin, Conrad-AmadeusUNSPECIFIEDorcid.org/0000-0002-5437-3959UNSPECIFIED
Mettler, JasminUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
van Heek, LutzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Goergen, HelenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, HorstUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Baues, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Keller, UlrichUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meissner, JuliaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Trautmann-Grill, KarolinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kerkhoff, AndreaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Fuchs, MichaelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Sasse, StephanieUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Tresckow, BastianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Dietlein, MarkusUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Borchmann, PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Engert, AndreasUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kobe, CarstenUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Broeckelmann, Paul J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-600328
DOI: 10.1158/1078-0432.CCR-20-3303
Journal or Publication Title: Clin. Cancer Res.
Volume: 27
Number: 2
Page Range: S. 402 - 408
Date: 2021
Publisher: AMER ASSOC CANCER RESEARCH
Place of Publication: PHILADELPHIA
ISSN: 1557-3265
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
SURVIVORS; CRITERIA; RISKMultiple languages
OncologyMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60032

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