Low-dose pembrolizumab re-treatment induced complete radiologic and molecular remission in Hodgkin lymphoma recurring from a previous relapse successfully treated by pembrolizumab
The neoplastic Reed-Sternberg (RS) cells in classical Hodgkin lymphoma (cHL) characteristically over-express the programmed cell death ligand 1 (PDL1) and PDL2. Ligation of PDL1 and PDL2 with the inhibitory receptor PD1 on effector T cells is a mechanism by which RS cells escape immunosurveillance. Accordingly, blockade of PDL1/PDL2 binding to PD1 on effector T cells with anti-PD1 antibodies re-establishes anti-lymphoma immunity and is a novel therapeutic strategy for relapsed/refractory cHL .
Studies of two anti-PD1 antibodies nivolumab  and pembrolizumab  in relapsed/refractory cHL showed overall response rates (ORR) of 65–87% and complete response rates (CR) of 16–17%. The optimal post-remission strategies for patients treated with anti-PD1 antibodies have not been defined. Hematopoietic stem cell transplantation (HSCT) is performed for eligible patients. For HSCT-ineligible patients, a continuation of anti-PD1 antibodies is adopted. However, for patients...
Y.L. Kwong: treated the patient and wrote and approved the manuscript
F. Loong: performed the histopathologic diagnosis and wrote and approved the manuscript
P.L. Khong: performed the radiologic diagnosis and wrote and approved the manuscript
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
Patient gave informed consent to treatment.
- 2.Ansell SM, Lesokhin AM, Borrello I, Halwani A, Scott EC, Gutierrez M, Schuster SJ, Millenson MM, Cattry D, Freeman GJ, Rodig SJ, Chapuy B, Ligon AH, Zhu L, Grosso JF, Kim SY, Timmerman JM, Shipp MA, Armand P (2015) PD-1 blockade with nivolumab in relapsed or refractory Hodgkin’s lymphoma. N Engl J Med 372(4):311–319CrossRefGoogle Scholar
- 3.Armand P, Shipp MA, Ribrag V, Michot JM, Zinzani PL, Kuruvilla J, Snyder ES, Ricart AD, Balakumaran A, Rose S, Moskowitz CH (2016) Programmed death-1 blockade with pembrolizumab in patients with classical Hodgkin lymphoma after brentuximab vedotin failure. J Clin Oncol 34(31):3733–3739CrossRefGoogle Scholar
- 8.Green MR, Rodig S, Juszczynski P, Ouyang J, Sinha P, O’Donnell E, Neuberg D, Shipp MA (2012) Constitutive AP-1 activity and EBV infection induce PD-L1 in Hodgkin lymphomas and posttransplant lymphoproliferative disorders: implications for targeted therapy. Clin Cancer Res 18(6):1611–1618CrossRefGoogle Scholar