Can a stem cell transplant improve outcomes of patients with cHL after nivolumab treatment?

This study evaluated the outcomes of a stem cell transplant after nivolumab (Opdivo) therapy in patients with classical Hodgkin’s lymphoma (cHL) that came back or stopped responding to treatment. This study concluded that nivolumab followed by stem cell transplant is safe and effective for these patients.

Standard first-line chemotherapy is highly effective in treating 70 – 80% of patients with cHL. Unfortunately, many patients experience cancer recurrence or develop disease that stops responding to treatment. Targeted therapy can help improve patient outcomes while minimizing side effects.

Targeted therapies attack cancer cells and interfere with their growth or function. Nivolumab is an antibody-based drug that helps the immune system attack cancer cells. Stem cell transplantation (SCT) can also be used after treatment to get rid of cancer cells. However, whether SCT can provide better outcomes for patients with cHL that came back or stopped responding to treatment that received nivolumab is unclear.

This study looked at the records of 74 patients with HL that came back or stopped responding to treatment. Patients were given nivolumab followed by a SCT. Patients were followed-up for an average of 18.4 months.

Overall, 59.7% of patients responded to nivolumab. 30.6% of patients had no signs of cancer after treatment. 29.1% of patients had tumor shrinkage. 42 patients then underwent SCT.

Overall, 52% of all patients were still alive 2 years later. Among patients who responded to nivolumab, significantly more patients who had SCT were still alive 2 years later (77.5% vs. 42.6%). These patients who had SCT were still alive 2 years later without the cancer getting worse (73.9% vs. 27.2%).

29 patients did not have SCT. Among these patients, 17.2% had no signs of cancer after nivolumab treatment. 27.6% had tumor shrinkage. 21% of these patients were still alive 2 years later. 18% were still alive without the cancer getting worse.

56.8% of patients had side effects. The most common ones were infection (20.3%), liver damage, diarrhea and rash (9.5% each), and low white blood cell levels (8%).

This study concluded that nivolumab is safe and effective in patients with HL that came back or stopped responding to treatment. The authors suggest that having SCT after nivolumab may improve survival outcomes for these patients.

This study was small and looked back in time to analyze data. This may limit the results. More studies are needed. This study received funding support from Bristol-Myers Squibb, the manufacturer of nivolumab.