In a nutshell
This study examined the safety and effectiveness of pembrolizumab in the treatment of chronic lymphocytic leukemia that has undergone Richter’s transformation. This study concluded that patients with Richter’s transformation responded to pembrolizumab.
Some background
Chronic lymphocytic leukemia is a cancer where the bone marrow makes too many lymphocytes (white blood cells). Some patients do not respond to initial treatment and the leukemia progresses. They can develop Richter’s transformation, which is a transformation into an aggressive cancer that can lead to poorer outcomes.
Pembrolizumab (Keytruda) is a treatment that blocks a protein (PD-1) present on many cancer cells. This can lead the immune system to attack the cells. Pembrolizumab is often used in lung cancer, skin cancer and Hodgkin’s lymphoma. It is suggested that pembrolizumab would be effective in chronic lymphocytic leukemia that has relapsed (cancer that has returned) or has undergone Richter’s transformation.
Methods & findings
16 patients with relapsed or refractory (not responding to treatment) chronic lymphocytic leukemia and 9 patients with Richter’s transformation were studied. Patients received an average 3 cycles of pembrolizumab. The average length of treatment was 7.5 weeks for patients with chronic lymphocytic leukemia and 13 weeks for patients with Richter’s transformation. Patients were followed-up for an average 10.4 months.
The average overall survival (time from treatment until death from any cause) for all patients was 10.7 months. 44% of patients with Richter transformation responded to pembrolizumab. Of these, one patient achieved a complete response to pembrolizumab (no evidence of disease). Three patients achieved a partial response, four patients had stable disease, and one saw disease progression. Patients with chronic lymphocytic leukemia and no Richter’s transformation stopped pembrolizumab treatment because there was no response.
All patients experienced negative side effects. 60% of patients had a severe adverse event. 20% of patients had low levels of white blood cells and 20% of patients had low red blood cells which was caused by treatment. 8% of patients had shortness of breath.
The bottom line
This study concluded taht patients with chronic lymphocytic leukemia who underwent Richter’s transformation responded to pembrolizumab.
The fine print
There was a small number of patients studied. Further studies are necessary.
Published By :
Blood
Date :
Apr 19, 2017
