Evaluating nivolumab plus brentuximab vedotin for patients with relapsed or unresponsive primary mediastinal large B-cell lymphoma

This study evaluated nivolumab (Opdivo) plus brentuximab vedotin (Adcetris) in patients with relapsed or unresponsive primary mediastinal B-cell lymphoma (PMBCL). This study concluded that this combination is promising and was well-tolerated.

PMBCL is a rare but aggressive type of non-Hodgkin’s lymphoma (NHL). First-line treatment typically involves high-dose chemotherapy with or without radiation therapy. However, the cancer comes back or stops responding to treatment in 10 – 20% of patients. These patients need new treatment options.

Previous studies have shown that nivolumab plus brentuximab vedotin combination is effective for classical Hodgkin’s lymphoma. These agents are monoclonal antibodies. This type of treatment helps the body’s immune system attack cancer cells. Whether this combination is safe and effective for relapsed or unresponsive PMBCL is unclear.

This study had 30 patients with PMBCL that came back or stopped responding to treatment. On average, patients had an average of 2 prior lines of therapy. More than half (27 patients) had prior radiotherapy. Patients were followed-up for an average of 11.1 months.

At follow-up, 70% of all patients responded to treatment. 43% of patients had no signs of cancer after treatment. 52% of patients who responded to treatment had their tumors shrink by more than 50%. After treatment, 11 patients underwent a stem cell transplant. Of these, 10 patients had no signs of cancer after the transplant.

Overall, 86.3% of all patients were still alive 6 months later. 63.5% of patients did not have tumor growth or spread.

Overall, 83% of patients experienced side effects. 53% (16 patients) had serious side effects after an average of 5 cycles of treatment. Low white blood cell count was the most common (30%). Low platelet count (cells involved in blood clotting) and numbness or tingling in the hands and feet were also reported (27% each).

Due to side effects, 2 patients stopped treatment. 59% of patients had one or more cycles of nivolumab delayed, and 53% had one or more cycles of brentuximab vedotin treatment delayed.

This study concluded that nivolumab plus brentuximab vedotin showed promising effectiveness, with manageable side effects. The authors suggest that this combination may help eligible patients have a successful stem cell transplant.

This study had a very small number of patients. The follow-up period was also short (11.1 months). Larger studies with longer follow-up are needed to confirm these results.