Abstract
Background Classic Hodgkin's lymphoma (cHL) is characterized by the unique biology in which rare Hodgkin-Reed-Sternberg cells propagate an immunosuppressive microenvironment. Checkpoint inhibitors that target the interaction of PD-1 immune checkpoint receptors have demonstrated remarkable activities in various cancers, such as cHL. This study aims to evaluate the safety and efficacy of PD-1 inhibitors in treating relapsed or refractory cHL (rrHL). Methods We searched PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang, Chinese Biological Medical Literature, and s of Conference proceedings of annual meetings without any language restrictions to limit language bias (up to January 2019) for prospective clinical trials that evaluate PD-1 inhibitors in treating relapsed or refractory cHL. Results A total of 9 prospective clinical trials with 731 patients were included in the meta-analysis. The pooled risks of all-grade and grade ≥3 adverse events (AEs) were 0.86 (95% CI: 0.66–0.98) and 0.21 (95% CI: 0.17–0.24), respectively. The pooled response, complete response, partial response, and stable disease rates were 0.74 (95% CI: 0.70–0.79), 0.24 (95% CI: 0.18–0.34), 0.48 (95% CI: 0.41–0.55), and 0.15 (95% CI: 0.12–0.17), respectively. The pooled 6-month progression-free survival and 1-year overall survival rates were 0.76 (95% CI: 0.72–0.79) and 0.93 (95% CI: 0.90–0.96), correspondingly. Conclusions Our meta-analysis suggested that anti-PD1 monoclonal antibodies improve the outcomes of response and survival rates with tolerable AEs in cHL. However, evidence of immune checkpoint inhibitors for patients with cHL remained insufficient. Well-designed randomized controlled trials or at least nonrandomized trials with a control group should be conducted to confirm the findings of this meta-analysis.
Highlights
Hodgkin’s lymphoma (HL) is a lymphatic system cancer and accounts for 10%–15% of all lymphomas, which involve the liver, lung, and bone marrow at different tumor stages [1]
Goldkuhle et al [25] reviewed the benefits and disadvantages of nivolumab in adults with HL, and the results showed that the 6-month progression-free survival (PFS) is between 60% and 86%, and complete response (CR) rates range from 12% to 29%
A total of 731 patients were included in the meta-analysis, in which 282 patients received nivolumab, 241 patients received pembrolizumab, 72 patients received nivolumab + brentuximab vedotin, 31 patients received nivolumab + ipilimumab, and 92 patients received sintilimab (IBI308)
Summary
Hodgkin’s lymphoma (HL) is a lymphatic system cancer and accounts for 10%–15% of all lymphomas, which involve the liver, lung, and bone marrow at different tumor stages [1]. E standard of care for patients with relapsed or refractory cHL is intensive salvage chemotherapy, followed by autologous hematopoietic cell transplantation, which can produce long-term remission in approximately 50% of patients [5]. Only 55% of the treated patients have been declared free from treatment failure with an 80% survival rate of 3 years [6]. Is study aims to evaluate the safety and efficacy of PD-1 inhibitors in treating relapsed or refractory cHL (rrHL). We searched PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang, Chinese Biological Medical Literature, and Abstracts of Conference proceedings of annual meetings without any language restrictions to limit language bias (up to January 2019) for prospective clinical trials that evaluate PD-1 inhibitors in treating relapsed or refractory cHL. Well-designed randomized controlled trials or at least nonrandomized trials with a control group should be conducted to confirm the findings of this meta-analysis
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