Posted: Wednesday, June 15, 2022
Combination treatment with the PD-1 inhibitor nivolumab and the antibody-drug conjugate brentuximab vedotin in patients with primary mediastinal large B-cell lymphoma (LBCL) may prove to be effective, according to the preliminary findings from the PACIFIC trial presented at the European Hematology Association (EHA) 2022 Hybrid Congress (Abstract P1222). However, the limited evidence suggests that additional efforts are necessary to optimize primary therapy for this patient population, explained Raphael Eric Steiner, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues.
A total of 40 patients with untreated primary mediastinal DLBCL are expected to be enrolled in the study; however, only 2 patients have been recruited to date and have begun treatment. All patients will begin by receiving an intravenous dose of 240 mg of nivolumab and 1.8 mg/kg of brentuximab vedotin on day 1 of the first two 21-day cycles. During cycles 3 and 4, a regimen of rituximab, cyclophosphamide, doxorubicin, and prednisone (R-CHP) will be added to the initial treatment protocol. Patients will then have a PET/CT scan to determine whether they exhibit a partial or complete response to treatment, which will dictate the remainder of therapy.
Thus far, a partial response after two cycles of nivolumab and brentuximab vedotin was observed in both patients. Both patients have experienced the typical grade 1 adverse effects associated with the drugs in the treatment regimen, including hypophosphatemia, leukocytosis, hyperglycemia, nausea, fatigue, and anemia. Moreover, one of the patients experienced a grade 3 rash thought to be associated with treatment.
Disclosure: For full disclosures of the study authors, visit library.ehaweb.org.