S822 NIVOLUMAB AND BRENTUXIMAB VEDOTIN‐BASED, RESPONSE‐ADAPTED TREATMENT IN PRIMARY REFRACTORY AND IN PEDIATRIC PATIENTS WITH RELAPSED/REFRACTORY CLASSICAL HODGKIN LYMPHOMA IN CHECKMATE 744
Notice bibliographique
Résumé
Background: Current first salvage therapies (tx) for younger patients (pts) with relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL) are associated with variable cure rates and long‐term toxicities. New strategies are required, especially in primary refractory and pediatric pts. In adult R/R cHL, first salvage with nivolumab + brentuximab vedotin (BV) resulted in 82% objective response rate (ORR) with 61% complete metabolic response (CMR; Herrera et al. Blood 2018). CheckMate 744 (NCT02927769) is an ongoing phase 2 study evaluating a risk‐stratified, response‐adapted approach using nivolumab, BV, and bendamustine in children, adolescents, and young adults with R/R cHL. In the standard‐risk cohort, the regimen was well tolerated and resulted in high CMR rates prior to consolidation with high‐dose chemotherapy and autologous transplantation (auto‐HCT; Harker‐Murray et al. ASH 2018). Aims: To assess efficacy and safety of this risk‐stratified, response‐adapted approach in primary refractory pts, and in pediatric pts (aged <18 y) in CheckMate 744, with a focus on the nivolumab + BV induction phase. Methods: Pts aged 5–30 y, after 1 prior tx without auto‐HCT were eligible. Risk stratification to the standard‐risk cohort (R2) was based on disease stage at diagnosis, time to relapse, B symptoms or extranodal disease at relapse, extensive disease with radiation tx (RT) contraindicated at relapse, or relapse in a prior RT field. In the #R2 cohort, pts received 4 cycles of induction tx with nivolumab + BV. Tx could be administered in the outpatient setting at the investigator's discretion. Tumors were assessed after every 2 cycles by investigators and blinded independent central review (BICR) per Lugano 2014 criteria. Pts who achieved CMR proceeded to consolidation with high‐dose chemotherapy/auto‐HCT. Pts with suboptimal response after induction received 2–4 cycles of BV + bendamustine intensification and proceeded to consolidation if they achieved CMR. Primary endpoint was CMR rate per BICR any time before consolidation. Efficacy and safety in primary refractory pts, and in pts aged <18 y were post hoc analyses. Results: 44 pts were treated in the #R2 cohort. At baseline, median age was 16 y; 31 pts (70%) were aged <18 y and 24 pts (55%) had primary refractory disease. Median duration of follow‐up was 43 wk overall and 47 wk in pts aged <18 y. Ten pts aged <18 y entered intensification; of these, only 2 received 4 intensification cycles. BICR‐assessed CMR rates and ORR after induction and at any time prior to consolidation for primary refractory pts and pts aged <18 y are shown in the Table. Overall, 12/44 pts (27%) experienced a grade 3–4 tx‐related adverse event (TRAE). Among pts aged <18 y, 10/31 (32%) experienced a grade 3–4 TRAE, most commonly neutropenia (2/31; 6%). There were no deaths or TRAEs leading to discontinuation. Tx‐related immune‐mediated AEs were all grade 1‐2, and were maculopapular rash, hypersensitivity, and infusion‐related reaction (1 pt each). Summary/Conclusion: Response‐adapted tx with nivolumab + BV achieved high CMR rates in primary refractory pts with cHL after 4 cycles of induction. In pediatric pts with a standard risk of relapse, induction with nivolumab + BV, followed by BV + bendamustine intensification for suboptimal response, demonstrated high CMR rates and a favorable safety profile prior to consolidation. image
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».