Blood: Efficacy and safety of netoplasm for relapse of blood malignancies after alloHCT
Last Update: 2020-06-16
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CTLA-4 blocking enhances the anti-tumor effect of an allogeneic hematopoietic cell transplant (alloHCT) in recurrent malignant blood disease (HMs)The interaction of PD-1/PDL-1 can also lead to impaired T-cell function, but retrospective studies of post-alloHCT anti-PD-1 therapy have reported significant toxicity to GVHDThis trial is a forward-looking, multi-center Phase I clinical trial designed to assess the effect of PD-1 blocking on recurrent HMs after alloHCTRecruit patients with alloHCT relapsed HMsThe main purpose is to identify the maximum tolerable dose and safety of Nivolumab for this type of patientThe secondary purpose is to assess the effectiveness and immune activity of NivolumabA total of 28 patients (19 myelin tumors, 9 lymphomas) were recruited and Treated with Nivolumab for 1/2 weeks until the course progresses or intolerable toxicity;The median age of the subjects was 57 years (range 27-76 years old), and the median time from alloHCT to the intake group was 21 months (range 5.6-108.5 months)Two of the 6 patients treated with 1 mg/kg had dose-restricted toxicity (DLT) caused by immuno-related adverse events (irAEs);The total effectiveness of the patient can be assessed is 32% (8/25)Median follow-up was 11 months, with 1 year PFS and OS at 23% and 56%, respectivelyIn summary, in the first anti-PD-1 antibody treatment after alloHCT recurrence of forward-looking clinical trials, gvHD and irAEs, the need to reduce the dose, and only moderate anti-tumor activity, suggesting that in the further study of anti-PD-1 treatment may need to develop specific toxicological mitigation strategies
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