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PD-1 blockade combined with ICE regimen in relapsed/refractory diffuse large B-cell lymphoma

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Abstract

The prognosis of relapsed/refractory (R/R) diffuse large B-cell lymphoma (DLBCL) is poor. The efficacy of salvage therapy with ICE (ifosfamide, carboplatin, and etoposide) is limited. DLBCL can evade immune surveillance by upregulating programmed cell death ligand 1 (PD-L1). The purpose of this study was to explore the efficacy and safety of programmed cell death 1 (PD-1) blockade combined with ICE regimen (P-ICE) in the treatment of R/R DLBCL patients. In this study, we retrospectively explored efficacy and toxicity in R/R DLBCL patients treated with P-ICE. Prognostic biomarkers, including clinical features and molecular markers related to efficacy, were explored. From February 2019 to May 2020, a total of 67 patients treated with the P-ICE regimen were analyzed. The median follow-up time was 24.7 months (range: 1.4–39.6 months), with an objective response rate (ORR) of 62.7% and a complete response rate (CRR) of 43.3%. The 2-year progression-free survival (PFS) and overall survival (OS) rates were 41.1% (95% CI: 35.0–47.2%) and 65.6% (95% CI: 59.5–71.7%), respectively. Age, Ann Arbor stage, international prognostic index (IPI) score, and response to first-line chemotherapy were correlated with the ORR. Grade 3 and 4 adverse events (AEs) related to the P-ICE regimen were reported in 21.5% of patients. The most common AE was thrombocytopenia (9.0%). No treatment-related deaths occurred. In patients with R/R DLBCL, the P-ICE regimen has promising efficacy and mild toxicity.

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Funding

This study was supported by the National Science & Technology Major Project (2017ZX09304021).

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Authors and Affiliations

  1. Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, Guangdong, People’s Republic of China

    Liqin Ping, Yan Gao, Yanxia He, Bing Bai, Cheng Huang, Xiaoxiao Wang & Huiqiang Huang

  2. Nanjing Geneseeq Technology Inc., Nanjing, Jiangsu, People’s Republic of China

    Lina Shi

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  1. Liqin Ping
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Contributions

All authors participated in this research, including conception and design (PLQ, WXX, HHQ), data acquisition (PLQ, GY, HYX, BB, HC, SLN, WXX, HHQ), data analysis and interpretation (PLQ, HYX, SLN, HHQ), material support (PLQ, WXX, HHQ), study supervision (PLQ, WXX, HHQ), and drafting the article or critically revising (PLQ, WXX, HHQ). The final version was ensured and approved by all authors.

Corresponding authors

Correspondence to Xiaoxiao Wang or Huiqiang Huang.

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Ethics approval

Our study was approved by the Ethics Committee of Sun Yat-sen University Cancer Center Health Authority (identifier: B2021-093).

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The authors declare no competing interests.

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Liqin Ping, Yan Gao, and Yanxia He contributed equally to this work and share first authorship.

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277_2023_5292_Fig8_ESM.png

Supplementary file1 Supplementary Figure 1. The status of plasma ctDNA after the P-ICE regimen did not affect the prognosis of patients. Undetectable ctDNA was not related to PFS (A) or OS (B) (PNG 67 kb)

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Ping, L., Gao, Y., He, Y. et al. PD-1 blockade combined with ICE regimen in relapsed/refractory diffuse large B-cell lymphoma. Ann Hematol 102, 2189–2198 (2023). https://doi.org/10.1007/s00277-023-05292-5

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  • DOI: https://doi.org/10.1007/s00277-023-05292-5

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