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Checkmate 436 finds good results for combo therapy in PMBCL
Moskowitz AJ et al. ASH 2018. Abstract 1691.
Key clinical point:
Major finding: The overall response rate was 70%, including a complete response rate of 27%.
Study details: A phase 1/2 study of 30 patients.
Disclosures: This trial is supported by Bristol-Myers Squibb in collaboration with Seattle Genetics, and investigators reported relationships with a range of other companies.
Source: Moskowitz AJ et al. ASH 2018, Abstract 1691.
Citation:
Moskowitz AJ et al. ASH 2018. Abstract 1691.
Dr. David Henry, Editor in chief of MDedge Hematology/Oncology comments : Nivolumab and brentuximab vedotin are two novel targeted therapies available now for a wide range of cancers and, in particular, lymphoma. Nivolumab is an antibody directed against the PD1 receptor and brentuximab vedotin is a drug antibody conjugate targeting CD30 antigen and conjugated to the toxin, Vedotin, which then attacks the CD30 positive malignant cells.
Checkmate 436 trial addressed primary mediastinal large B-cell lymphoma (PMBCL) in the relapse refractory setting. These patients have very little effective therapies at this point.
PMBCL often over expresses the PD1 ligands, PDL1 and PDL2, and most PMBCL over express CD30 making combination therapy with these two antibodies promising. Checkmate 436 studied 30 patients with relapse refractory PMBCL. Median prior therapies 2. Surprisingly, the response rate was 70% with a complete response rate 27%. Nivolumab 240 mg and brentuximab vedotin 1.8 mg/kg IV every three weeks until progression or toxicity.
The toxicities were typical of these two drugs. Most common were neutropenia 27%, peripheral neuropathy 20%, hyperthyroidism 13%, rash 10%, thrombocytopenia 10%.
While this poster presentation at the ASH meeting in San Diego, December 2018, only had a median followup of 6.1 months and 10 patients are still on treatment, nevertheless, the results are extremely promising in this very difficult patient population. Overall progression free survival data not yet matured, but we will await with enthusiasm the next update of results in this trial.