Complete remission of refractory disseminated NK/T cell lymphoma with brentuximab vedotin and bendamustine

Poon, Limei; Kwong, Yok–Lam

doi:10.1007/s00277-016-2627-9

Cited by 50 publications

(42 citation statements)

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“…From the results of this study, it is feasible that many ENKTL cases could be treated with anti‐CD30 antibody‐based therapies, including BV. According to 2 previous reports, BV is effective for the treatment of patients with refractory ENKTL expressing CD30 . One patient achieved a complete response after salvage treatment with BV (1.8 mg/kg on day 1) and bendamustine (90 mg/m 2 on days 1 and 2) every 3 weeks .…”

Section: Discussionmentioning

confidence: 95%

“…According to 2 previous reports, BV is effective for the treatment of patients with refractory ENKTL expressing CD30 . One patient achieved a complete response after salvage treatment with BV (1.8 mg/kg on day 1) and bendamustine (90 mg/m 2 on days 1 and 2) every 3 weeks . The other patient also achieved a complete response after 4 cycles of single BV (1.8 mg/kg on day 1 every 3 wk) .…”

Section: Discussionmentioning

confidence: 97%

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Frequent expression of CD30 in extranodal NK/T‐cell lymphoma: Potential therapeutic target for anti‐CD30 antibody‐based therapy

Kawamoto

Miyoshi

Suzuki

et al. 2017

Hematological Oncology

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Extranodal NK/T-cell lymphoma, nasal type (ENKTL) is a subtype of non-Hodgkin lymphoma with a poor prognosis. Although first-line treatments for patients with localized ENKTL have been established, there is no gold standard treatment for patients with advanced ENKTL and refractory and/or relapsed disease. Anti-CD30 antibody-based therapy, including brentuximab vedotin (BV), has been shown to target malignant lymphomas with CD30 expression. In particular, this therapeutic agent has recently been suggested to be effective for Hodgkin lymphoma and mature T-cell lymphoma. However, the efficacy of BV toward ENKTL has not yet been established. Therefore, we investigated the expression of CD30 in a large cohort to evaluate BV as a potential treatment for ENKTL. In this study, 97 Japanese patients with newly diagnosed ENKTL between January 2007 and December 2015 were enrolled. Flow cytometry and immunohistochemistry were performed for the evaluation of CD30 expression. If the cut-off value of CD30 expression is 1% or more, there were 55 positive cases (56.5%). According to the localization of lesion, the frequency of CD30 expression was significantly higher in the non-nasal type than in the nasal type (P = .0394). No differences were observed in almost all clinical characteristics between CD30-positive cases and CD30-negative cases. In addition, the expression of CD30 was not a prognostic factor for either overall survival or progression-free survival. In conclusion, frequent expression of CD30 in ENKTL suggests anti-CD30 antibody-based therapy may be an effective treatment.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 97%

Frequent expression of CD30 in extranodal NK/T‐cell lymphoma: Potential therapeutic target for anti‐CD30 antibody‐based therapy

Kawamoto

Miyoshi

Suzuki

et al. 2017

Hematological Oncology

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“…The expression of CD30 has reported in about 40% of NK/T-cell lymphoma (with 5% positivity as cutoff) 81. Accordingly, the use of the anti-CD30 antibody conjugate brentuximab vedotin has resulted in remission in two cases of refractory disseminated NK/T-cell lymphoma 82,83. Hence, the use of brentuximab vedotin in NK/T-cell lymphoma should be further investigated.…”

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confidence: 94%

Diagnosis and management of extranodal NK/T cell lymphoma nasal type

Tse

Kwong

2016

Expert Review of Hematology

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The diagnosis and management of NK/T-cell lymphoma is discussed, based on a literature search on PubMed. NK/T-cell lymphoma are typically positive for CD3 (cytoplasmic), CD56, cytotoxic markers (granzyme B, TIA1) and Epstein Barr virus (EBV). Plasma EBV DNA is an accurate surrogate biomarker for lymphoma load. For stage I/II nasal lymphoma, a combination of chemotherapy and radiotherapy yields the best results. Concomitant chemoradiotherapy and sequential chemotherapy and radiotherapy give similar response rates and survivals. For stage III/IV nasal lymphoma and non-nasal lymphomas, chemotherapy is the mainstay of treatment. Conventional anthracycline-based regimens are ineffective. Recommended chemotherapy protocols are based on the use of L-asparaginase combined with other effective drugs. Durable remission can be expected in at least 60% of patients irrespective of stage. Prognostically models based on clinicopathologic parameters and EBV DNA load are useful in stratification of patients for therapy. Expert commentary: Current treatment leads to long-term survival in a significant proportion of patients. For relapsed patients, novel strategies are needed.

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“…NK/T-cell lymphomas express CD30 in about 40% of cases [79]. In cases that expressed CD30, the anti-CD30 antibody brentuximab vedotin had been shown in anecdotal reports to be effective after failure of L-asparaginase regimens [80, 81]. …”

Section: Introductionmentioning

confidence: 99%

The diagnosis and management of NK/T-cell lymphomas

2017

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Extranodal natural killer (NK)/T-cell lymphoma is an aggressive malignancy of putative NK-cell origin, with a minority deriving from the T-cell lineage. Pathologically, the malignancy occurs in two forms, extranodal NK/T-cell lymphoma, nasal type; and aggressive NK-cell leukaemia. Lymphoma occur most commonly (80%) in the nose and upper aerodigestive tract, less commonly (20%) in non-nasal areas (skin, gastrointestinal tract, testis, salivary gland), and rarely as disseminated disease with a leukemic phase. Genetic analysis showed mutations of genes involved in the JAK/STAT pathway, RNA assembly, epigenetic regulation, and tumor suppression. In initial clinical evaluation, positron emission tomography computed tomography, and quantification of plasma EBV DNA are mandatory as they are useful for response monitoring and prognostication. In stage I/II diseases, combined chemotherapy and radiotherapy (sequentially or concurrently) is the best approach. Conventional anthracycline-containing regimens are ineffective and should be replaced by non-anthracycline-containing regimens, preferably including L-asparaginase. Radiotherapy alone is associated with high systemic relapse rates and should be avoided. In stage III/IV diseases, non-anthracycline-regimens-containing L-asparaginase are the standard. In relapsed/refractory cases, blockade of the programmed death protein 1 has recently shown promising results with high response rates. In the era of effective non-anthracycline-containing regimens, autologous haematopoietic stem cell transplantation (HSCT) has not been shown to be beneficial. However, allogeneic HSCT may be considered for high-risk or advanced-stage patients in remission or relapsed/refractory patients responding to salvage therapy. Prognostic models taking into account presentation, interim, and end-of-treatment parameters are useful in triaging patients to different treatment strategies.

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Complete remission of refractory disseminated NK/T cell lymphoma with brentuximab vedotin and bendamustine

Cited by 50 publications

References 10 publications

Frequent expression of CD30 in extranodal NK/T‐cell lymphoma: Potential therapeutic target for anti‐CD30 antibody‐based therapy

Frequent expression of CD30 in extranodal NK/T‐cell lymphoma: Potential therapeutic target for anti‐CD30 antibody‐based therapy

Diagnosis and management of extranodal NK/T cell lymphoma nasal type

The diagnosis and management of NK/T-cell lymphomas

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