The FDA-approved Hodgkin’s-lymphoma treatment Opdivo (nivolumab) may also be effective against primary central nervous system lymphoma (PCNSL) or primary testicular lymphoma (PTL), case studies suggest.
Researchers presented the results at the 58th annual meeting of the American Society of Hematology Dec. 3-6 in San Diego.
Opdivo acts against a protein called programmed death-1 (PD-1), which inhibits the immune system’s ability to detect cancer cells. By countering PD-1, Opdivo restores the body’s capacity to activate the anti-tumor response and fight cancer cells.
Because of its potential role as an immune-system-response enhancer, a range of clinical trials has been evaluating Opdivo’s ability to deal with a variety of tumors.
Two trials indicate that Opdivo holds great promise for patients with relapsed or refractory classical Hodgkin lymphoma who have received autologous stem cell transplants and treatment with Adcetris (brentuximab vendotin). The trials are Phase 2 CheckMate 205 (NCT02181738) and Phase 1 CheckMate 039.
A team led by Dr. Margaret Shipp of the Dana-Farber Cancer Institute found that both PCNSL and PTL have a key molecular abnormality in common with Hodgkin’s lymphoma. This prompted them to think that Opdivo might also be effective against the two non-Hodgkin’s lymphoma types.
Their study covered five patients with recurrent or refractory PCNSL or PTL who received Opdivo. Four showed no signs of a brain tumor after treatment. One showed a partial response to the therapy.
“There have been major advances in treatment of PCNSL, including high-dose chemotherapy and autologous stem cell transplant, particularly for young and healthy patients,” Lakshmi Nayak, MD, lead author of the study, said in a news release. “But because the median age at which patients are diagnosed is 65, transplant is often not an option. Our findings are very encouraging, particularly as the responses to nivolumab in our patients have been durable for more than 10 months.”
Based on the results, patients are being recruited for a new Phase 2 trial (CheckMate 647) of Opdivo. It will include a larger group with either relapsed or treatment-resistant PCNSL or PTL.
PCNSL and PTL are aggressive non-Hodgkin’s lymphomas that develop outside the lymph nodes and are resistant to conventional therapy. About half of PCNSL patients have relapses of the cancer within two years of diagnosis. In addition, about half of PTL patients’ conditions worsen after initial chemotherapy treatment.
