PB2308: NIVOLUMAB-BASED THERAPY OF RELAPSED OR REFRACTORY PRIMARY LARGE B-CELL LYMPHOMA OF IMMUNE-PRIVILEGED SITES AND DLBCL WITH SECONDARY CNS INVOLVEMENT

• DOI: 10.1097/01.hs9.0000975956.49127.b4
• Publication Date: 2023-08-09T03:02:45Z
• Authors: Andrey Gavrilenko; Vladislav Markelov; Nikita Volkov; Daniil Shmidt; Yaroslav Skiba; Elena Kondakova; Lepik Kirill; Liudmila Fedorova; Marina Popova; Natalya Mikhaylova; Alexander Kulagin
• Keywords: Refractory (planetary science)

Topic: 19. Aggressive Non-Hodgkin lymphoma - Clinical Background: Primary large B-cell of immune-privileged sites (PLBLIPS) encompass primary central nervous system (PLCNS) and testicular (PTL) which are characterized by alterations the 9p24 locus leading to increased PD-L1 expression on tumor cells. Chapuy et al. demonstrated that systemic diffuse (DLBCL) with involvement CNS (SLCNS) or testis is generally belonged C5 subtype has mutational profile similar PLCNS PTL. In all mentioned diseases types, patients (pts) relapsed/refractory (r/r) disease after intensive chemotherapy have dismal prognosis, defining need for novel treatment approaches. such cases, anti-PD1 antibody nivolumab (Nivo) may represent an attractive feasible biology-driven therapeutic option. However, published data shown controversial information about efficacy Nivo in PLCNS. one case series 5 pts objective response (OR) r/r PLBLIPS was 100%, mono-Nivo, contrast CheckMate 647 study, enrolled 47 PLCNS, OR only reached 6,4% (L. Nayak al., Blood, 2017; L. NCT02857426). Aims: To evaluate Nivo-based therapy SLCNS. Methods: Since 2017 RM Gorbacheva Research Institute 14 9 SLCNS received treatment. cohort included 13 1 PTL involvement. tumors were presented DLBCL 8 (89%) mediastinal (11%). All had active at moment Patients characteristics summarized Table 1. Expression studied 4 Among positive (more then %) observed 7 cases (88%), among (100%). Response evaluated according International Lymphoma Collaborative Group criteria (Abrey al 2005). Results: monotherapy combined used 12 (86%) 2 (14%) (56%) (44%) respectively (Table 1). 10 (71%) from group 6 (67%) (p>0.05). Complete achieved (50%) respectively. At cut off median follow-up alive 32 months (mo) 33 mo Two-year overall survival (OS) 53% OS not (10,9 NR). 44%, (4,5 There no difference between groups (p=0.39). progression free (PFS) 31% 44% (p=0.93). The PFS 11,6 (2,2 NR) 5,6 (0,7 After 3 consolidation radiation (RT), underwent autologous hematopoietic stem cell transplantation (auto-HSCT), pt got maintenance ibrutinib. consolidated RT, auto-HSCT lenalidomide Summary/Conclusion: While reports regarding Nivolumab discordant, our analysis demonstrate its promising activity as part combination SLNCS. Keywords: Immunotherapy, Relapsed lymphoma,