A Chinese patient with relapsed and refractory Hodgkin lymphoma treated with brentuximab vedotin

At present,approximately 20%of Hodgkin lymphomas(HL)are relapsed and refractory,and therapeutic methods including chemotherapy,radiotherapy,and even stem cell transplantation are unsatisfactory.Brentuximab vedotin,composed of CD30 antibody and a chemotherapeutic agent,is a new targeted drug that eradicates tumor cells by binding to the CD30 antigen on their surface.In clinical trials,the response rate and complete remission rate of this drug were 73%and 40%,respectively,for relapsed and refractory HL.Here we report a case of CD30-positive relapsed and refractory HL that was treated with brentuximab.Before the treatment with brentuximab,the patient underwent chemotherapy,radiotherapy,and autologous stem cell transplantation.However,the disease continued to progress,affecting multiple organs and prompting symptoms such as persistent fever.After the treatment with brentuximab,the patient′s condition improved.Body temperature returned to normal after 4 days.Lung nodules were reduced in size and number after a single course of treatment,and PET/CT showed partial remission and complete remission after 3 and 6 courses of treatment,respectively.The entire treatment process progressed smoothly,though the patient experienced some symptoms due to chemotherapy,including peripheral neuritis of the limbs,irritating dry cough,and mild increase in aminotransferase.No serious adverse effects were observed.The current general condition of the patient is good;the continuous complete remission has amounted to 6 months.

Treatment of CD20-directed Chimeric Antigen Receptor-modified T cells in patients with relapsed or refractory B-cell non-Hodgkin lymphoma:an early phase IIa trial report

Patients with relapsed or refractory non-Hodgkin lymphoma have a dismal prognosis.Chimeric Antigen Receptor(CAR)-modified T cells(CART cells)that targeted CD20 were effective in a phase I clinical trial for patients with advanced B-cell lymphomas.We performed a phase IIa trial to further assess the safety and efficacy of administering autologous anti-CD20 CART(CART-20)cells to patients with refractory or relapsed CD20^(+)B-cell lymphoma.Eleven patients were enrolled,and seven patients underwent cytoreductive chemotherapy to debulk the tumors and deplete the lymphocytes before receiving T-cell infusions.The overall objective response rate was 9 of 11(81.8%),with 6 complete remissions(CRs)and 3 partial remissions;no severe toxicity was observed.The median progression-free survival lasted for 46 months,and 1 patient had a 27-month continuous CR.A significant inverse correlation between the levels of the CAR gene and disease recurrence or progression was observed.Clinically,the lesions in special sites,specifically the spleen and testicle,were refractory to CART-20 treatment.Collectively,these results together with our data from phase I strongly demonstrated the feasibility and efficacy of CART-20 treatment in lymphomas and suggest large-scale patient recruitment in a future study.This study was registered at www.clinicaltrials.org as NCT01735604.

Long-term safety and efficacy of CART-20 cells in patients with refractory or relapsed B-cell non-Hodgkin lymphoma:5-years follow-up results of the phase I and IIa trials

For refractory or relapsed(r/r)B-cell non-Hodgkin lymphoma(NHL),the response rates to conventional salvage chemotherapy are 27–44%.1 Chimeric antigen receptors(CARs)efficiently redirect T-cell specificity and cytotoxicity to cells expressing the targeted Ag in an HLA-independent manner.2 The early phase clinical trials of CART cells for(r/r)B-cell NHL have demonstrated promising results..