Hao YY, Chen PP, Yuan XG, Zhao AQ, Liang Y, Liu H, Qian WB. Chidamide and sintilimab combination in diffuse large B-cell lymphoma progressing after chimeric antigen receptor T therapy. World J Clin Cases 2022; 10(19): 6555-6562 [PMID: 35979312 DOI: 10.12998/wjcc.v10.i19.6555]
Corresponding Author of This Article
Wen-Bin Qian, MD, PhD, Doctor, Professor, Department of Hematology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. qianwb@zju.edu.cn
Research Domain of This Article
Hematology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yuan-Yuan Hao, Pan-Pan Chen, Xiang-Gui Yuan, Ai-Qi Zhao, Yun Liang, Hui Liu, Wen-Bin Qian, Department of Hematology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China
Author contributions: Hao YY conceived the study, analyzed data and drafted the manuscript; Chen PP and Yuan XG collected and analyzed data; Zhao AQ, Liang Y and Liu H reviewed the manuscript; Qian WB supported the study technically and reviewed the manuscript; all authors read and approved the final manuscript.
Informed consent statement: All involved persons gave their informed consent (verbal) prior to study inclusion.
Conflict-of-interest statement: The authors declare no competing interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Bin Qian, MD, PhD, Doctor, Professor, Department of Hematology, The Second Affiliated Hospital of Zhejiang University School of Medicine, No. 88 Jiefang Road, Hangzhou 310009, Zhejiang Province, China. qianwb@zju.edu.cn
Received: October 31, 2021 Peer-review started: October 31, 2021 First decision: March 7, 2022 Revised: April 10, 2022 Accepted: May 12, 2022 Article in press: May 12, 2022 Published online: July 6, 2022
Abstract
BACKGROUND
Diffuse large B-cell lymphoma (DLBCL) is curable with first-line chemoimmunotherapy but patients with relapsed/refractory (R/R) DLBCL still face a poor prognosis. For patients with R/R DLBCL, the complete response rate to traditional next-line therapy is only 7% and the median overall survival is 6.3 mo. Recently, CD19-targeting chimeric antigen receptor T cells (CAR-T) have shown promise in clinical trials. However, approximately 50% of patients treated with CAR-T cells ultimately progress and few salvage therapies are effective.
CASE SUMMARY
Here, we report on 7 patients with R/R DLBCL whose disease progressed after CAR-T infusion. They received a PD-1 inhibitor (sintilimab) and a histone deacetylase inhibitor (chidamide). Five of the 7 patients tolerated the treatment without any serious adverse events. Two patients discontinued the treatment due to lung infection and rash. At the 20-mo follow-up, the median overall survival of these 7 patients was 6 mo. Of note, there were 2 complete response rates (CRs) and 2 partial response rates (PRs) during this novel therapy, with an overall response rate (ORR) of 57.1%, and one patient had a durable CR that lasted at least 20 mo.
CONCLUSION
In conclusion, chidamide combined with sintilimab may be a choice for DLBCL patients progressing after CD19-targeting CAR-T therapy.
Core Tip: We used histone deacetylase inhibitor chidamide combined with PD-1 blockade sintilimab for 7 patients with diffuse large B-cell lymphoma progressing after CART therapy. There are 2 complete response rates (CRs) and 2 PRs during this novel therapy, with an overall response rates of 57.1%, and one patient had a durable CR that lasted at least 20 mo.
