Pidilizumab in the treatment of diffuse large B-cell lymphoma

• Published in: Expert opinion on biological therapy Vol. 14; no. 9; p. 1361
• Main Authors: Bryan, Locke J, Gordon, Leo I
• Format: Journal Article
• Language: English
• Published: England 01-09-2014
• Subjects: Adjuvants, Immunologic - therapeutic use; Antibodies, Monoclonal - therapeutic use; Antineoplastic Agents - therapeutic use; Clinical Trials as Topic; Disease-Free Survival; Hematopoietic Stem Cell Transplantation; Humans; Immunotherapy - methods; Lymphoma, Large B-Cell, Diffuse - drug therapy; Lymphoma, Large B-Cell, Diffuse - therapy; Molecular Targeted Therapy; Programmed Cell Death 1 Receptor - antagonists & inhibitors; pidilizumab; non-Hodgkin lymphoma; diffuse large B-cell lymphoma; programmed death-1; monoclonal antibody
• ISSN: 1744-7682
• DOI: 10.1517/14712598.2014.942637

The programmed death-1 (PD-1) immune checkpoint pathway is an emerging target in the treatment of hematologic malignancies. Pidilizumab is an mAb that binds to PD-1 and is a safe and well-tolerated therapy. Recent data have shown clinical activity utilizing this strategy in diffuse large B-cell lymphoma (DLBCL).
The role of PD-1 expression in hematologic malignancies is explored. Recent clinical trials including the results of a Phase I trial in hematologic malignancies and a Phase II trial of pidilizumab following autologous hematopoietic stem-cell transplant (AHSCT) are reviewed.
We review data that suggest that PD-1 is a promising target in the treatment and management of DLBCL. Changes in immune subsets following administration of pidilizumab are felt to represent on-target responses. The improvement in progression-free survival (PFS) following AHSCT supports a response to therapy. Importantly, the improvement in PFS for patients with positive FDG-PET/CT following AHSCT indicating residual disease further supports direct activity of pidilizumab in DLBCL.