Lymphoma Express: The first XPO1 inhibitor to treat r/r DLBCL; how is CAR-T treatment progress

Article source: Med

Author: MedWatch×

Based on PubMed, Clinicaltrials.

1.

In July 2020, the study was officially published in Lancet Haematology (ORR: 28%).

SADAL research key data (source: NextMed database)

OS subgroup analysis (Source: J Hematol Oncol)

The results show that for patients with relapsed or refractory DLBCL who have previously received ≥2 lines of chemoimmunotherapy, the oral monotherapy Selinesor can induce sustained anti-tumor activity, and adverse reactions can be controlled

2.

In July of this year, J Hematol Oncol reported a single-center, retrospective study conducted by Professor Han Weidong’s team from the Chinese People’s Liberation Army General Hospital.

Two patients achieved complete remission after receiving PD-1 blockade therapy, one patient had partial remission, and the other two patients had disease progression

The study shows that PD-1 blockade therapy is effective for DLBCL patients who have failed the treatment of CAR-T cells expressed by tumor cells PD-1, and it is worthy of further study

3.

The median age of the patients was 64 years old, 90% had advanced disease, 81% of patients received an anthracycline-based treatment regimen, and 13% of patients received consolidated autologous stem cell transplantation (ASCT) at the first complete remission

Multivariate analysis showed that age ≥60 years, ECOG PS ＞2, elevated C-reactive protein and elevated β2 microglobulin were associated with poor prognosis

This large-scale prospective observational study shows that the demand for AITL treatment is still unmet, and there is an urgent need to find new and effective treatment options

4.

FDG-PET imaging is the gold standard for the mid-term evaluation of patients with classic Hodgkin’s lymphoma (cHL).
However, due to its radioactivity and high cost, FDG-PET imaging cannot be used repeatedly and repeatedly.
Therefore, a new, micro Innovative assessment methods are necessary
.
In July of this year, J Extracell Vesicles published the latest research by D Michiel Pegtel's team from Vrije Universiteit Amsterdam, Netherlands, and found that extracellular vesicles (EVs) miRNA can effectively predict the FDG-PET CT response of cHL patients after treatment
.

The study included a total of 193 samples of 31 cHL patients and 19 healthy donors as controls.
Small RNA sequencing and qRT-PCR analysis showed that compared with patients with complete metabolic remission of PET, patients with active disease (before treatment or partial remission) ) The levels of five miRNAs (miR-127-3p, miR-155-5p, miR-21-5p, miR-24-3p and let-7a-5p) in plasma EVs increased significantly
.
Further analysis showed that the combination of these five miRNAs predicted the AUC (area under the ROC curve) of PET-positive and PET-negative patients to be 0.
855, while the combined AUC of miR-127-3p and miR-24-3p was 0.
872
.

Since serum TARC is a known and definite cHL biomarker, the authors further combined TARC with EV-miRNAl and found that when serum TARC was combined with five miRNAs, the AUC was 0.
924, the sensitivity was 96%, and the negative predictive value (NPV) was 97%
.
When combined with EV-miR-127-3p and/or EV-let-7a-5p levels and serum TARC, the AUC can reach 0.
93, the sensitivity is 93.
5%, the specificity is 83.
8/85.
0%, and the NPV is 96%
.

This study suggests that miRNA in plasma extracellular vesicles is a reliable predictor of PET response (metabolism) in patients with classic Hodgkin’s lymphoma after treatment
.

Reference materials:

1.
Blood (IF: 22.
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2020010387

2.
J Hematol Oncol (IF:17.
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1186/s13045-021-01122-1

3.
J Hematol Oncol (IF:17.
38) 2021 Jul Doi: 10.
1186/s13045-021-01120-

4.
J Extracell Vesicles (IF: 25.
842) 2021 Jul Doi: 10.
1002/jev2.
12121.