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Case Reports
. 2017 Jun 8;129(23):3071-3073.
doi: 10.1182/blood-2017-01-764209. Epub 2017 Mar 29.

PD-1 blockade with nivolumab in relapsed/refractory primary central nervous system and testicular lymphoma

Lakshmi Nayak  1   2 , Fabio M Iwamoto  3 , Ann LaCasce  1   2 , Srinivasan Mukundan  1   2 , Margaretha G M Roemer  1 , Bjoern Chapuy  1 , Philippe Armand  1   2 , Scott J Rodig  1   2 , Margaret A Shipp  1   2
Affiliations
Case Reports

PD-1 blockade with nivolumab in relapsed/refractory primary central nervous system and testicular lymphoma

Lakshmi Nayak et al. Blood. .

Abstract

Primary central nervous system (CNS) lymphoma (PCNSL) and primary testicular lymphoma (PTL) are rare extranodal large B-cell lymphomas with similar genetic signatures. There are no standard-of-care treatment options for patients with relapsed and refractory PCNSL and PTL, and the overall prognosis is poor. PCNSLs and PTLs exhibit frequent 9p24.1 copy-number alterations and infrequent translocations of 9p24.1 and associated increased expression of the programmed cell death protein 1 (PD-1) ligands, PD-L1 and PD-L2. The activity of PD-1 blockade in other lymphomas with 9p24.1 alterations prompted us to test the efficacy of the anti-PD1 antibody, nivolumab, in 4 patients with relapsed/refractory PCNSL and 1 patient with CNS relapse of PTL. All 5 patients had clinical and radiographic responses to PD-1 blockade, and 3 patients remain progression-free at 13+ to 17+ months. Our data suggest that nivolumab is active in relapsed/refractory PCNSL and PTL and support further investigation of PD-1 blockade in these diseases.

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Figures

Figure 1.
Figure 1.
Pre- and posttreatment head CTs with contrast in a patient with primary refractory PCNSL. (Left) The contrast-enhancing lesion before treatment with nivolumab. (Middle) Complete response following 2 months therapy with nivolumab. (Right) Continued complete response 13 months following initiation of therapy.
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