Pembrolizumab in newly diagnosed EBV‑negative extranodal natural killer/T‑cell lymphoma: A case report

Asif,Samia; Begemann,Madeline; Bennett,Joseph; Fatima,Rawish; Masood,Ashiq; Raza,Shahzad

doi:10.3892/mco.2019.1805

March-2019 Volume 10 Issue 3

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March-2019 Volume 10 Issue 3

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Case Report

Pembrolizumab in newly diagnosed EBV‑negative extranodal natural killer/T‑cell lymphoma: A case report

Authors:
- Samia Asif
- Madeline Begemann
- Joseph Bennett
- Rawish Fatima
- Ashiq Masood
- Shahzad Raza
View Affiliations / Copyright

Affiliations: Department of Hematological Malignancies, Saint-Luke's Cancer Institute/University of Missouri School of Medicine, Kansas City, MO 64111, USA, Rush University Medical Center, Chicago, IL 60612, USA
Pages: 397-400
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Published online on: January 23, 2019

https://doi.org/10.3892/mco.2019.1805
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Abstract

Extranodal natural killer (NK)/T‑cell lymphoma (ENKTL) is a rare subtype of non‑Hodgkin's lymphoma with a dismal prognosis. The pathogenesis almost invariably involves Epstein‑Barr virus (EBV) infection, although EBV‑negative ENKTLs are frequently reported in the western hemisphere. Treatment of these lymphomas consists of aggressive chemotherapy with dexamethasone, methotrexate, ifosfamide, L‑asparaginase and etoposide (SMILE regimen). However, the SMILE regimen is poorly tolerated by elderly patients; therefore, treatment options are limited to palliative radiation and chemotherapy and/or hospice care. Recently, binding of programmed death (PD)‑1 with its ligand (PD‑L1) expressed on tumor cells was shown to downregulate effector T‑cell function and may represent a potent mechanism of immune evasion in classical Hodgkin's lymphoma and aggressive B‑cell lymphomas. Thus, targeting PD‑L1/PD‑1 to inhibit effector T‑cell signaling may be a promising therapeutic strategy for these NK/T‑cell lymphomas. We herein report the clinical efficacy and feasibility of the anti‑PD‑1 inhibitor pembrolizumab used concurrently with radiation therapy and as maintenance therapy in an elderly female patient. The findings demonstrated that pembrolizumab may be an effective and well‑tolerated treatment for this type of lymphoma.

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1	Sun J, Yang Q, Lu Z, He M, Gao L, Zhu M, Sun L, Wei L, Li M, Liu C, et al: Distribution of lymphoid neoplasms in China: Analysis of 4,638 cases according to the World Health Organization classification. Am J Clin Pathol. 138:429–434. 2012. View Article : Google Scholar : PubMed/NCBI
2	Tse E and Kwong YL: The diagnosis and management of NK/T-cell lymphomas. J Hematol Oncol. 10:852017. View Article : Google Scholar : PubMed/NCBI
3	Nicolae A, Ganapathi KA, Pham TH, Xi L, Torres-Cabala CA, Nanaji NM, Zha HD, Fan Z, Irwin S, Pittaluga S, et al: EBV-negative aggressive NK-cell leukemia/lymphoma: Clinical, pathologic, and genetic features. Am J Surg Pathol. 41:67–74. 2017. View Article : Google Scholar : PubMed/NCBI
4	Gao J, Behdad A, Ji P, Wolniak KL, Frankfurt O and Chen YH: EBV-negative aggressive NK-cell leukemia/lymphoma: A clinical and pathological study from a single institution. Mod Pathol. 30:1100–1115. 2017. View Article : Google Scholar : PubMed/NCBI
5	Vari F, Arpon D, Keane C, Hertzberg MS, Talaulikar D, Jain S, Cui Q, Han E, Tobin J, Bird R, et al: Immune evasion via PD-1/PD-L1 on NK cells and monocyte/macrophages is more prominent in Hodgkin lymphoma than DLBCL. Blood. 131:1809–1819. 2018. View Article : Google Scholar : PubMed/NCBI
6	Kwong YL, Chan TSY, Tan D, Kim SJ, Poon LM, Mow B, Khong PL, Loong F, Au-Yeung R, Iqbal J, et al: PD1 blockade with pembrolizumab is highly effective in relapsed or refractory NK/T-cell lymphoma failing l-asparaginase. Blood. 129:2437–2442. 2017. View Article : Google Scholar : PubMed/NCBI
7	Li X, Cui Y, Sun Z, Zhang L, Li L, Wang X, Wu J, Fu X, Ma W, Zhang X, et al: DDGP versus SMILE in newly diagnosed advanced natural killer/T-cell lymphoma: A randomized controlled, multicenter, open-label study in China. Clin Cancer Res. 22:5223–5228. 2016. View Article : Google Scholar : PubMed/NCBI
8	Li X, Cheng Y, Zhang M, Yan J, Li L, Fu X, Zhang X, Chang Y, Sun Z, Yu H, et al: Activity of pembrolizumab in relapsed/refractory NK/T-cell lymphoma. J Hematol Oncol. 11:152018. View Article : Google Scholar : PubMed/NCBI
9	Liu Y, Dong Y, Kong L, Shi F, Zhu H and Yu J: Abscopal effect of radiotherapy combined with immune checkpoint inhibitors. J Hematol Oncol. 11:1042018. View Article : Google Scholar : PubMed/NCBI

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Pembrolizumab in newly diagnosed EBV‑negative extranodal natural killer/T‑cell lymphoma: A case report

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