Pembrolizumab in newly diagnosed EBV‑negative extranodal natural killer/T‑cell lymphoma: A case report
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- Published online on: January 23, 2019 https://doi.org/10.3892/mco.2019.1805
- Pages: 397-400
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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.
