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Treating relapsed/refractory mature T- and NK-cell neoplasms with tislelizumab: a multicenter open-label phase 2
Emmanuel Bachy1, Kerry J Savage2, Huiqiang Huang3
1Hematology Department, Lyon Sud Hospital and Claude Bernard Lyon 1 University, Lyon, France.
Abstract:
Patients with relapsed/refractory (R/R) mature T- and natural killer (NK)-cell neoplasms lack effective treatments after failure of standard therapies. This phase 2 study evaluated the efficacy and safety of the programmed cell death protein 1 inhibitor tislelizumab in these patients. Seventy-seven patients were treated with 200 mg tislelizumab every 3 weeks. Twenty-two patients with extranodal NK-/T-cell lymphomas were enrolled in cohort 1; 44 patients with peripheral T-cell lymphoma (PTCL) were enrolled in cohort 2 (21 patients had PTCL not otherwise specified, 11 patients had angioimmunoblastic T-cell lymphoma, and 12 patients had anaplastic large-cell lymphoma). Cohort 3 comprised 11 patients with cutaneous T-cell lymphoma, of which 8 patients had mycosis fungoides (MF) and 3 had Sézary syndrome. Of the 77 patients, 76.6% had advanced-stage disease, 51.9% had refractory disease, and 49.4% received ≥3 prior systemic regimens. Promising efficacy was observed in cohort 3 (median follow-up [FU], 16.6 months; overall response rate [ORR], 45.5%; complete response [CR], 9.1%; median duration of response [DOR], 11.3 months; median progression-free survival, 16.8 months; median overall survival, not reached). Modest efficacy was observed in cohort 1 (median FU, 8.4 months; ORR, 31.8%; CR, 18.2%; median DOR, not reached) and cohort 2 (median FU, 9.3 months; ORR, 20.5%; CR, 9.1%; median DOR, 8.2 months). Most treatment-related adverse events were grade 1 or 2, and the safety profile was consistent with the known safety profile of tislelizumab. In conclusion, tislelizumab was well tolerated, achieving modest efficacy in R/R mature T- and NK-cell neoplasms, with some long-lasting remissions. This trial was registered at www.clinicaltrials.gov as #NCT03493451.
Insights
Tislelizumab, a programmed cell death protein 1 inhibitor, showed modest efficacy and good tolerability in patients with relapsed/refractory mature T- and natural killer (NK)-cell neoplasms, offering potential long-lasting remissions.
Area of Science:
- Oncology
- Immunotherapy
- Hematology
Background:
- Relapsed/refractory (R/R) mature T- and natural killer (NK)-cell neoplasms have limited effective treatment options.
- Standard therapies often fail in these aggressive hematologic malignancies.
Purpose of the Study:
- To evaluate the efficacy and safety of tislelizumab, a programmed cell death protein 1 (PD-1) inhibitor, in patients with R/R mature T- and NK-cell neoplasms.
- To assess response rates, duration of response, progression-free survival, and overall survival in different subtypes of these neoplasms.
Main Methods:
- A phase 2 clinical trial involving 77 patients with R/R mature T- and NK-cell neoplasms.
- Patients received 200 mg of tislelizumab intravenously every 3 weeks.
- The study included cohorts for extranodal NK/T-cell lymphoma, peripheral T-cell lymphoma (PTCL) subtypes, and cutaneous T-cell lymphoma (including mycosis fungoides and Sézary syndrome).
Main Results:
- Promising efficacy was observed in cutaneous T-cell lymphoma (cohort 3) with an overall response rate (ORR) of 45.5% and a median duration of response (DOR) of 11.3 months.
- Modest efficacy was noted in extranodal NK/T-cell lymphoma (cohort 1, ORR 31.8%) and PTCL (cohort 2, ORR 20.5%).
- Tislelizumab was well tolerated, with most treatment-related adverse events being low grade (1 or 2), consistent with its known safety profile.
Conclusions:
- Tislelizumab demonstrated acceptable safety and achieved modest efficacy in patients with R/R mature T- and NK-cell neoplasms.
- The study identified potential for long-lasting remissions, particularly in cutaneous T-cell lymphoma.
- Tislelizumab represents a potential therapeutic option for patients with limited treatment alternatives.
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