Last year there was a published study that showed that in Hodgkin’s lymphoma patients with relapsed refractory disease their overall response rate to chemotherapy after checkpoint therapy was 61% but this has never been studied in the non-Hodgkin’s lymphoma population and the response rates to later lines of therapy in non-Hodgkin’s tend to be low. So we wanted to see if we could have a high overall response rate to therapy after checkpoint blockade in the non-Hodgkin’s population as well.

How did you look at this?

We did a retrospective analysis, it involved 17 centres across the United States and Canada. We queried the medical records of each institution and evaluated their responses to therapy that were after checkpoint blockade by using the Lugano criteria.

What was the method of study?

We did a statistical analysis of the Kaplan-Meier method to evaluate the progression free survival, the overall survival and the overall response rates and we looked at this for the entire study population and then also looked at the overall survival based on post-checkpoint blockade treatment regimen.

What did you find?

We found that when we stratified the overall survival based upon post-checkpoint regimen, for standard chemotherapy, clinical trials, stem cell transplant conditioning and targeted therapies there was no difference in overall survival. It’s worth noting that we didn’t include any patients who had received CAR T-cells and no patients had received immunotherapy after checkpoint blockade either.

What does this information tell us?

We can’t say for sure because this is a retrospective analysis, we had many different non-Hodgkin lymphoma subtypes and some of them had a very small number of patients per subtype but it’s very encouraging because there was a response for every single subtype. So possibly this could be a new strategy where using checkpoint blockade and then a subsequent treatment may cause a better response than to checkpoint blockade or to earlier lines of therapy that these particular patients used. So if this pans out in a prospective clinical trial we may want to move immunotherapy like the checkpoint blockers more to the frontline so that we can get patients having a response and get them transplanted before they become too sick.

Is that something you intend to look at?

I’m a third year Fellow now and I don’t know exactly where I’ll be next year so definitely we want to look at it. I don’t know if it will be me, myself, though.