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Poster Display session 3

2996 - Evolution of Myeloid-Derived Suppressor Cells and Objective Response Rate in Relapsed/Refractory Diffuse Large B Cell Lymphoma (R/R DLBCL) patients after receiving immunotherapy

Date

30 Sep 2019

Session

Poster Display session 3

Topics

Immunotherapy

Tumour Site

Lymphomas

Presenters

Carlos Jiménez Cortegana

Citation

Annals of Oncology (2019) 30 (suppl_5): v475-v532. 10.1093/annonc/mdz253

Authors

C. Jiménez Cortegana1, N. Palazón Carrión2, E. Nogales Fernández2, M.A. Nieto García3, V. Sánchez Margalet1, M.D.C. Álamo de la Gala2, M. Suengas Martínez de Ilárduya2, E. Montilla Burgos2, I. Araújo Fernández2, F. Henao Carrasco4, A. Martín García-Sancho5, F. Carnicero6, E. Rios Herranz7, F. de la Cruz Vicente8, R. Fernández9, A. Rueda Dominguez10, L. de la Cruz Merino4

Author affiliations

  • 1 Medical Biochemistry, Virgen Macarena University Hospital, 41007 - Seville/ES
  • 2 Medical Oncology, Virgen Macarena University Hospital, 41007 - Seville/ES
  • 3 Preventive Medicine And Public Health, University of Seville, 41007 - Seville/ES
  • 4 Medical Oncology, Virgen Macarena University Hospital, 41007 - Sevilla/ES
  • 5 Hematology And Hemotherapy, University Hospital of Salamanca, Salamanca/ES
  • 6 Hematology And Hemotherapy, San Pedro de Alcántara Hospital, Cáceres/ES
  • 7 Hematology, Virgen de Valme University Hospital, 41014 - Sevilla/ES
  • 8 Hematology And Hemotherapy, Virgen del Rocío University Hospital, Seville/ES
  • 9 Hematology And Hemotherapy, Hospital of Cabueñes, Gijón/ES
  • 10 Medical Oncology, Costa del Sol Hospital, 29603 - Marbella/ES

Resources

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Abstract 2996

Background

Myeloid derived suppresor cells (MDSC) are a heterogeneous population of immature myeloid cells that inhibits antitumor responses by T lymphocytes. High levels of MDSC have been found in the tumor microenvironment, which is correlated with a poor prognosis of the disease. Our purposes are to evaluate the objective response rate (ORR) to test the treatment efficacy and to show the decrease of MDSC in clinical benefit (CB) patients, that includes complete response (CR), partial response (PR) and stabilization of disease (SD), when compared with progression of disease (PD).

Methods

58 patients diagnosed of R/R DLBCL who were not high dose chemotherapy and autologous bone narrow transplantation candidates were recruited from Spanish hospitals. The patients progressed to a prior R-CHOP therapy and had ECOG ≤ 1. They were treated with the R2-GDP chemotherapy schedule (rituximab, lenalidomide, gemcitabine, dexamethasone and cisplatin). Three peripheral blood analysis were carried out: basal, cycle 3 (C3) and end of induction (EI) by flow cytometry to determine the MDSC level.

Results

30 patients obtained CB response to treatment (PR 11 patients, CR 14 patients and SD 5 patients) and 28 patients obtained PD. A remarkable decrease of MDSC is shown in the Table, except in PD patients. On the other hand, ORR was 69% at C3 (PR 53%+ CR 16%) and 66% at EI (PR 40% + CR 26%).Table:

1267P MDSC levels (cells/uL) in CB (CR, PR, SD) and PD. Av: average; St: Standard Deviation; *: Statistically significant differences (P < 0.05) compared with basal

ResponseBasal Av (St)C3 Av (St)EI Av (St)
CB19.9 (4.0)10.0 (3.1)4.8 (2.1)*
CR18.6 (4.9)12.4 (3.7)2.7 (1.1)*
PR13.0 (3.2)4.5 (0.8)1.4 (0.5)*
SD35.3 (14.8)18.8 (11.6)18.5 (9.2)
PD10.7 (4.0)8.6 (2.4)12.2 (2.9)

Conclusions

The ORR obtained shown the treatment efficacy in R/R DLBCL to stimulate the immune system antitumor response, which explains the decrease of MDSC in all CB groups and a non-important increase in PD patients. Based on these results, MDSC seem to be an important therapeutic target against tumor progression, as well as being a potentially promising marker of response.

Clinical trial identification

EudraCT number: 2014-001620-29.

Editorial acknowledgement

Legal entity responsible for the study

Grupo Español para el Tratamiento y Estudio de los Linfomas (GOTEL).

Funding

Grupo Español para el Tratamiento y Estudio de los Linfomas (GOTEL).

Disclosure

All authors have declared no conflicts of interest.

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