| Objective:The meta analysis is to evaluate the efficacy and safety of programmed death receptor-l(PD-1)inhibitors in the treatment of relapsed/refractory Hodgkin lymphoma(RRHL),and to explore the feasibility of PD-1 inhibitors combined with transplantation.Methods:We systematically searched Pub Med,Web of Science,Medline,Embase,Cochrane Library by December 2020.Efficacy analyses were performed for overall response rate(ORR),6-month progression-free survival(PFS)and 6-month overall survival(OS)of nivolumab and pembrolizumab,respectively.Safety assessments were performed for the the clinical symptoms of the adverse events(AEs),incidence of AEs and drug related mortality.Results:A total of 13 records were included,including 2 phase Ⅰb records,11 phase Ⅱrecords.8 records on nivolumab and 2 on pembrolizumab,and 1 record each on Sintilimab,Tislelizumab and Camrelizumab.The pooled ORR,6 month-PFS rate and6month-OS rate were 75.2%,76.5% and 99.4%,respectively.Among the subgroup,patients with RRHL treated with PD-1 inhibitors after transplantation had a pooled ORR of 77.6%,the pooled ORR of PD-1 inhibitor was 66.7% in patients with non-transplant treatment,and the ORR of patients treated with allogeneic hematopoietic stem cell transplantation(allo-HSCT)after PD-1 blockade was 73.0%.The pooled incidences of any grade and grade≥3 AEs were 83.9% and 16.9%.The most common any grade AEs were Fatigue(16.4%),fever(12.0%),rash(11.5%),and hypothyroidism(11.2%).The most common grade≥3 AEs were Neutropenia(2.4%),diarrhea(0.7%),fatigue(0.5%).Drug-related deaths have been found in patients with RRHL treated with nivolumab.Conclusion:PD-1 inhibitors are effective in patients with RRHL,with low incidence of adverse events and high security,and can be used as an appropriate option for treating relapsed HL after hematopoietic stem cell transplantation.Furthermore,our current data suggest that bridging allo-HSCT with Nivolumab is also promising. |
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