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<p>We evaluated the effectiveness of adding anti-PD-1 antibody to P-GEMOX regimen in previously untreated advanced-stage natural killer/T-cell lymphoma (NKTCL) compared to P-GEMOX alone or with autologous stem cell transplantation (ASCT). 418 patients (135 and 283 in the immunochemotherapy and chemotherapy groups, respectively) were analyzed from 15 Chinese centers (2014–2023). The median follow-up was 40.7 months. The immunochemotherapy group had a higher objective response rate (ORR) (89.6% versus 77.0%), complete response (CR) rate (77.0% versus 50.5%), 3-year progression-free survival (PFS) rate (64.1% versus 40.7%), and 3-year overall survival (OS) rate (79.5% versus 60.8%) compared to the chemotherapy group. Grade 3–4 neutropenia was more common in the immunochemotherapy group (40.0% versus 20.8% in the chemotherapy group, <i>p</i> &lt; 0.001). Grade 3–4 hematologic toxicities were prevalent during ASCT, whereas anti-PD-1 maintenance was well tolerated. Grade ≥3 non-hematologic adverse events during anti-PD-1 maintenance were rare. In propensity score-matched (PSM) analysis of patients achieving CR after induction (<i>n</i> = 41 per group), the 3-year disease-free survival (DFS) rate was 72.6% for immunochemotherapy plus anti-PD-1 maintenance versus 50.9% for chemotherapy plus ASCT (<i>p</i> = 0.032), and the 3-year OS rate was 91.5% versus 72.9% (<i>p</i> = 0.029). First-line anti-PD-1 antibody plus P-GEMOX followed by anti-PD-1 maintenance shows better response and survival over P-GEMOX chemotherapy alone and P-GEMOX with ASCT, while maintaining acceptable toxicity.</p>

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Anti-PD-1 antibody combined with P-GEMOX chemotherapy versus P-GEMOX chemotherapy with or without autologous stem-cell transplantation for previously untreated advanced natural killer/T cell lymphoma: a retrospective cohort study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年3月10日

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  • Qihua Zou,
  • Yi Cao,
  • Liang Wang,
  • Wuping Li,
  • Qingsong Yin,
  • Yudan Wu,
  • Hongmei Jing,
  • Zhigang Peng,
  • Xiuhua Sun,
  • Jun Rao,
  • Ying Chen,
  • Hongyu Zhang,
  • Dongfeng Zeng,
  • Bingzong Li,
  • Ying Zhao,
  • Xudong Zhang,
  • Yuchen Zhang,
  • Yan Gao,
  • Bing Bai,
  • Yi Xia,
  • Yu Fang,
  • Zouxiang Chen,
  • Man Nie,
  • Xiaojie Fang,
  • Shenrui Bai,
  • Huiqiang Huang,
  • Qingqing Cai,
  • Jun Cai

摘要

We evaluated the effectiveness of adding anti-PD-1 antibody to P-GEMOX regimen in previously untreated advanced-stage natural killer/T-cell lymphoma (NKTCL) compared to P-GEMOX alone or with autologous stem cell transplantation (ASCT). 418 patients (135 and 283 in the immunochemotherapy and chemotherapy groups, respectively) were analyzed from 15 Chinese centers (2014–2023). The median follow-up was 40.7 months. The immunochemotherapy group had a higher objective response rate (ORR) (89.6% versus 77.0%), complete response (CR) rate (77.0% versus 50.5%), 3-year progression-free survival (PFS) rate (64.1% versus 40.7%), and 3-year overall survival (OS) rate (79.5% versus 60.8%) compared to the chemotherapy group. Grade 3–4 neutropenia was more common in the immunochemotherapy group (40.0% versus 20.8% in the chemotherapy group, p < 0.001). Grade 3–4 hematologic toxicities were prevalent during ASCT, whereas anti-PD-1 maintenance was well tolerated. Grade ≥3 non-hematologic adverse events during anti-PD-1 maintenance were rare. In propensity score-matched (PSM) analysis of patients achieving CR after induction (n = 41 per group), the 3-year disease-free survival (DFS) rate was 72.6% for immunochemotherapy plus anti-PD-1 maintenance versus 50.9% for chemotherapy plus ASCT (p = 0.032), and the 3-year OS rate was 91.5% versus 72.9% (p = 0.029). First-line anti-PD-1 antibody plus P-GEMOX followed by anti-PD-1 maintenance shows better response and survival over P-GEMOX chemotherapy alone and P-GEMOX with ASCT, while maintaining acceptable toxicity.