This clinical trial intends to analyze the efficacy of PD-1 inhibitor combined with radiotherapy for newly diagnosed NK/T-cell lymphoma. The investigational product in this clinical trial is tislelizumab, a PD-1 inhibitor. As a rationale for using PD-1 inhibitors in patients with NK/T-cell lymphoma, their efficacy has been proved several times mostly in patients with relapsed NK/T-cell lymphoma. Patients with low-stage NK/T-cell lymphoma usually receive high-concentration cytotoxic chemotherapy combined with radiotherapy, with treatment response rates of approximately 60 to 80%, but 80-90% of them experience hematological and non-hematologic toxicities during treatment. Therefore, this study intends to determine the efficacy and safety of PD-1 inhibitor(Tislelizumab) combined with radiotherapy as a first-line therapy compared with pre-existing cytotoxic chemotherapy combined with radiotherapy in patients with NK/T-cell lymphoma with low stage and International Prognostic Index.
This clinical trial intends to analyze the efficacy of PD-1 inhibitor combined with radiotherapy for newly diagnosed NK/T-cell lymphoma. The investigational product in this clinical trial is tislelizumab, a PD-1 inhibitor. As a rationale for using PD-1 inhibitors in patients with NK/T-cell lymphoma, their efficacy has been proved several times mostly in patients with relapsed NK/T-cell lymphoma. However, a tumor-immune microenvironment(TIME) analysis at our institution confirmed that patients with relapsed or refractory NK/T-cell lymphoma had a peritumoral microenvironment with suppressed activity of T cells and macrophages (immune suppression, IS), in which case the efficacy of PD-1 inhibitor decreased compared to a more immune-active microenvironment (immune evasion or immune tolerance, IE or IT). On the other hand, most patients who were newly diagnosed with NK/T-cell lymphoma had a peritumoral microenvironment with active T cells and macrophages(IE or IT). Patients with low-stage(Stage IE or IIE) NK/T-cell lymphoma usually receive high-concentration cytotoxic chemotherapy combined with radiotherapy, with treatment response rates of approximately 60 to 80%, but 80-90% of them experience grade 3 or 4 hematological and non-hematologic toxicities during treatment. Therefore, based on the tumor microenvironment of NK/T-cell lymphoma, this study intends to determine the efficacy and safety of PD-1 inhibitor(Tislelizumab) combined with radiotherapy as a first-line therapy compared with pre-existing cytotoxic chemotherapy combined with radiotherapy in patients with NK/T-cell lymphoma with low stage and International Prognostic Index.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
38
Induction therapy: Tislelizumab combined with radiation * Tislelizumab: 200mg, IV at 3-week intervals combined with radiotherapy. * Radiotherapy: 400Gy/20 fractions Maintenance therapy(after termination of combination therapy) * Tislelizumab: 200mg IV at 3-week intervals for up to 2 years until disease progression or intolerance.
81, Irwon-ro, Gangnam-gu, Seoul, Republic of Korea
Seoul, South Korea
RECRUITINGComplete response rate
The percentage of subjects with complete response(CR)
Time frame: After induction therapy is completed, Every 6 cycles of maintenance, up to 51 months every 6month
Overall response rate
Time frame: After induction therapy is completed, Every 6 cycles of maintenance, up to 51 months every 6month
Duration of response
Time frame: Up to 51 months
Progression free-survival
The time until defined by date of all-cause mortality from the date of investigational procuct administration
Time frame: Up to 51 months
Overall survival
It is a measure of the period of survival without disease progression
Time frame: the time between the date of treatment start and the date of death due to any cause of disease progression assessed up to 51 months
Time to response
Time frame: Up to 51 months
Adverse events
Investigation of adverse events occurred in subject
Time frame: From the day 1 of the clinical trial to 28 days after last drug administration
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