@article{10.37349/etat.2025.1002318,
abstract = {Aim: This research aims to guide future strategies for personalized treatment of primary mediastinal large B-cell lymphoma (PMBCL), particularly to identify high-risk patients who may benefit from incorporating immune checkpoint inhibitors (ICIs) in the first-line setting. Methods: A retrospective, single-center study included 254 newly diagnosed PMBCL patients treated with rituximab, dose-adjusted etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin (R-DA-EPOCH), rituximab, modified protocol NHL-BFM-90 (RmNHL-BFM-90), or R-DA-EPOCH combined with nivolumab. Clinical parameters, immunohistochemical markers [programmed death ligand-1 (PD-L1), programmed death-1 (PD-1), cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), human leucocyte antigen (HLA)-DR, Ki-67, multiple myeloma oncogene 1 (MUM1)], molecular markers (mutations in tumor protein p53 (TP53), CD58, beta-2-microglobulin (B2M), and exportin 1 (XPO1) genes; short tandem repeats at 6p21.3 [major histocompatibility complex (MHC) class I/II], 9p24.1 (PD-L1/PD-L2), 16p13.13 [class II, MHC, transactivator gene (CIITA)]), and cytogenetic profiles [myelocytomatosis oncogene (MYC)/8q24, B-cell lymphoma 2 (BCL2)/18q21, BCL6/3q27, del17p13, and karyotype abnormalities] were analyzed. Results: The addition of nivolumab to R-DA-EPOCH as a first-line regimen significantly improved event-free survival (EFS; P = 0.018). This study identified that adverse prognostic factors for PMBCL include allelic imbalance at specific loci 6p21.3 (MHC class I/II), 9p24.1 (PD-L1/PD-L2), and 16p13.13 (CIITA). Incorporating nivolumab into the R-DA-EPOCH regimen as a first-line therapy has shown potential in reducing adverse prognostic factors. Conclusions: These findings suggest that high-risk patients may benefit significantly from the early incorporation of ICIs into their treatment plans.},
author = {Mangasarova, Yana K. and Abdurashidova, Runiza R. and Risinskaya, Natalya V. and Biderman, Bella V. and Abramova, Tatiana V. and Surin, Vadim L. and Shupletsova, Irina A. and Obukhova, Tatiana N. and Iusupov, Rasul I. and Chabaeva, Yulia A. and Magomedova, Aminat U. and Nikulina, Lena E. and Kulikov, Sergei M. and Zvonkov, Eugene E. and Kovrigina, Alla M. and Sudarikov, Andrey B.},
doi = {10.37349/etat.2025.1002318},
journal = {Exploration of Targeted Anti-tumor Therapy},
elocation-id = {1002318},
title = {Prognostic impact of biomarkers in PMBCL: rationale for early integration of immune checkpoint inhibitors},
url = {https://www.explorationpub.com/Journals/etat/Article/1002318},
volume = {6},
year = {2025}
}