9p24.1 alterations and programmed cell death 1 ligand 1 expression in early stage unfavourable classical Hodgkin lymphoma: an analysis from the German Hodgkin Study Group NIVAHL trial

  • Elena Gerhard‐Hartmann
    Institute of Pathology University of Würzburg Würzburg Germany
  • Helen Goergen
    Department I of Internal Medicine Faculty of Medicine and University Hospital of Cologne Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG) University of Cologne Cologne Germany
  • Paul J. Bröckelmann
    Department I of Internal Medicine Faculty of Medicine and University Hospital of Cologne Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG) University of Cologne Cologne Germany
  • Anja Mottok
    Department of Pathology University Hospital Gießen and Marburg GmbH Gießen Germany
  • Tabea Steinmüller
    Institute of Pathology University of Würzburg Würzburg Germany
  • Johanna Grund
    Hematopathology Section and Lymph Node Registry Department of Pathology University Hospital Schleswig‐Holstein Kiel Germany
  • Alberto Zamò
    Institute of Pathology University of Würzburg Würzburg Germany
  • Susana Ben‐Neriah
    Department for Lymphoid Cancer Research and Center for Lymphoid Cancer BC Cancer Vancouver, BC Canada
  • Stephanie Sasse
    Department IV of Internal Medicine University Hospital of Aachen University of Aachen Aachen Germany
  • Sven Borchmann
    Department I of Internal Medicine Faculty of Medicine and University Hospital of Cologne Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG) University of Cologne Cologne Germany
  • Michael Fuchs
    Department I of Internal Medicine Faculty of Medicine and University Hospital of Cologne Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG) University of Cologne Cologne Germany
  • Peter Borchmann
    Department I of Internal Medicine Faculty of Medicine and University Hospital of Cologne Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG) University of Cologne Cologne Germany
  • Sarah Reinke
    Hematopathology Section and Lymph Node Registry Department of Pathology University Hospital Schleswig‐Holstein Kiel Germany
  • Andreas Engert
    Department I of Internal Medicine Faculty of Medicine and University Hospital of Cologne Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf (CIO ABCD) and German Hodgkin Study Group (GHSG) University of Cologne Cologne Germany
  • Johanna Veldman
    Department of Pathology and Medical Biology University of Groningen University Medical Center Groningen Groningen the Netherlands
  • Arjan Diepstra
    Department of Pathology and Medical Biology University of Groningen University Medical Center Groningen Groningen the Netherlands
  • Wolfram Klapper
    Hematopathology Section and Lymph Node Registry Department of Pathology University Hospital Schleswig‐Holstein Kiel Germany
  • Andreas Rosenwald
    Institute of Pathology University of Würzburg Würzburg Germany

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<jats:title>Summary</jats:title><jats:p>High programmed cell death 1 ligand 1 (PD‐L1) protein expression and copy number alterations (CNAs) of the corresponding genomic locus 9p24.1 in Hodgkin‐ and Reed–Sternberg cells (HRSC) have been shown to be associated with favourable response to anti‐PD‐1 checkpoint inhibition in relapsed/refractory (r/r) classical Hodgkin lymphoma (cHL). In the present study, we investigated baseline 9p24.1 status as well as PD‐L1 and major histocompatibility complex (MHC) class I and II protein expression in 82 biopsies from patients with early stage unfavourable cHL treated with anti‐PD‐1‐based first‐line treatment in the German Hodgkin Study Group (GHSG) NIVAHL trial (ClinicalTrials.gov Identifier: NCT03004833). All evaluated specimens showed 9p24.1 CNA in HRSC to some extent, but with high intratumoral heterogeneity and an overall smaller range of alterations than reported in advanced‐stage or r/r cHL. All but two cases (97%) showed PD‐L1 expression by the tumour cells in variable amounts. While MHC‐I was rarely expressed in >50% of HRSC, MHC‐II expression in >50% of HRSC was found more frequently. No obvious impact of 9p24.1 CNA or PD‐L1 and MHC‐I/II expression on early response to the highly effective anti‐PD‐1‐based NIVAHL first‐line treatment was observed. Further studies evaluating an expanded panel of potential biomarkers are needed to optimally stratify anti‐PD‐1 first‐line cHL treatment.</jats:p>

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