# Sintilimab for relapsed/refractory extranodal NK/T cell lymphoma: a multicenter, single-arm, phase 2 trial (ORIENT-4)

**Authors:** Rong Tao, Lei Fan, Yongping Song, Yu Hu, Wei Zhang, Yafei Wang, Wei Xu, Jianyong Li

PMC · DOI: 10.1038/s41392-021-00768-0 · Signal Transduction and Targeted Therapy · 2021-10-27

## TL;DR

This study shows that sintilimab, an anti-PD-1 antibody, is effective and safe for treating relapsed/refractory extranodal NK/T cell lymphoma.

## Contribution

Demonstrates sintilimab's efficacy and safety in a phase 2 trial for a rare and aggressive lymphoma type.

## Key findings

- 75% of patients achieved an objective response to sintilimab treatment.
- The 24-month overall survival rate was 78.6% with mostly mild adverse events.
- Sintilimab was well tolerated, with no treatment-related deaths.

## Abstract

This study (ORIENT-4) aimed to assess the efficacy and safety of sintilimab, a humanized anti-PD-1 antibody, in patients with relapsed/refractory extranodal NK/T cell lymphoma (r/r ENKTL). ORIENT-4 is a multicenter, single-arm, phase 2 clinical trial (NCT03228836). Patients with r/r ENKTL who failed to at least one asparaginase-based regimen were enrolled to receive sintilimab 200 mg intravenously every 3 weeks for up to 24 months. The primary endpoint was the objective response rate (ORR) based on Lugano 2014 criteria. Twenty-eight patients with r/r ENKTL were enrolled from August 31, 2017 to February 7, 2018. Twenty-one patients (75.0%, 95% CI: 55.1–89.3%) achieved an objective response. With a median follow-up of 30.4 months, the median overall survival (OS) was not reached. The 24-month OS rate was 78.6% (95% CI, 58.4–89.8%). Most treatment-related adverse events (TRAEs) were grade 1–2 (71.4%), and the most common TRAE was decreased lymphocyte count (42.9%). Serious adverse events (SAEs) occurred in 7 (25.0%) patients, and no patient died of adverse events. Sintilimab is effective and well tolerated in patients with r/r ENKTL and could be a novel therapeutic approach for the control of ENKTL in patients.

## Linked entities

- **Proteins:** PDCD1 (programmed cell death 1)

## Full-text entities

- **Genes:** ABCB1 (ATP binding cassette subfamily B member 1) [NCBI Gene 5243] {aka ABC20, CD243, CLCS, ENPAT, GP170, MDR1}, CD274 (CD274 molecule) [NCBI Gene 29126] {aka ADMIO5, B7-H, B7H1, PD-L1, PDCD1L1, PDCD1LG1}, PDCD1 (programmed cell death 1) [NCBI Gene 5133] {aka ADMIO4, AIMTBS, CD279, PD-1, PD1, SLEB2}, ASPG (asparaginase) [NCBI Gene 374569] {aka C14orf76, GPA/WT, LYSOLP, hASNase1}, TNFRSF8 (TNF receptor superfamily member 8) [NCBI Gene 943] {aka CD30, D1S166E, Ki-1}
- **Diseases:** mediastinal pleura lesions (MESH:D008477), ADA (MESH:D016736), aggressive NK cell leukemia (MESH:D054066), Extranodal natural killer (NK)/T cell lymphoma (MESH:D000077428), diffuse large B cell lymphoma (MESH:D016403), lymphoma (MESH:D008223), decreased lymphocyte (MESH:D007945), ketoacidosis (MESH:D007662), anaphylactic shock (MESH:D000707), EBV infection (MESH:D020031), Urinary tract infection (MESH:D014552), Hypothyroidism (MESH:D007037), SD (MESH:D060050), Hodgkin lymphoma (MESH:D006689), pancreatitis (MESH:D010195), Cancer (MESH:D009369), PD 3 (MESH:C567095), diabetes (MESH:D003920), DOR (MESH:D018746), ORIENT-4 (MESH:D016773), peripheral T lymphomas (MESH:D016411), NHL (MESH:D008228), Pyrexia (MESH:D005334), infection (MESH:D007239), Bone marrow involvement (MESH:D001855), CR (MESH:D001766), decreased white blood cell count (MESH:D009845), Oncology (MESH:D000072716), disease (MESH:D004194), PR (MESH:D004828), gastrointestinal hemorrhage (MESH:D006471), PD (MESH:D018450), ENKTL-NT (MESH:D054391), death (MESH:D003643), -related adverse event (MESH:D002318), SAEs (MESH:D064420), pulmonary infection (MESH:D012141), hepatitis B (MESH:D006509), intervertebral disc disorder (MESH:C535531), hemophagocytic syndrome (MESH:D051359)
- **Species:** Homo sapiens (human, species) [taxon 9606]
- **Cell lines:** S2 — Drosophila melanogaster (Fruit fly), Spontaneously immortalized cell line (CVCL_Z232)

## Full text

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## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC8548511/full.md

## References

33 references — full list in the complete paper: https://tomesphere.com/paper/PMC8548511/full.md

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Source: https://tomesphere.com/paper/PMC8548511