Brentuximab vedotin plus dacarbazine or bendamustine to treat elderly patients with Hodgkin lymphoma

The authors compared the effectiveness of brentuximab vedotin (BV, Adcetris) plus dacarbazine versus BV plus bendamustine (Treanda). The authors concluded that both treatments are effective, but BV plus dacarbazine is recommended because it is safer than BV plus bendamustine. 

Hodgkin lymphoma (HL) is largely considered a curable disease. However, elderly patients (60 years or older) often have fewer treatment options. Elderly patients have more comorbidities (additional diseases) and may not be able to tolerate intensive regimens.

Brentuximab vedotin (BV) has been used to treat elderly patients with HL. BV has been used in combination with some types of chemotherapy. More research is needed to determine if BV is safe and effective when combined with dacarbazine or bendamustine. 

42 patients participated in the study. 22 patients were treated with BV plus dacarbazine. These patients received 375 mg/m² of dacarbazine. 20 patients were treated with BV plus bendamustine. These patients received 70 mg/m². All patients received 1.8 mg/kg of BV. The patients were followed for approximately 2 years.

The complete response rate (no detectable cancer) in the BV plus dacarbazine group was 62%. The complete response rate in the BV plus bendamustine group was 88%. Both groups had a 100% overall response rate (reduction or elimination of cancer).

The average overall survival time (time from treatment to death from any cause) had not been reached in either group. This means that patients have to be followed for longer to determine how long they survive after treatment, on average.

Study authors stopped adding patients to the BV plus bendamustine group because of safety issues. Many patients (65%) in the BV plus bendamustine group had very negative side effects, and 2 patients died during the study. 

The study concluded that both treatments are effective, however, BV plus bendamustine has significant side effects and negative outcomes, and is not recommended for elderly patients with Hodgkin lymphoma.