Can a combination of brentuximab vedotin and salvage chemotherapy treat classical Hodgkin’s lymphoma not responding to standard treatment?

This study looked at the combination of brentuximab vedotin (BV; Adcetris) and ICE salvage chemotherapy with ifosfamide (Ifex), carboplatin (Paraplatin), and etoposide (Etopophos) for the treatment of relapsing or refractory Hodgkin lymphoma (HL). This study showed that BV-ICE was a good salvage treatment option for these patients. 

HL is a cancer of the blood and lymph nodes. It is usually treated with chemotherapy. HL can sometimes be called "refractory" or "relapsed". Refractory disease means that the disease did not improve with standard treatment. Relapsed disease means that the disease improved with standard treatment, but it came back after a period of time.

Refractory or relapsed HL needs a different treatment approach in salvage therapies. Immune therapy such BV alone is approved for patients with relapsed or refractory HL. However, the safety and effectiveness of the combination of BV with ICE chemotherapy as a salvage regimen in patients with relapsed or refractory HL are still unknown.

43 patients with relapsed or refractory HL completed this study. Patients were given two courses of treatment, each lasting 21 days. Patients received BV 1.5 mg/kg on days 1 and 8 of each course, and chemotherapy with ICE on days 1 – 3 of each course. Patients were followed up for an average of 3.1 years. 

91% of patients responded to treatment. 74% of all patients had a complete response to treatment (defined as disappearance of all tumors). 

98% of all patients had at least one side effect. Serious side effects occurred in 29% of patients. The most common side effects were low blood cell counts and nerve damage in the hands and feet.

This study showed that combining BV with ICE is an effective short-term treatment for relapsed and refractory HL.

This study only included patients from one institution that is very experienced with this type of treatment. The number of patients included was small. More studies are needed to see if this treatment is safe and effective in other settings.