In a nutshell
This study evaluated the effectiveness of brentuximab-vedotin therapy in relapsed- and refractory Hodgkin lymphoma patients. The authors concluded that the treatment was safe and effective.
Some background
Some Hodgkin lymphoma patients are either unresponsive to treatment (refractory disease), or relapse soon afterwards. These patients are often treated with salvage chemotherapy (SC, a second course) as their second-line treatment. SC is used to shrink the size of tumors. This is usually followed by high-dose chemotherapy (HDC) and stem-cell (immature blood cell) transplantation. Many patients will experience a relapse following transplantation. Patients who respond well to SC are more likely to respond to transplantation. This is particularly true for patients who have no sign of cancer activity on a PET scan following SC.
Brentuximab vedotin is an antibody therapy and chemotherapy. It attaches to CD30 (a protein), allowing the chemotherapy to enter and kill cancer cells. Previous trials have shown that BV is effective in patients as an SC or as a treatment after stem cell transplantation. The effectiveness of BV therapy in patients outside of clinical trials is currently unknown.
Methods & findings
This study examined the safety and effectiveness of BV therapy through examining the medical records of a group of 43 relapsed and refractory disease patients. They were treated with thirty minutes of BV (1.8 mg / kg) every three weeks for an average of eight cycles. Patients were followed for an average of 36.8 months.
After 12.3 weeks, the best response rate was 69.8%. 46.5% had complete response (CR, no sign of disease). 20.9% had progressive disease after treatment.
The average response duration was 31.5 months. At the latest available follow-up, 75% were still showing a response to treatment. 45% did not undergo further therapy (such as stem cell transplant).
Among CR-patients the 3-year disease-free survival (DFS) was 74.6%. DFS was survival from BV-treatment to relapse, lymphoma death, or acute toxicity. 63.3% of patients had a treatment response of longer than 12 months.
34.5% experienced low-grade and 6.97% experienced high-grade neurological side effects. These effects reversed after the end of treatment.
The bottom line
The authors concluded that BV treatment was safe and effective in patients with relapsed or refractory Hodgkin lymphoma.
The fine print
Larger prospective trials are needed.
Published By :
The Oncologist
Date :
Dec 01, 2016
