Evaluating brentuximab vedotin for elderly patients with hard to treat Hodgkin lymphoma

This study evaluated the safety and effectiveness of brentuximab vedotin (Adcetris) in elderly patients with relapsed or unresponsive Hodgkin lymphoma (HL). This study found that this treatment was effective, although frail patients may be at higher risk for side effects.

Most patients with HL respond to front-line chemotherapy regimens. However, up to 20% have HL that comes back (relapse) or becomes refractory (stops responding to treatment). Elderly patients are particularly at high risk of poor outcomes. For example, having additional medical conditions can lead to more side effects or require lower doses of treatment. This can lower the effectiveness of treatment.

Treating elderly patients with relapsed or refractory HL remains challenging. One treatment option is brentuximab vedotin (BV), a monoclonal antibody. This type of treatment binds to cancer cells, leading to cancer cell death. The safety and effectiveness of BV in older patients with relapsed or refractory HL is unclear.

This study had 20 elderly patients with HL that came back or stopped responding to initial treatment. Patients received an average of 7 cycles of BV treatment. 17 patients were included in the final analysis. Patients were followed for an average of 24.9 months.

Overall, 9 patients (52.9%) responded to treatment. 4 patients (23.5%) had no signs of cancer after treatment (complete response). The average survival was 21.7 months. Patients survived for an average of 8.8 months without the cancer getting worse. Among those who had no signs of cancer after treatment, one patient continued to be in remission 16.4 months after the end of treatment.

The most common side effects were low white blood cell levels (5 patients, 27%) and numbness or tingling in the hands or feet (6 patients, 33%). 4 patients (22%) developed skin rash. Overall, 9 patients (50%) had serious side effects. These included infections, nausea or vomiting, and numbness or tingling in the hands or feet. 7 patients stopped treatment due to side effects.

This study concluded that BV was effective for elderly patients with HL that came back or stopped responding to treatment. The authors suggest that frail patients should be monitored during treatment due to potential side effects.

This phase 2 study had a very small number of patients. Also, this study did not compare BV to other treatments. More studies are needed to evaluate which patients could benefit most from therapy with BV.

This study received partial funding support from Takeda, the manufacturer of BV.