In a nutshell
This study examined how well brentuximab vedotin (Adcetris) plus high-dose bendamustine (Treanda) worked in patients with recurrent or non-responsive classical Hodgkin’s lymphoma (cHL). This study concluded that this regimen was highly effective for these patients.
Some background
After initial treatment, many patients with cHL eventually experience relapse (cancer comes back) or develop disease that stops responding to treatment (refractory). For these patients, the next step typically is salvage therapy. This goal of this therapy is to eliminate remaining cancer or induce a response in refractory disease.
Brentuximab vedotin (Bv) and bendamustine (Bs) are drugs used for the treatment of blood cancers. Previous studies have shown that long-term survival outcomes remain low with either of these treatments alone. New studies suggest that increasing the dose of Bs and combining it with Bv may help. The effectiveness of this combination for patients with relapsed or unresponsive cHL remains under investigation.
Methods & findings
This study involved 20 patients with cHL that has come back or stopped responding to treatment. 70% of patients had stage 3 – 4 disease. Patients had an average of 3 prior lines of treatment. In this study, all patients received 4 courses of Bv + Bs. PET scanning was done after treatment. If there were remaining cancer cells, patients then had a stem cell transplant (SCT) or more Bv + Bs treatment. Patients were followed-up for an average of 27 months.
80% of patients responded very well to treatment, with minimal cancer remaining. At follow-up, 93.7% of all patients were still alive without tumor growth or spread. 18 patients out of 20 underwent SCT. 2 patients received 2 more courses of Bv + Bs treatment.
Overall, 10 patients (50%) had severe side effects. The most common were severe low white blood cell count (3 patients) and severe viral infection with fever (5 patients). These side effects were managed with treatment. 2 patients (10%) had infusion-related reactions. These included fever, chills, and shortness of breath. Overall, 8 patients (40%) stopped treatment temporarily due to side effects. These patients finished all 4 courses of study treatment.
The bottom line
This study concluded that the Bv + Bs regimen was highly effective for patients with relapsed or unresponsive cHL. The authors suggest that this regimen may help improve long-term control of cHL, especially for high-risk patients.
The fine print
This was a very small study. More studies with larger patient populations are needed to confirm these results.
Published By :
Blood advances
Date :
May 14, 2019
