Evaluating the combination of brentuximab vedotin and bendamustine in hard to treat Hodgkin lymphoma.

This study examined the safety and effectiveness of combining brentuximab vedotin (Adcetris) and bendamustine (Treanda) in patients with reoccurring or unresponsive Hodgkin lymphoma (HL). The authors concluded that this regimen shows promise in HL which is difficult to treat. 

The standard treatment for HL which reoccurs or does not respond to initial treatment is called salvage therapy. This can be then followed by high dose chemotherapy and bone marrow transplant. The reoccurrence of disease is the main cause of bone marrow transplant failure. Therefore, optimizing patient outcomes when HL relapses or does not respond to treatment is a priority. 

Brentuximab vedotin and bendamustine have both proven effective in HL treatment when used alone. Therefore, it has been suggested that combining the treatments may be useful in hard to treat HL cases. 

This study included 40 patients with reoccurring or unresponsive HL. All participants were given the combined bendamustine and brentuximab vedotin (BBV) treatment. Patients received an average of 4 cycles of BBV. Imaging studies were used to assess disease progression. The average follow-up period was 23 months.

38 of the initial 40 patients were able to be assessed for the effectiveness of the therapy. Overall, 84.2% responded to treatment. In those who had reoccurring disease, the response rate was 94.4% vs 75% in those whose HL had not responded to initial treatment. 78.9% of patients had a complete response (no signs of cancer) and 5.3% had a partial response (tumor shrinkage). 33 patients underwent a bone marrow transplant after the BBV treatment.  

At 3 years, 88.1% of patients were still alive and 67.3% of patients had no disease progression. 3 people experienced low immune cell counts which resolved in one week. Skin reactions were also common. No high-grade side effects were noted.  

The authors concluded that the BBV treatment regimen shows promise for use in hard to treat HL.

This study was partially supported by Takeda, the manufacturer of brentuximab vedotin. This study included a small number of participants. Larger studies are needed for stronger evidence.