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Posted by on Aug 27, 2023 in Hodgkin's lymphoma | 0 comments

In a nutshell

This study evaluated the effectiveness and safety of brentuximab vedotin (BV; Adcetris) plus nivolumab (Opdivo) consolidation therapy after autologous hematopoietic stem-cell transplantation (HSCT) in patients with high-risk relapsed or refractory (r/r) classical Hodgkin lymphoma (cHL). The data showed that the BV plus nivolumab combination was effective with manageable side effects in these patients.

Some background

Classical Hodgkin lymphoma (cHL) is a cancer of white blood cells. A high number of patients with cHL experience relapse (worsening of the disease) or are refractory (not responsive) to standard treatments. Immunotherapies have improved the outcomes of these patients.

BV is an immune therapy used for the treatment of r/r cHL. BV is an antibody-drug conjugate. It combines an immune protein with an anti-cancer drug. Nivolumab is an immune checkpoint inhibitor that prevents the immune system from switching off. This allows the immune system to target and kill cancer cells.

Studies have shown that consolidation with BV improved the survival without cancer worsening in high-risk patients with r/r cHL after autologous stem cell transplantation (auto-SCT). Auto-SCT involves transplanting healthy stem cells from the same patient. Consolidation treatment is used immediately after induction treatment (lead-in treatment to kill cancer cells) in order to deepen response to treatment. The effectiveness and safety of combining BV with nivolumab after autologous HSCT in patients with high-risk r/r cHL are still unknown.

Methods & findings

This study involved 59 patients with high-risk r/r cHL. After autologous HSCT, all patients received BV plus nivolumab once every 3 weeks for 8 cycles. The average follow-up time was 29.9 months.

After 18 months, 94% of the patients were alive without cancer worsening. After 24 months, 92% of the patients were alive without cancer worsening. After 24 months, 98% of the patients were alive.

53% of the patients experienced sensory peripheral neuropathy (nerve damage in the hands and feet). 42% of the patients experienced low white blood cell counts. 29% of the patients experienced serious immune-related side effects such as lung inflammation, low thyroid function, rash, and liver damage.

The bottom line

This study concluded that the BV plus nivolumab combination after HSCT was effective with manageable side effects in patients with high-risk r/r cHL.

The fine print

This study was funded by Bristol Myers Squibb, the manufacturer of nivolumab. The sample size was very small. There was no control group. This study was conducted only at institutions in the USA.

Published By :

The Lancet. Haematology

Date :

Nov 17, 2022

Original Title :

Brentuximab vedotin plus nivolumab after autologous haematopoietic stem-cell transplantation for adult patients with high-risk classic Hodgkin lymphoma: a multicentre, phase 2 trial.

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