Evaluating the long-term outcomes of brentuximab vedotin after stem cell transplantation for classical Hodgkin’s lymphoma

This study evaluated the long-term survival and safety of brentuximab vedotin (Adcetris) treatment for patients with classical Hodgkin’s lymphoma (cHL) after autologous stem cell transplantation (auto-SCT; patient's own healthy stem cells are retrieved and then returned into the body after cancer has been removed with chemotherapy or radiation). This study concluded that brentuximab vedotin was well-tolerated and improved long-term survival outcomes for these patients.

Most patients with cHL respond to front-line chemotherapy regimens. However, up to 20% of these patients experience relapse (cancer recurrence) or disease progression (tumor growth or spread) after initial treatment. The standard of care for these patients is high-dose chemotherapy followed by auto-SCT.  

However, most patients with high-risk disease experience disease progression after auto-SCT. Brentuximab vedotin is a monoclonal antibody. This type of treatment binds to cancer cells, leading to cancer cell death. Whether treatment with brentuximab vedotin after auto-SCT improves outcomes on the long-term for these patients remains under investigation.

This study involved 329 patients with cHL treated with auto-SCT. After the auto-SCT, patients received either brentuximab vedotin (50.2%) or placebo (a substance with no active effect; 49.8%). Patients were followed-up for an average of 5 years.

At follow-up, five-year progression-free survival (patients still alive at 5 years without disease progression) was higher in the brentuximab vedotin group (59%) compared to placebo (41%). For patients with 2 or more risk factors for disease progression, brentuximab vedotin was associated with a 57.6% lower risk of disease progression at 5 years compared to placebo.

The most common side effect in the brentuximab vedotin group was neuropathy (numbness and tingling in the hands or feet; 67%). Low white blood cell count (35%) and chest infections (26%) were also reported. In 73% of patients in the brentuximab vedotin group who reported neuropathy had complete disappearance of their symptoms.

Overall, significantly fewer patients in the brentuximab vedotin group (32%) received further anti-cancer therapy after auto-SCT compared to placebo (54%). 87% of patients in the placebo group received additional therapy with brentuximab vedotin.

This study concluded that brentuximab vedotin was well-tolerated and improved long-term progression-free survival in high-risk patients with cHL.