Is BRESHAP an effective treatment for relapsed and unresponsive Hodgkin lymphoma?

This study examined how safe and effective brentuximab vedotin (Adcedris) is when added to conventional treatments for relapsed and unresponsive Hodgkin lymphoma. 

This study concluded that this treatment is safe and effective when used as part of the treatment for Hodgkin lymphoma.

Standard treatment for patients with Hodgkin lymphoma (HL) includes high dose chemotherapy followed by a stem cell transplantation (SCT). SCT is a procedure where a patient receives healthy blood-forming cells (stem cells). These replace cells that have been destroyed by disease or toxic treatment. ESHAP (etoposide, methylprednisolone, cytarabine, and cisplatin) is a chemotherapy commonly used to treat Hodgkin lymphoma.

Brentuximab vedotin (BV) is a drug that helps the immune system to kill cancer cells. It is commonly used in patients who do not respond or relapse after first-line treatments. The combination of BV and ESHAP is called BRESHAP. It is unknown if BRESHAP before SCT is safe and effective as a treatment for relapsed and unresponsive HL.

66 patients with relapsed or unresponsive HL were included in this study. The patients were given BRESHAP treatment before SCT, followed by 3 courses of BV after SCT.

91% of patients had a positive response to treatment before the transplant. 70% of these patients had a complete response (disappearance of all signs of cancer). 60 patients had a SCT. After the transplant, 82% of patients had no signs of HL. 10% of patients had a reduction in the size of cancer. 

The 30-month overall survival was 91% of the patients had survived. The 30-month survival without the tumor growing or spreading was 71%. 

There were 39 severe and life-threatening treatment side effects recorded. Some patients experienced more than one serious side effect. Most of these were high fever and low blood cell counts

This study concluded that BRESHAP is safe and effective for patients with relapsed or unresponsive HL before a SCT.

This was a very small study carried out over a short period of time. Larger studies are needed, with longer follow up. This research was funded by Takeda, the manufacturer of BV.