In a nutshell
This study determined the real-world outcomes for patients with relapsed or refractory Hodgkin’s lymphoma (rrHL) who were given brentuximab vedotin (Adcetris) due to ineligibility for autologous stem cell transplant (ASCT). The study concluded that brentuximab vedotin is feasible and effective in patients with rrHL who are ineligible for ASCT, especially those who are elderly or frail.
Some background
Most patients with Hodgkin’s lymphoma (HL) respond to front-line chemotherapy regimens, but up to 20% experience relapse or progression after initial treatment. The standard therapies for these patients are high-dose chemotherapy and autologous stem cell transplant (ASCT) to eliminate remaining cancer cells. However, some patients may not be candidates for ASCT due to their older age or disease not responding to chemotherapy, resulting in a poor prognosis.
Brentuximab vedotin is a monoclonal antibody. This type of treatment binds to cancer cells, leading to cancer cell death. This treatment is used for refractory or relapsed HL patients for whom ASCT is not an option. Outcomes for these patients who receive brentuximab vedotin have not been studied in a real-world setting outside of clinical trials.
Methods & findings
This study involved 136 patients (average age of 70 years) with relapsed or refractory HL at various stages. 46% of patients had radiotherapy before the study as a front-line treatment (26%) or before getting brentuximab vedotin (20%). The most common reasons for ASCT ineligibility were comorbidities (64%) or older age (57%). At time of treatment with brentuximab vedotin during the study, 54% of relapsed patients had stage 3 or 4 disease. 9.6% of relapsed patients had bulky disease (tumors 10 centimeters or bigger). Patients were followed for an average of 10.9 months.
Patients showed a 74.3% response rate (tumor shrinkage or disappearance). 34.6% of patients showed complete tumor disappearance and 39.7% of patients showing tumor shrinkage. Average progression-free survival (time from treatment until disease progression) was 15.1 months. Average overall survival (time from treatment until death from any cause) was 17.8 months.
44% of patients reported side effects, with the most common being low white blood cell count (12.5%), low red blood cell count (8.8%), and peripheral neuropathy (9.6%, numbness or pain in the hands and feet). 92.3% of peripheral neuropathy cases were not serious.
The bottom line
This study concluded that brentuximab vedotin is feasible and effective for patients with relapsed or refractory HL who are ineligible for ASCT.
The fine print
The current study received funding from Bristol-Myers Squibb, a company that worked on clinical trials with the makers of brentuximab vedotin (Seattle Genetics). At the time of this study, the authors had various roles in Takeda as advisors, paid consultants, or employees. Takeda is developing brentuximab vedotin with Seattle Genetics, and has rights to commercialize it outside of the U.S.
Because study data came from patient medical charts, the data was limited, and side effects due to treatment may have been under-reported. Because this study did not have a control group, more research is needed to compare the effectiveness of brentuximab vedotin to other treatments.
What’s next?
If you have relapsed or refractory Hodgkin’s lymphoma and are ineligible for stem cell transplant, talk to your care team about including brentuximab vedotin in your treatment regimen.
Published By :
European Journal of Haematology
Date :
Sep 26, 2017
