How safe and effective is biological drug brentuximab vedotin combined with R-CHP chemotherapy for patients with non-Hodgkin lymphoma?

This study examined the effectiveness and safety of adding brentuximab vedotin (Adcetris) to R-CHP (rituximab, cyclophosphamide, doxorubicin, and prednisone) chemotherapy for patients with non-Hodgkin lymphoma (NHL). The authors concluded that the treatment was very effective and safe for patients.

Chemotherapy combinations are effective treatments for patients with NHL. These include R-CHP. However, the effectiveness of R-CHP can be improved. 

Brentuximab vedotin (BV) is a biological therapy that identifies cancer cells with a molecule called CD30. Some subtypes of NHL have CD30, especially primary mediastinal B-cell lymphoma (PMBCL). CD30 may also be present in other NHL subtypes such as diffuse large B-cell lymphoma (DLBCL) and gray zone lymphoma (GZL). It is unclear if BV combined with R-CHP is safe and effective for patients with NHL.

31 patients with NHL received BV and R-CHP.  23 patients had PMBCL, 6 had DLBCL, and 2 had GZL.  Patients were followed for an average of 30 months.

All patients had a response to treatment. 86% of patients had no signs of cancer after treatment (complete response) and 14% had a significant reduction in cancer (partial response). 52% of patients were given radiotherapy based on the results of BV and R-CHP treatment.

After 2 years, 85% of patients did not experience worsening of NHL and all had survived. Of the patients with PMBCL, 86% did not experience cancer worsening. Of the patients who did experience cancer worsening, low levels of CD30 were detected in their tumors.

84% of the patients experienced serious side effects. The most common side effect was blood-related, such as low levels of white or red blood cells (77% of patients). 32% of patients developed other serious side effects. The most common of these were infections and blood clots.

The authors concluded that BV with R-CHP was an effective treatment for patients with NHL, particularly for those with significant levels of CD30.

The manufacturer of BV, Seattle Genetics, funded this study. There was no comparison treatment in this study so it is difficult to know how it compares to other available treatments. There were very few patients included in this study and it would benefit from being repeated with a larger group.