Brentuximab Vedotin Effective, Safe in Elderly Hodgkin Lymphoma Patients Who Cannot Tolerate Standard Chemotherapy
A study published by Forero-Torres et al in Blood reported that brentuximab vedotin (Adcetris) is an effective and safe first course of treatment for older patients with Hodgkin lymphoma who are unfit for chemotherapy.
Ineligibility for Chemotherapy
Although standard chemotherapy can achieve complete remissions in younger patients with Hodgkin lymphoma, the majority of those 60 and older are either ineligible or refuse treatment to avoid complications related to drug toxicity. As the rate of remission is much lower for older than younger patients with Hodgkin lymphoma, there is a clear need for less-toxic treatments that allow patients 60 and older to complete their full regimen without complications or interruptions.
Researchers suggest that one promising treatment is brentuximab vedotin, a therapy that targets Hodgkin lymphoma cells and delivers a potent dose of chemotherapy without harming healthy cells. In previous studies, brentuximab vedotin has achieved remissions in patients with relapsed or treatment-resistant disease.
To examine the potential of brentuximab vedotin as a first course of treatment for older patients with Hodgkin lymphoma, a research team lead by Andres Forero-Torres, MD, of the University of Alabama at Birmingham and the UAB Comprehensive Cancer Center, conducted a phase II open-label study evaluating 26 patients, aged 64 to 92, who were either ineligible for conventional chemotherapy or declined treatment after receiving information about its risks.
Study Details
Researchers administered 1.8 mg/kg of intravenous brentuximab vedotin treatment every 3 weeks for up to 16 doses. Those who benefitted from the drug could continue beyond this period until disease progression, unacceptable toxicity, or study closure. Patients received a median of eight cycles, with four completing 16 cycles and one completing 23 cycles.
At the time of analysis, 92% of patients achieved a complete or partial response to the drug that lasted approximately 9.1 months. Of those patients, 73% achieved a complete remission that lasted approximately 9.2 months.
The treatment was generally well tolerated and consistent with previous reports of brentuximab vedotin in patients with relapsed and treatment-resistant Hodgkin lymphoma. The most common adverse event was peripheral sensory neuropathy (78%). Fewer than half of patients experienced fatigue and nausea.
“In this population of older patients with Hodgkin lymphoma who were unfit for standard chemotherapy, we observed that brentuximab vedotin as a single agent produced a very high rate of response, including a very high rate of complete remission,” said Dr. Forero-Torres. “While we observed promising responses, the next step is to evaluate this drug in combination with additional chemotherapy or immunotherapies that might allow us to prolong the response without relapse.”
Dr. Forero-Torres is the corresponding author of the Blood article.
The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.
