Five-Year Survival Data: Brentuximab Vedotin May Be Curative in Some Patients With Hodgkin Lymphoma
Five-year survival data published by Chen et al in Blood suggest that the targeted therapy brentuximab vedotin (Adcetris) may be curative in some patients with Hodgkin lymphoma whose disease has persisted despite receiving previous therapies.
This multinational phase II study examined brentuximab vedotin in patients with Hodgkin lymphoma who relapsed after stem cell transplant. The study reported that 13 of 34 patients (38%) who achieved complete remission have remained disease-free for over 5 years and may be cured. Of those patients, nine received only single-agent brentuximab vedotin.
Brentuximab vedotin is an immunotherapy that targets CD30, a protein on the surface of some Hodgkin lymphoma cells, and delivers a potent dose of chemotherapy to destroy the cell. The therapy is approved by the U.S. Food and Drug Administration for relapsed or treatment-resistant Hodgkin lymphoma, and it is commonly prescribed to patients whose disease has progressed after autologous stem cell transplant. This is the first study to observe long-term success with brentuximab vedotin in such patients who have exhausted all other treatment options.
“For a patient population that typically only sees an overall survival of 1 to 2 years after relapse from autologous stem cell transplantation, the fact that we can report such durable results after 5 [years] is incredible,” said lead author Robert Chen, MD, Assistant Professor in the Department of Hematology & Hematopoietic Cell Transplantation at City of Hope Cancer Research Center. Referencing the 15 patients still in remission at the close of this longitudinal study, Dr. Chen said, “Each day that these individuals continue to spend with their loved ones is a testament to the strides our community is making in understanding and beating treatment-resistant lymphomas.”
Study Details
In this study, 102 patients with CD30-positive Hodgkin lymphoma were given one dose (1.8 mg/kg) of brentuximab vedotin through outpatient intravenous infusion every 3 weeks for up to 16 cycles. Prior to beginning this trial, these patients had failed to achieve remission on a median of 3.5 therapies including stem cell transplant, which, prior to brentuximab vedotin, was the only potentially curative treatment for those who failed to respond to standard chemotherapy. Researchers monitored patients from their initial response (either complete or partial reduction of the tumor) until disease progression or death and continued the study for approximately 5 years after final treatment.
5-Year Findings
At 5 years, 34 of the 102 patients had achieved a complete response, with an estimated 64% of patients surviving with or without disease (median 5-year overall survival was 40.5 months) and an estimated 52% surviving without disease progression. Of these 34 patients, 13 (38%) have remained in remission for 5 years, and an additional 2 patients whose disease did not progress after brentuximab vedotin went on to achieve remission after receiving allogeneic stem cell transplant. These two patients also remain in remission 5 years later.
“It is critical to note that nine of the complete response patients have been in remission for over 5 years after receiving only brentuximab vedotin,” said Dr. Chen. “The fact that these patients are doing so well, even 5 years out, provides a new perspective for prognosis.”
Dr. Chen pointed out that although 56 of the patients treated in the study experienced mild peripheral neuropathy, 88% reported that symptoms abated over time.
Currently, brentuximab vedotin is the subject of several clinical trials. Notable among them are the use of brentuximab vedotin prior to autologous stem cell transplant in patients with Hodgkin lymphoma, to treat additional CD30-positive lymphomas, and in patients with relapsed or treatment-resistant non-Hodgkin lymphoma.
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®.
