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Walewski J, Hellmann A, Siritanaratkul N, Ozsan GH, Ozcan M, Chuncharunee S, Goh AS, Jurczak W, Koren J, Paszkiewicz-Kozik E, Wang B, Singh S, Huebner D, Engert A, von Tresckow B. Prospective study of brentuximab vedotin in relapsed/refractory Hodgkin lymphoma patients who are not suitable for stem cell transplant or multi-agent chemotherapy. Br J Haematol 2018; 183:400-410. [PMID: 30168134 DOI: 10.1111/bjh.15539] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Accepted: 06/21/2018] [Indexed: 01/22/2023]
Abstract
Some patients with relapsed/refractory Hodgkin lymphoma (HL) are not considered suitable for stem cell transplant (SCT) and have a poor prognosis. This phase IV study (NCT01990534) evaluated brentuximab vedotin (1·8 mg/kg intravenously once every 3 weeks) in 60 patients (aged ≥18 years) with CD30-positive relapsed/refractory HL, a history of ≥1 prior systemic chemotherapy regimen, who were considered unsuitable for SCT/multi-agent chemotherapy. Primary endpoint was overall response rate (ORR) per independent review facility (IRF). Secondary endpoints included duration of response (DOR), progression-free survival (PFS) per IRF, overall survival (OS), proportion proceeding to SCT and safety. The ORR was 50%, with 12% CR; 47% proceeded to SCT. Median DOR was 4·6 months and median duration of CR was 6·1 months. After a median follow-up of 6·9 and 16·6 months, median PFS and OS were 4·8 months (95% confidence interval, 3·0-5·3) and not reached, respectively; estimated OS rate was 86% at 12 months. Most common adverse events (≥10%) were peripheral neuropathy (35%), pyrexia (18%), diarrhoea and neutropenia (each 10%). Brentuximab vedotin showed notable activity with a safety profile consistent with known toxicities, and may act as a bridge to SCT, enabling high-risk patients who achieve suboptimal response to frontline/salvage chemotherapy/radiotherapy to receive potentially curative SCT.
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Affiliation(s)
- Jan Walewski
- Department of Lymphoid Malignancy, Maria Sklodowska-Curie Institute - Oncology Centre, Warszawa, Poland
| | - Andrzej Hellmann
- Department of Haematology, Medical University of Gdańsk, Gdańsk, Poland
| | | | | | - Muhit Ozcan
- Department of Haematology, Ankara University School of Medicine, Ankara, Turkey
| | - Suporn Chuncharunee
- Oncology Centre, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Ai Sim Goh
- Department of Medicine, Hospital Pulau Pinang, Pulau Pinang, Malaysia
| | - Wojciech Jurczak
- Department of Haematology, Jagiellonian University, Kraków, Poland
| | - Jan Koren
- Department of Haematology, Charles University, Prague, Czech Republic
| | - Ewa Paszkiewicz-Kozik
- Department of Lymphoid Malignancy, Maria Sklodowska-Curie Institute - Oncology Centre, Warszawa, Poland
| | - Bingxia Wang
- Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA, USA
| | - Shalini Singh
- Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA, USA
| | - Dirk Huebner
- Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited, Cambridge, MA, USA
| | - Andreas Engert
- Department of Internal Medicine, University Hospital Cologne, Cologne, Germany
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