BRENTUXIMAB VEDOTIN WITH CHEMOTHERAPY FOR STAGE III OR IV HODGKIN LYMPHOMA: IMPACT OF CYCLE 2 PET RESULT ON MODIFIED PROGRESSION-FREE SURVIVAL
Author(s): ,
Robert Chen
Affiliations:
Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center,Duarte,United States
,
Stephen Ansell
Affiliations:
Department of Internal Medicine, Division of Hematology, Mayo Clinic,Rochester,United States
,
Andrea Gallamini
Affiliations:
Research Innovation and Statistics, Antoine-Lacassagne Cancer Centre,Nice,France
,
Joseph Connors
Affiliations:
University of British Columbia and British Columbia Cancer Agency Centre for Lymphoid Cancer,Vancouver,Canada
,
Kerry Savage
Affiliations:
University of British Columbia and British Columbia Cancer Agency Centre for Lymphoid Cancer,Vancouver,Canada
,
Graham Collins
Affiliations:
Oxford Cancer and Haematology Centre, Churchill Hospital,Oxford,United Kingdom
,
Andrew Grigg
Affiliations:
Department of Clinical Haematology, Austin Hospital,Melbourne,Australia
,
Anna Sureda
Affiliations:
Clinical Hematology Department, Institut Català d'Oncologia-Hospitalet,Barcelona,Spain
,
Nilanjan Ghosh
Affiliations:
Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Carolinas HealthCare System,Charlotte,United States
,
Tatyana Feldman
Affiliations:
John Theurer Cancer Centre, Hackensack University Medical Center,Hackensack,United States
,
Alexander Fosså
Affiliations:
Department of Oncology, Oslo University Hospital-Norwegian Radium Hospital,Oslo,Norway
,
Evren Ozdemir
Affiliations:
Institute of Cancer, Hacettepe University,Ankara,Turkey
,
Fritz Offner
Affiliations:
Hematology, Department of Internal Medicine, Ghent University Hospital,Ghent,Belgium
,
Gerald Engley
Affiliations:
Seattle Genetics, Inc.,Bothell,United States
,
Keenan Fenton
Affiliations:
Seattle Genetics, Inc.,Bothell,United States
,
Connie Lee
Affiliations:
Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited,Cambridge,United States
,
Hina Jolin
Affiliations:
Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited,Cambridge,United States
,
Ashish Gautam
Affiliations:
Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited,Cambridge,United States
Martin Hutchings
Affiliations:
Department of Hematology, Rigshospitalet, Copenhagen University Hospital,Copenhagen,Denmark
EHA Library. Chen R. 06/16/18; 215482; PS1172
Robert Chen
Robert Chen
Contributions
Abstract

Abstract: PS1172

Type: Poster Presentation

Presentation during EHA23: On Saturday, June 16, 2018 from 17:30 - 19:00

Location: Poster area

Background
The ECHELON-1 trial demonstrated improved outcomes for patients with advanced Hodgkin lymphoma (HL) who received frontline A+AVD (brentuximab vedotin, doxorubicin, vinblastine, dacarbazine) vs ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), with 2-year modified progression-free survival (mPFS) rates of 82% and 77%, respectively.

Aims
In this post-hoc analysis, we examine the mPFS outcomes and clinical characteristics by Cycle 2 positron-emission tomography (PET2) status, per independent review facility (IRF).

Methods
Patients were randomized 1:1 to A+AVD or ABVD on Days 1 and 15 for up to six 28-day cycles. PET scans were conducted at the end of Cycle 2 and end of treatment. PET2 results guided an optional switch to alternative therapy at the treating physician’s discretion for patients with a Deauville score of 5. A switch to alternative therapy was not considered an event. The primary endpoint, mPFS, was defined as time to progression, death, or absence of a complete response with subsequent anticancer therapy, per IRF.

Results
PET2 negativity rates (Deauville ≤3) were 89% (588/664 patients) in the A+AVD arm and 86% (577/670) with ABVD. Baseline characteristics were well-balanced across arms, with no significant differences in PET2– vs PET2+ patients in either arm. PET2 positivity rates (Deauville ≥4) were 7% (47/644) in the A+AVD arm and 9% (58/670) with ABVD; in total, 5 patients with a Deauville score of 5 switched to alternative frontline therapy.  Subgroup analyses showed a favorable treatment effect for both subgroups in favor of A+AVD (Table), with 2-year mPFS (PET2– vs PET2+) of 85.2 vs 57.5% in the A+AVD arm, and 80.9 vs 42.0% in the ABVD arm. In both arms, outcomes for PET2+ patients were poor compared with PET– patients, consistent with findings from other studies.

Conclusion
Overall, ECHELON-1 demonstrated a treatment effect in favor of A+AVD over ABVD. This post-hoc analysis showed a similar treatment effect on mPFS consistently in favor of A+AVD regardless of PET2 status.

Session topic: 17. Hodgkin lymphoma – Clinical

Keyword(s): CD30, Clinical Trial, Hodgkin's Lymphoma

Abstract: PS1172

Type: Poster Presentation

Presentation during EHA23: On Saturday, June 16, 2018 from 17:30 - 19:00

Location: Poster area

Background
The ECHELON-1 trial demonstrated improved outcomes for patients with advanced Hodgkin lymphoma (HL) who received frontline A+AVD (brentuximab vedotin, doxorubicin, vinblastine, dacarbazine) vs ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), with 2-year modified progression-free survival (mPFS) rates of 82% and 77%, respectively.

Aims
In this post-hoc analysis, we examine the mPFS outcomes and clinical characteristics by Cycle 2 positron-emission tomography (PET2) status, per independent review facility (IRF).

Methods
Patients were randomized 1:1 to A+AVD or ABVD on Days 1 and 15 for up to six 28-day cycles. PET scans were conducted at the end of Cycle 2 and end of treatment. PET2 results guided an optional switch to alternative therapy at the treating physician’s discretion for patients with a Deauville score of 5. A switch to alternative therapy was not considered an event. The primary endpoint, mPFS, was defined as time to progression, death, or absence of a complete response with subsequent anticancer therapy, per IRF.

Results
PET2 negativity rates (Deauville ≤3) were 89% (588/664 patients) in the A+AVD arm and 86% (577/670) with ABVD. Baseline characteristics were well-balanced across arms, with no significant differences in PET2– vs PET2+ patients in either arm. PET2 positivity rates (Deauville ≥4) were 7% (47/644) in the A+AVD arm and 9% (58/670) with ABVD; in total, 5 patients with a Deauville score of 5 switched to alternative frontline therapy.  Subgroup analyses showed a favorable treatment effect for both subgroups in favor of A+AVD (Table), with 2-year mPFS (PET2– vs PET2+) of 85.2 vs 57.5% in the A+AVD arm, and 80.9 vs 42.0% in the ABVD arm. In both arms, outcomes for PET2+ patients were poor compared with PET– patients, consistent with findings from other studies.

Conclusion
Overall, ECHELON-1 demonstrated a treatment effect in favor of A+AVD over ABVD. This post-hoc analysis showed a similar treatment effect on mPFS consistently in favor of A+AVD regardless of PET2 status.

Session topic: 17. Hodgkin lymphoma – Clinical

Keyword(s): CD30, Clinical Trial, Hodgkin's Lymphoma

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