Contributions
Abstract: PB2016
Type: Publication Only
Background
Brentuximab vedotin (BV) is an antibody-drug conjugate (ADC) that selectively delivers monomethyl auristatin E, an antimicrotubule agent, into CD30-expressing cells. A phase I and II studies with BV demonstrated significant activity with favourable safety profile in patients with relapsed and refractory (R/R) CD30 positive lymphomas.
Aims
To evaluate epidemiological data and the impact of BV on survival in R/R Hodgkin lymphoma (HL) patients.
Methods
This is a retrospective analysis of 51 patients with R/R HL treated at three Slovak centers from 1/2014 to 12/2016. Fifty one patients received BV treatment in the period from 07/2012 to 02/2017. Bretuximab vedotin was administrated intravenously in the dose of 1.8 mg/kg every 3 weeks.
Results
In brief, the median age at the time of diagnosis was 33 years. In addition, the median age of participants at the time of initiation of our study was 38.8 years. Median time from the first-line therapy to BV treatment was 28 months. In total, 35 patients (70.0%) had R/R HL within 1 year after the end of last treatment. Based on clinical judgment, the treating physician categorized participants as eligible (n=39) or ineligible (n=11) for autologous stem cell transplantation (ASCT). The median number of previous lines of the therapy was 5 in ASCT-eligible patients and 3 in ASCT-ineligible patients. The progression free survival (PFS) was 7.0 months for 32 patients who did not undergo SCT. In patients (n=8) who achieved complete (CR) or partial remission (PR), the PFS was 34 months. On the other hand, 24 patients with stable disease (SD) or disease progression had PFS only 4.9 months. The median PFS for patients (n=13) treated with BV therapy and immediately followed by allogeneic stem cell transplant (aloSCT) has not been reached. In patients (n=5) who had undergone chemotherapy followed by aloSCT, PFS was only 5.8 months (Figure 1). We have identified 29 patients who underwent ASCT with at least one risk factor for relapse or disease progression. The most common risk factor was early progression after first-line treatment. The patients underwent BV treatment with a median of 8 cycles, and 4 patients (8%) completed 16 cycles of the treatment. BV dose was reduced in 16% of patients; most common reasons were anemia, neutropenia and thrombocytopenia existing prior to initiating BV treatment, toxicity during the treatment was reason for reduction only in one patient.
Conclusion
Our study included patients in second or further line of therapy. Overall, 70% of patients had documented R/R HL within 1 year after the end of last treatment. No severe toxicity related to BV regimen was observed. Improved outcomes were observed in patients who achieved a complete remission on BV. BV use pre-allogeneic SCT is associated with a rapid response in a majority of patients with R/R HL compared with standard chemotherapy. Therefore, BV may represent also an optimal therapeutic option as a bridge to aloSCT in R/R HL patients. Our analysis confirmed BV efficacy in heavily pretreated R/R HL patients in real clinical practice.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Allogeneic, Autologous, Hodgkin's Lymphoma, Transplant
Abstract: PB2016
Type: Publication Only
Background
Brentuximab vedotin (BV) is an antibody-drug conjugate (ADC) that selectively delivers monomethyl auristatin E, an antimicrotubule agent, into CD30-expressing cells. A phase I and II studies with BV demonstrated significant activity with favourable safety profile in patients with relapsed and refractory (R/R) CD30 positive lymphomas.
Aims
To evaluate epidemiological data and the impact of BV on survival in R/R Hodgkin lymphoma (HL) patients.
Methods
This is a retrospective analysis of 51 patients with R/R HL treated at three Slovak centers from 1/2014 to 12/2016. Fifty one patients received BV treatment in the period from 07/2012 to 02/2017. Bretuximab vedotin was administrated intravenously in the dose of 1.8 mg/kg every 3 weeks.
Results
In brief, the median age at the time of diagnosis was 33 years. In addition, the median age of participants at the time of initiation of our study was 38.8 years. Median time from the first-line therapy to BV treatment was 28 months. In total, 35 patients (70.0%) had R/R HL within 1 year after the end of last treatment. Based on clinical judgment, the treating physician categorized participants as eligible (n=39) or ineligible (n=11) for autologous stem cell transplantation (ASCT). The median number of previous lines of the therapy was 5 in ASCT-eligible patients and 3 in ASCT-ineligible patients. The progression free survival (PFS) was 7.0 months for 32 patients who did not undergo SCT. In patients (n=8) who achieved complete (CR) or partial remission (PR), the PFS was 34 months. On the other hand, 24 patients with stable disease (SD) or disease progression had PFS only 4.9 months. The median PFS for patients (n=13) treated with BV therapy and immediately followed by allogeneic stem cell transplant (aloSCT) has not been reached. In patients (n=5) who had undergone chemotherapy followed by aloSCT, PFS was only 5.8 months (Figure 1). We have identified 29 patients who underwent ASCT with at least one risk factor for relapse or disease progression. The most common risk factor was early progression after first-line treatment. The patients underwent BV treatment with a median of 8 cycles, and 4 patients (8%) completed 16 cycles of the treatment. BV dose was reduced in 16% of patients; most common reasons were anemia, neutropenia and thrombocytopenia existing prior to initiating BV treatment, toxicity during the treatment was reason for reduction only in one patient.
Conclusion
Our study included patients in second or further line of therapy. Overall, 70% of patients had documented R/R HL within 1 year after the end of last treatment. No severe toxicity related to BV regimen was observed. Improved outcomes were observed in patients who achieved a complete remission on BV. BV use pre-allogeneic SCT is associated with a rapid response in a majority of patients with R/R HL compared with standard chemotherapy. Therefore, BV may represent also an optimal therapeutic option as a bridge to aloSCT in R/R HL patients. Our analysis confirmed BV efficacy in heavily pretreated R/R HL patients in real clinical practice.
Session topic: 17. Hodgkin lymphoma – Clinical
Keyword(s): Allogeneic, Autologous, Hodgkin's Lymphoma, Transplant