FRONTLINE BRENTUXIMAB VEDOTIN WITH CHEMOTHERAPY FOR STAGE 3/4 CLASSICAL HODGKIN LYMPHOMA: 3-YEAR UPDATE OF THE ECHELON-1 STUDY
Author(s): ,
Andrea Gallamini
Affiliations:
Research, Innovation and Statistics,Antoine Lacassagne Cancer Center,Nice,France
,
David Straus
Affiliations:
Lymphoma Service, Department of Medicine,Memorial Sloan Kettering Cancer Center,New York,United States
,
Monika Dlugosz-Danecka
Affiliations:
Department of Hematology,Jagiellonian University,Krakow,Poland
,
Sergey Alekseev
Affiliations:
N.N. Petrov Scientific Research Institute of Oncology,St Petersburg,Russian Federation
,
Arpad Illes
Affiliations:
Department of Hematology, Faculty of Medicine,University of Debrecen,Debrecen,Hungary
,
Marco Picardi
Affiliations:
Department of Advanced Biomedical Science,Federico II University Hospital,Naples,Italy
,
Ewa Lech-Maranda
Affiliations:
Department of Hematology,Institute of Hematology and Transfusion Medicine,Warsaw,Poland
,
Tatyana Feldman
Affiliations:
John Theurer Cancer Center,Hackensack University Medical Center,Hackensack,United States
,
Piotr Smolewski
Affiliations:
Department of Experimental Hematology,Medical University of Lodz,Lodz,Poland
,
Kerry Savage
Affiliations:
University of British Columbia and the Department of Medical Oncology,BC Cancer Centre for Lymphoid Cancer,Vancouver,Canada
,
Nancy Bartlett
Affiliations:
Department of Medicine, Division of Oncology,Washington University School of Medicine,St. Louis,United States
,
Jan Walewski
Affiliations:
Department of Lymphoid Malignancy,The Maria Sklodowska-Curie Institute and Oncology Center,Warsaw,Poland
,
Radhakrsihnan Ramchandren
Affiliations:
Department of Hematology-Oncology,Barbara Ann Karmanos Cancer Center,Detroit,United States
,
Pier Zinzani
Affiliations:
Institute of Hematology Seragnoli,University of Bologna,Bologna,Italy
,
Joseph Connors
Affiliations:
University of British Columbia and the Department of Medical Oncology,BC Cancer Centre for Lymphoid Cancer,Vancouver,Canada
,
Hina Jolin
Affiliations:
Millennium Pharmaceuticals, Inc.,Cambridge,United States
,
Rachel Liu
Affiliations:
Millennium Pharmaceuticals, Inc.,Cambridge,United States
,
Keenan Fenton
Affiliations:
Seattle Genetics, Inc.,Bothell,United States
,
Neil Josephson
Affiliations:
Seattle Genetics, Inc.,Bothell,United States
John Radford
Affiliations:
University of Manchester and the Christie NHS Foundation Trust, Manchester Academic Health Science Centre,Manchester,United Kingdom
EHA Library. GALLAMINI A. Jun 15, 2019; 267403; S820
Andrea GALLAMINI
Andrea GALLAMINI
Contributions
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Abstract

Abstract: S820

Type: Oral Presentation

Presentation during EHA24: On Saturday, June 15, 2019 from 12:00 - 12:15

Location: Hall 5

Background
The phase 3 ECHELON-1 study (NCT01712490) demonstrated that brentuximab vedotin with doxorubicin, vinblastine, and dacarbazine (A+AVD) was superior to doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD), in terms of modified progression-free survival (PFS) per independent review and per investigator, for the frontline treatment of stage 3/4 classical Hodgkin lymphoma (cHL) (Connors JM, et al. N Engl J Med 2018;378: 331–344). The RATHL, and SWOG S0816 studies utilized positron-emission tomography (PET) scan-adapted strategies performed after cycle 2 (PET2), demonstrating short- and long-term toxicities in PET2-positive (PET2+) patients switched to bleomycin, etoposide, adriamycin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), or escalated BEACOPP, and frequent relapses in PET2-negative (PET2-) patients. Long-term follow-up of patients with stage 3/4 disease who were aged ≤60 years in the RATHL and SWOG S0816 studies demonstrated 3-year PFS of 79.8% (PET2-, 82.1%), and 5-year PFS of 74% (PET2-, 76%), respectively.

Aims
Here we present a 3-year update of the ECHELON-1 study to compare the effects of frontline A+AVD vs ABVD in patients with stage 3/4 cHL, including PFS per investigator and outcomes by PET status for the intention-to-treat (ITT) population.

Methods
Patients with stage 3/4 cHL were randomized 1:1 to receive up to six cycles of A+AVD (n=664) or ABVD (n=670). Interim PET2 was conducted, patients with Deauville score of 5 at PET2 were allowed to switch to an alternative therapy. All analyses of PFS are exploratory and per investigator assessment.

Results
At a median follow-up of 37 months, analysis of PFS in the ITT population favored the A+AVD treatment arm (Table), with a 3-year PFS of 83.1% for A+AVD vs 76.0% for ABVD; the 3-year PFS values for PET2- patients aged <60 years were 87.2% vs 81.0%, respectively. A trend toward benefit for PET2+ patients aged <60 years treated with A+AVD was also observed, with a 3-year PFS of 69.2% vs 54.7% with ABVD.

Data from subgroups, together with safety follow-up, including for peripheral neuropathy, will be presented.

Conclusion
Follow-up at 3 years demonstrates that frontline treatment of stage 3/4 cHL with A+AVD provides a durable treatment benefit compared with ABVD that is independent of PET2 status. While direct comparisons cannot be made, efficacy with A+AVD appears favorable in the context of findings with PET-adapted strategies, without requiring interim PET assessment, escalation of therapy, or bleomycin.

Session topic: 17. Hodgkin lymphoma - Clinical

Keyword(s): Clinical trial, Hodgkin's lymphoma, Long-term follow-up

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