Drug May Slow Disease Progression in Patients With Hard-to-Treat Hodgkin Lymphoma

Brentuximab vedotin (BV) may help prevent Hodgkin lymphoma progression if given to patients immediately after autologous stem cell transplantation (ASCT), according to the results of a phase III trial recently published in The Lancet.¹

BV is an antibody that sticks to protein CD30 on the surface of Hodgkin lymphoma cells. By sticking to this protein, BV has the ability to deliver chemotherapy directly to the cancer cells.

The trial included 329 patients ages 18 or older with Hodgkin lymphoma who were at high risk of disease progression, or relapse following ASCT. The patients were randomly assigned to receive either 16 cycles of BV intravenous infusions once every 3 weeks, or a placebo after undergoing ASCT. The researchers found that at 2 years after treatment, 65% of patients who received BV had no cancer progression compared with 45% of patients who received the placebo. On average, BV-treated patients survived for 42.9 months without disease progression compared with only 24.1 months for those who received the placebo.

Lead study author Craig Moskowitz, MD, who is a professor of medicine at Memorial Sloan Kettering Cancer Center in New York, said  the majority of Hodgkin lymphoma patients respond to chemotherapy and radiotherapy. However, for patients who don’t respond, high-dose chemotherapy combined with ASCT is considered standard of care.

Dr. Moskowitz said BV appears to be a very effective drug in poor-risk Hodgkin lymphoma, and it spares patients from the harmful effects of further chemotherapy. No other medication available today has demonstrated such dramatic results in patients with hard-to-treat Hodgkin lymphoma.

Since it is unlikely patients will relapse 2 years after ASCT, Dr. Moskowitz said almost all patients who experienced no disease progression during follow-up are likely to be cured. In the final analysis, the researchers found that 28 of 167 patients (17%) had died in the BV group compared to 25 of 160 patients (16%) in the placebo group.

BV was found to be generally well tolerated. The most frequent adverse events (AEs) in the BV group were peripheral sensory neuropathy (which occurred in 56% patients vs 16% in the placebo group), and neutropenia, which occurred in 58 of the patients (35%) in the BV group compared with 12% of patients in the placebo group.

In an accompanying editorial, Professor Andreas Engert, who is with the University Hospital of Cologne in Germany, writes that the trial establishes a promising new treatment approach. However, he noted that there was almost a 50% survival rate at 24 months for patients in the placebo group, which raises the question of how many of the patients included in the trial were actually at high risk for relapse.²  

Disclosures:

• Moskowitz CH, Nademanee A, Masszi T, et al. (2015). Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin's lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet.
• Whiteman H. (2015). New drug 'halts disease progression' in patients with hard-to-treat Hodgkin lymphoma. Medical News Today.