Dr. Hamlin on Integrating Brentuximab Vedotin

Paul A. Hamlin, MD, Clinical Director, Lymphoma Outpatient Unit, Memorial Sloan-Kettering Cancer Center, discusses the integration of brentuximab vedotin (Adcetris), an antidrug conjugate, into the treatment paradigm for Hodgkin lymphoma.

Hamlin explains that we have entered a new era for cancer treatment. Targeted therapies are becoming more specific to smaller subtypes of disease. Antidrug conjugates mark specific proteins on the surface of a cell; tumors without this antigen are not suitable to receive the drug. In the case of brentuximab vedotin it is limited to lymphomas that express the CD30 antigen, which is generally a marker for Hodgkin's lymphoma.

Clinical trials investigated the agent after the failure of either autologous stem cell transplant (ASCT) or 2 or more multi-agent chemotherapy regimens. Cure rates are generally high for patients with Hodgkin lymphoma, even in advanced disease; the main challenge for new agents is to maintain the high cure rate while lowering or eliminating toxicities.

The initial approval for brentuximab vedotin was for a minority of patients, but it is still a life altering addition to the armament. Clinical trials are underway examining this agent in the first-line setting, initially to gauge its efficacy in untreated, elderly patients with Hodgkin lymphoma.