Dr Hoppe on Outcomes of the CheckMate 744 Trial in Hodgkin Lymphoma

Bradford (Brad) S. Hoppe, MD, MPH, professor, radiation oncology, medical director, Particle Therapy, radiation oncologist, Mayo Clinic, discusses the rationale for investigating consolidative radiotherapy in place of autologous stem cell transplant in patients with low-risk, relapsed/refractory classic Hodgkin lymphoma who have been previously treated with nivolumab (Opdivo) plus brentuximab vedotin (Adcetris), as investigated in the phase 2 CheckMate 744 study (NCT02927769), as well as key findings from this trial.

Hodgkin lymphoma primarily affects children, adolescents, and young adults, Hoppe begins. Consequently, as investigators search for a cure for these patients, they should also consider the potential long-term adverse effects (AEs) of treatment, Hoppe states. Treatment in the relapsed setting involves second-line chemotherapy and transplantation, yielding progression-free survival rates of approximately 60%, he notes. However, this approach is associated with a significant risk of late AEs, including second cancers, cardiac and pulmonary diseases, fertility issues, and endocrinopathies, that oncologists should be aware of, Hoppe explains.

To address this challenge, the Children's Oncology Group and the European Network for Pediatric Hodgkin Lymphoma collaborated to design a study aimed at enhancing the therapeutic balance in patients with Hodgkin lymphoma, he expands. This entails striving to improve cure rates while concurrently mitigating the AEs of treatment, Hoppe says. In a low-risk cohort comprising 27 patients, investigators observed a 96.4% overall response rate withnivolumab plus brentuximab vedotin in patients who had received 4 cycles of induction therapy, and 82.1% of these patients achieved a complete response (CR), Hoppe emphasizes.Furthermore, in patients who received the combination at any point before involved site radiation therapy, the CR rate climbed to 92.9%. These response rates prior to radiation therapy were notably high, Hoppe emphasizes.

Ultimately, the 3-year progression-free survival rate, with a median follow-up period of 32 months, stood at 95% (95% CI, 76.7%-99%), Hoppe continues. These data indicate that this regimen is a potentially promising treatment approach for patients experiencing more favorable relapses, with the added advantage of avoiding the need for transplantation, he concludes.