Evolving Role of Brentuximab Vedotin in Hodgkin Lymphoma

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Primary refractory disease, length of initial remission, and presence of extranodal disease are factors that can help identify patients with Hodgkin lymphoma (HL) who may be at high risk for relapse, explains John Sweetenham, MD. The utilization of risk factors to identify patients who might benefit from brentuximab vedotin is an emerging concept that was tested in the phase III AETHERA trial.

In AETHERA, individuals were randomized between receiving either maintenance treatment with brentuximab vedotin or placebo. Data, from both an Independent Response Facility (IRF) and the investigators, demonstrated benefit in median progression-free survival in those who received brentuximab vedotin. After a median follow-up of 2 years, the PFS rate with brentuximab was 65% compared with 45% with placebo (HR = 0.50). An independent review board found that 63% of patients with Hodgkin lymphoma and risk factors for relapse or progression had continued PFS at 2 years when taking brentuximab vedotin compared with 51% for those on placebo.

Robert W. Chen, MD, adds that a study released at the 2014 ASCO Annual Meeting showed that 2 cycles of brentuximab vedotin induced a complete metabolic response in the majority of patients with previously untreated, limited stage HL. After the 2 cycles of brentuximab vedotin, all patients but one (91%) responded, 10 with complete (83%) and 1 (8%) with partial metabolic response.