Brentuximab vedotin in combination with bendamustine in pediatric patients or young adults with relapsed or refractory Hodgkin lymphoma

Vinti, Luciana; Pagliara, Daria; Buffardi, Salvatore; Ruscio, Valentina Di; Stocchi, Francesca; Mariggiò, Elena; Parasole, Rosanna; Matteo, Antonia Di; Petruzziello, Fara; Paganelli, Valeria; Vito, Rita De; Bufalo, Francesca Del; Strocchio, Luisa; Locatelli, Franco

doi:10.1002/pbc.29557

Cited by 7 publications

(5 citation statements)

References 62 publications

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“…Another study with 29 pediatric patients who received the previous combination found severe neutropenia in 31% of the cohort, while there was a single grade 3 lung infection that resulted in treatment discontinuation [ 192 ]. A third study on 32 pediatric patients under BV and bendamustine for r/r HL noted severe neutropenia in 71.9% of patients and no severe infection [ 193 ]. The AHOD1221 phase I/II study that combined BV with gemcitabine in 45 pediatric patients with r/r HL displayed grade ≥3 neutropenia in 88.9% of patients and grade ≥3 infections in 15.6% [ 194 ].…”

Section: Other Targeted Therapies With Off-label Usementioning

confidence: 99%

Infectious Complications of Targeted Therapies in Children with Leukemias and Lymphomas

Kyriakidis

Mantadakis

Stiakaki

et al. 2022

Cancers

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The aim of this review is to highlight mechanisms of immunosuppression for each agent, along with pooled analyses of infectious complications from the available medical literature. Rituximab confers no increase in grade ≥3 infectious risks, except in the case of patients with advanced-stage non-Hodgkin lymphoma. Gemtuzumab ozogamicin links with high rates of grade ≥3 infections which, however, are comparable with historical cohorts. Pembrolizumab exhibits a favorable safety profile in terms of severe infections. Despite high rates of hypogammaglobulinemia (HGG) with blinatumomab, low-grade ≥3 infection rates were observed, especially in the post-reinduction therapy of relapsed B-acute lymphoblastic leukemia. Imatinib and nilotinib are generally devoid of severe infectious complications, but dasatinib may slightly increase the risk of opportunistic infections. Data on crizotinib and pan-Trk inhibitors entrectinib and larotrectinib are limited. CAR T-cell therapy with tisagenlecleucel is associated with grade ≥3 infections in children and is linked with HGG and the emergence of immune-related adverse events. Off-label therapies inotuzumab ozogamicin, brentuximab vedotin, and venetoclax demonstrate low rates of treatment-related grade ≥3 infections, while the addition of bortezomib to standard chemotherapy in T-cell malignancies seems to decrease the infection risk during induction. Prophylaxis, immune reconstitution, and vaccinations for each targeted agent are discussed, along with comparisons to adult studies.

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Section: Other Targeted Therapies With Off-label Usementioning

confidence: 99%

Infectious Complications of Targeted Therapies in Children with Leukemias and Lymphomas

Kyriakidis

Mantadakis

Stiakaki

et al. 2022

Cancers

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“…In contrast to the AETHERA study, which excluded patients with prior brentuximab vedotin exposure, in this study, 69% of patients received brentuximab vedotin before ASCT, which is reflective of the common use of brentuximab vedotin–containing salvage regimens during the time these data were collected. 16 , 17 , 19 , 27 In our cohort, patients with prior brentuximab exposure had an improved 3-year PFS compared with those who were brentuximab–naive. Caution should be used when interpreting these data; however, it is possible that the selection of patients for brentuximab maintenance is enriched for patients who had a response to brentuximab vedotin before ASCT.…”

Section: Discussionmentioning

confidence: 70%

Brentuximab vedotin after autologous transplantation in pediatric patients with relapsed/refractory Hodgkin lymphoma

et al. 2023

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Outcomes for children and adolescents with relapsed and refractory Hodgkin lymphoma (HL) are poor, with approximately 50% of patients experiencing a subsequent relapse. The anti-CD30 antibody-drug conjugate brentuximab vedotin improved progression-free survival (PFS) when used as consolidation after autologous stem cell transplant (ASCT) in adults with high-risk relapsed/refractory HL. Data on brentuximab vedotin as consolidative therapy after ASCT in pediatric patients with HL are extremely limited, with only 11 patients reported in the literature. We performed a retrospective analysis of 67 pediatric patients who received brentuximab vedotin as consolidation therapy following ASCT for the treatment of relapsed/refractory HL to describe the experience of this regimen in the pediatric population. This is the largest cohort reported to date. We found that brentuximab vedotin was well tolerated with a safety profile similar to adult patients. With a median follow up of 37 months, the 3-year PFS was 85%. These data suggest a potential role for the use of brentuximab vedotin as consolidation therapy after ASCT for children with relapsed/refractory Hodgkin lymphoma.

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“…16 Recently, the combination regimen of BVbendamustine in pediatric patients reported an ORR of 81%. 17 Data considering the combination of BV with chemotherapy in the pediatric/adolescent setting are rarely reported. 16,18 In adults, the combination of BV plus DHAP has shown favorable outcomes, achieving cMR in a high percentage of patients with an ORR of 90%.…”

Section: Discussionmentioning

confidence: 99%

“…An Italian retrospective multicentric real-life study on 66 young patients demonstrated the efficacy of BV as a single agent or combined with chemotherapy in R/R cHL with manageable toxicity 16 . Recently, the combination regimen of BV-bendamustine in pediatric patients reported an ORR of 81% 17 . Data considering the combination of BV with chemotherapy in the pediatric/adolescent setting are rarely reported 16,18 …”

Section: Discussionmentioning

confidence: 99%

Combining Brentuximab Vedotin With Dexamethasone, High-dose Cytarabine, and Cisplatin as Salvage Treatment in Pediatric Relapsed or Refractory Classic Hodgkin Lymphoma: Two Case Reports

Muggeo,

Sinisi,

Angarano

et al. 2024

Journal of Pediatric Hematology/Oncology

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Hodgkin lymphoma (HL) is among the most commonly occurring malignancies in adolescents. For relapsed/refractory disease, many regimens have been proposed. Novel agents are increasingly used, like brentuximab vedotin (BV), an antiCD30 antibody-drug conjugate, used as a single agent or in combination with classic regimens mainly in adults, while limited is the experience in pediatrics. We report here on 2 boys with aggressive and high-risk relapsed HL, successfully treated with the BV plus dexamethasone, high-dose cytarabine, cisplatin regimen as induction salvage treatment. Our experience provides real-world evidence on the use of BV-dexamethasone, high-dose cytarabine, cisplatin as first-line salvage therapy for relapsed/refractory HL and expands the current therapeutic choices.

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Brentuximab vedotin in combination with bendamustine in pediatric patients or young adults with relapsed or refractory Hodgkin lymphoma

Cited by 7 publications

References 62 publications

Infectious Complications of Targeted Therapies in Children with Leukemias and Lymphomas

Infectious Complications of Targeted Therapies in Children with Leukemias and Lymphomas

Brentuximab vedotin after autologous transplantation in pediatric patients with relapsed/refractory Hodgkin lymphoma

Combining Brentuximab Vedotin With Dexamethasone, High-dose Cytarabine, and Cisplatin as Salvage Treatment in Pediatric Relapsed or Refractory Classic Hodgkin Lymphoma: Two Case Reports

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