Effectiveness of brentuximab vedotin monotherapy in relapsed or refractory Hodgkin lymphoma: a systematic review and meta-analysis

Abstract

This systematic review and meta-analysis aimed to determine the effectiveness of brentuximab vedotin (BV) in relapsed/refractory classical Hodgkin lymphoma (R/R cHL) in the clinical practice setting using most recent results. A total of 32 observational studies reporting on treatment patterns, overall response rate (ORR), complete response (CR) rate, progression-free survival (PFS), overall survival (OS), and adverse events were found. After four cycles, a random-effect model yielded pooled ORR and CR rates of 62.6% (95% confidence interval (CI): 56.0-68.9; I 2 ¼ 9.7%) and 32.9% (95% CI, 20.8-46.3, I 2 ¼ 64.8%), respectively. Regarding survival, 1-year, 2-year, and 5year PFS ranged from 52.1% to 63.2%, 45.2% to 56.2%, and 31.9% to 33.0%, respectively. OS rates were 68.2-82.7%, 58.0-81.9%, and 58.0-62.0%, respectively. Most common adverse events were hematological toxicities (neutropenia: 13.3-23%, anemia: 8.8-39.0%, and thrombocytopenia: 4-4.6%), and grade 3 peripheral neuropathy (3.3-7.3%). This study supports the effectiveness and safety of BV in R/R cHL patients in the real-world setting.

Brentuximab-Induced Peripheral Neurotoxicity: A Multidisciplinary Approach to Manage an Emerging Challenge in Hodgkin Lymphoma Therapy

“…In a real-life context, reported neurotoxicity rates in BV monotherapy in R/R HL are slightly lower to those published in clinical trial data, with grade ≥3 PN observed in 3.3-7.3% of cases [ 20 ] ( Table 1 ). Importantly, overall higher rates of PN are observed when a formal, detailed neurologic assessment is performed.…”

Brentuximab vedotin in the treatment of paediatric patients with relapsed or refractory Hodgkin's lymphoma: Results of a real‐life study

“…The efficacy and low toxicity profile of BV in the treatment of relapsed or refractory HL were confirmed in preclinical and postmarketing studies on adult patients. 8,9 Dose finding studies in adults recom-mended to administer 1.8 mg/kg dose every 3 weeks, 17 and the phase I clinical trial in children confirmed it is a safe and tolerable dose. 12 Monotherapy in adults showed an ORR ranging from 46.6% to 84%, with a CR rate ranged from 21.1% to 43.8% and a 3-year PFS of 36.7%.…”

“…Moreover, the presented data seemed to demonstrate a higher efficacy of BV to induce CR than the previously reported data. 9 Univariate analyses suggested that female gender, higher median age, NS histological subtype and performing SCT could positively influence PFS. Multivariate analysis did not confirm the prognostic role of age and gender.…”

“…12 Monotherapy in adults showed an ORR ranging from 46.6% to 84%, with a CR rate ranged from 21.1% to 43.8% and a 3-year PFS of 36.7%. 9 Studies on the use of BV in childhood are very limited and include small cohorts of patients. Two prospective phase I/II trials have investigated efficacy and safety of BV on 22 paediatric patients with refractory or recurrent HL.…”

“…3 BV is a chimeric anti-CD30 antibody conjugate to monometil auristatin E, an antitubulin agent, 4 approved only for adult patients with refractory and recurrent HL 5,6 and as first-line treatment, in association to AVD chemotherapy courses, for adult patients with advanced stage HL. 7 Despite the widespread use of BV in adult's oncology and the large number of prospective and retrospective studies, 8,9 there are few data on efficacy and safety in paediatric setting. [10][11][12] Therefore, there are still some concerns about its use in paediatrics, especially in younger patients.…”