Phase 2 study of frontline brentuximab vedotin monotherapy in Hodgkin lymphoma patients aged 60 years and older

Abstract

• Frontline brentuximab vedotin monotherapy provided a 92% ORR and was generally well tolerated in elderly HL patients.Outcomes in older patients with Hodgkin lymphoma (HL) tend to be poor following conventional chemotherapy regimens. Treatment-related toxicity is significant and comorbidities often limit therapeutic options. This phase 2, open-label study evaluated the efficacy and safety of brentuximab vedotin, a CD30-directed antibody-drug conjugate, as frontline therapy in 27 HL patients aged ‡60 years. The objective response rate (ORR) was 92%, with 73% achieving complete remission. All patients achieved stable disease or better, and had decreased tumor volume following treatment. At the time of this analysis, the median duration of objective response for efficacy-evaluable patients (N 5 26) was 9.1 months (range, 2.8 to 20.91 months), median progression-free survival was 10.5 months (range, 2.61 to 22.31 months), and median overall survival had not been reached (range, 4.61 to 24.91 months). The observed adverse events (AEs) were generally consistent with the known safety profile of brentuximab vedotin. The most common AEs were peripheral sensory neuropathy (78%), fatigue (44%), and nausea (44%), and were £ grade 2 for most patients. The incidence of grade 3 peripheral neuropathy events was relatively high (30% overall), particularly among patients with the known risk factors of diabetes and/or hypothyroidism (46% vs 14% for those without). However, these risk factors were not associated with delayed time to resolution/improvement of peripheral neuropathy. Preliminary data showed no substantial age-related changes in brentuximab vedotin pharmacokinetics. Brentuximab vedotin monotherapy may provide a frontline treatment option for older patients who cannot tolerate conventional combination chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT01716806. (Blood. 2015;126(26):2798-2804

Selective inhibition of nuclear export with selinexor in patients with non-Hodgkin lymphoma

“…Unlike in Hodgkin lymphoma, where response rates of 70% to 80% have been seen with the antibody-drug conjugate brentuximab vedotin and the immune checkpoint inhibitor nivolumab, broadly successful agents in NHL after rituximab have not been commonly identified. [39][40][41][42] Compared with other targeted therapies studied across a spectrum of R/R NHL, selinexor showed comparable or favorable response rates with durable clinical benefit. Although there is potential for synergistic antilymphoma effects in patients who received an antiemetic dose of dexamethasone as a supportive care agent, more than half of the responses occurred in the absence of concomitant dexamethasone use, demonstrating the single-agent activity of selinexor in NHL.…”

Hodgkin’s Lymphoma - evaluation of patients submitted to Autologous transplantation of hematopoietic cells in the Hematology Service of the Hospital Walter Cantídio – Fortaleza, Brazil.

“…7,8,9,10,11,12 The present analysis of transplanted patients at UTMO/HUWC/UFC shows a young population (mean age of 28 years), with a predominance of localized disease (I+II), mostly B, initially treated with standard regimen (ABVD) and who did not respond or had recurrence, becoming candidates for a new treatment regimen and the possibility of BMT indication. However, 50.0% of them came to transplantation in partial remission of the lymphoma, showing much lower results when considering the patient coming to the BMT in complete remission (64.7% vs. 35.3%).…”

The IVDG Regimen is the Possible Treatment of Choice as First Line Therapy For Hodgkin’s Lymphoma in Elderly Patients with Cardiovascular and Pulmonary Comorbidity

“…Возможно, результаты проводимых в настоящее время клиниче-ских исследований брентуксимаба ведотина как в моно-режиме, так и в сочетании с различными противоопухо-левыми препаратами (бендамустин, дакарбазин, схемы CAP, AVD) также позволят расширить выбор терапии первой линии в группе пожилых больных ЛХ [18].…”