TY - JOUR
T1 - Impact of cumulative dose of brentuximab vedotin on outcomes of frontline therapy for advanced-stage Hodgkin lymphoma
AU - Steiner, Raphael E.
AU - Hwang, Steven R.
AU - Khurana, Arushi
AU - Habermann, Thomas M.
AU - Epperla, Narendranath
AU - Annunzio, Kaitlin
AU - Allen, Pamela Blair
AU - Baird, Katelin
AU - Paulino, Darina
AU - Alderuccio, Juan Pablo
AU - Lossos, Izidore S.
AU - David, Kevin
AU - Evens, Andrew M.
AU - Pandya, Karan
AU - Bair, Steven M.
AU - Kamdar, Manali
AU - Aqeel, Sheeba Ba
AU - Torka, Pallawi
AU - Lynch, Ryan
AU - Smith, Stephen
AU - Feng, Lei
AU - Noorani, Mansoor
AU - Ahmed, Sairah
AU - Nair, Ranjit
AU - Vega, Francisco
AU - Wu, Susan
AU - Fang, Penny
AU - Pinnix, Chelsea C.
AU - Gunther, Jillian R.
AU - Dabaja, Bouthaina S.
AU - Lee, Hun J.
N1 - Publisher Copyright:
© 2023 by The American Society of Hematology.
PY - 2023/12/26
Y1 - 2023/12/26
N2 - In the pivotal study ECHELON-1, brentuximab vedotin (BV), doxorubicin, vinblastine, and dacarbazine (A + AVD) demonstrated superior efficacy compared with bleomycin + AVD for the treatment of advanced-stage classic Hodgkin lymphoma (cHL). However, there are minimal available data regarding the frequency of dose reductions or omission of BV during curative therapy and the potential impact on patient outcomes. In a real-world analysis, we retrospectively reviewed the characteristics and outcomes of 179 patients with stage III or IV cHL treated with frontline A + AVD from January 2010 to April 2022. Treatment consisted of up to 1.2 mg/kg of BV and standard dose AVD IV on days 1 and 15 of each 28-day cycle for up to 6 cycles. At the time of treatment, the median patient age was 37 years, and a high-risk International Prognostic Score was observed in 46% of patients. Overall, 91% of patients received 6 cycles of AVD; 55% of patients did not receive the intended cumulative dose of BV (CDB); 28% of patients received two-thirds or less than the planned CDB. At a median follow-up time of 27.4 months (95% confidence interval [CI], 24.8-29), the median progression-free survival (PFS) was not reached, and the 12-month PFS was 90.3% (95% CI, 85.9-95.0). The impact of CDB on PFS was not significant (P = .15), nor was high CDB significantly associated with increased adverse events. In real-world experience, A + AVD is a highly effective treatment for patients with advanced-stage cHL, including for patients with prominent dose reductions of BV.
AB - In the pivotal study ECHELON-1, brentuximab vedotin (BV), doxorubicin, vinblastine, and dacarbazine (A + AVD) demonstrated superior efficacy compared with bleomycin + AVD for the treatment of advanced-stage classic Hodgkin lymphoma (cHL). However, there are minimal available data regarding the frequency of dose reductions or omission of BV during curative therapy and the potential impact on patient outcomes. In a real-world analysis, we retrospectively reviewed the characteristics and outcomes of 179 patients with stage III or IV cHL treated with frontline A + AVD from January 2010 to April 2022. Treatment consisted of up to 1.2 mg/kg of BV and standard dose AVD IV on days 1 and 15 of each 28-day cycle for up to 6 cycles. At the time of treatment, the median patient age was 37 years, and a high-risk International Prognostic Score was observed in 46% of patients. Overall, 91% of patients received 6 cycles of AVD; 55% of patients did not receive the intended cumulative dose of BV (CDB); 28% of patients received two-thirds or less than the planned CDB. At a median follow-up time of 27.4 months (95% confidence interval [CI], 24.8-29), the median progression-free survival (PFS) was not reached, and the 12-month PFS was 90.3% (95% CI, 85.9-95.0). The impact of CDB on PFS was not significant (P = .15), nor was high CDB significantly associated with increased adverse events. In real-world experience, A + AVD is a highly effective treatment for patients with advanced-stage cHL, including for patients with prominent dose reductions of BV.
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U2 - 10.1182/bloodadvances.2023010700
DO - 10.1182/bloodadvances.2023010700
M3 - Article
C2 - 37603594
AN - SCOPUS:85181001218
SN - 2473-9529
VL - 7
SP - 7485
EP - 7493
JO - Blood Advances
JF - Blood Advances
IS - 24
ER -