New evidence supports bretuximab vedotin as an efective and safe monotherapy for Hodgkin lymphoma (HL) patients 60 or older for whom chemotherapy is too risky. The study entitled “Phase 2 study of frontline brentuximab vedotin monotherapy in Hodgkin lymphoma patients aged 60 years and older”, was published in the journal Blood.
The study was conducted by a research team led by Andres Forero-Torres, MD, of the University of Alabama at Birmingham (UAB) and the UAB Comprehensive Cancer Center, and included 27 patients, between ages 64 and 92. Traditional chemotherapy, very effective to achieve complete remissions in younger HL patients, was either deemed inadequate or refused by these patients. This is common in patients over 60, due to drug-related toxicity and other risks associated with conventional chemotherapy.
Bretuximab vedotin is a a CD30-directed antibody-drug conjugate, that specifically targets HL cells. Up to 16 doses of the drug were administered intravenously every 3 weeks. Treatment was discontinued when harmful toxicity, disease progression or the end of the study were reached.
The results showed that brentuximab vedotin provided a 92% objective response rate lasting 9.1 months, with 73% of patients reaching complete remission. Concerning the treatment profile safety, tolerability was consistent with previous studies of brentuximab vedotin in patients with treatment-resistant or relapsed HL. The most frequent adverse events were peripheral sensory neuropathy (78%), nausea (44%) and fatigue (44%). Importantly, 30% of patients experienced more severe (Grade 3) peripheral sensory neuropathy.
These results highlight the potential of brentuximab vedotin as a much needed alternative to conventional chemotherapy in more fragile older patients. Dr. Forero-Torres commented on the study’s results and on future directions: “In this population of older patients with Hodgkin lymphoma who were unfit for standard chemotherapy, we observed that brentuximab vedotin as a single agent produced a very high rate of response, including a very high rate of complete remission. While we observed promising responses, the next step is to evaluate this drug in combination with additional chemotherapy or immunotherapies that might allow us to prolong the response without relapse.”