Brentuximab vedotin plus doxorubicin and dacarbazine in nonbulky limited-stage classical Hodgkin lymphoma.

Autor:	Abramson JS; Center for Lymphoma, Massachusetts General Hospital Cancer Center, Boston, MA., Bengston E; Dartmouth Cancer Center, Lebanon, NH., Redd R; Dana-Farber Cancer Institute, Boston, MA., Barnes JA; Center for Lymphoma, Massachusetts General Hospital Cancer Center, Boston, MA., Takvorian T; Center for Lymphoma, Massachusetts General Hospital Cancer Center, Boston, MA., Sokol L; Moffitt Cancer Center, Tampa, FL., Lansigan F; Dartmouth Cancer Center, Lebanon, NH., Armand P; Dana-Farber Cancer Institute, Boston, MA., Shah B; Moffitt Cancer Center, Tampa, FL., Jacobsen E; Dana-Farber Cancer Institute, Boston, MA., Martignetti R; Center for Lymphoma, Massachusetts General Hospital Cancer Center, Boston, MA., Turba E; Moffitt Cancer Center, Tampa, FL., Metzler S; Dartmouth Cancer Center, Lebanon, NH., Patterson V; Dana-Farber Cancer Institute, Boston, MA., LaCasce AS; Dana-Farber Cancer Institute, Boston, MA., Bello CM; Moffitt Cancer Center, Tampa, FL.
Jazyk:	angličtina
Zdroj:	Blood advances [Blood Adv] 2023 Apr 11; Vol. 7 (7), pp. 1130-1136.
DOI:	10.1182/bloodadvances.2022008420
Abstrakt:	ABVD (Adriamycin, bleomycin, vinblastine, dacarbazine) with or without radiation has been the standard treatment for limited-stage Hodgkin lymphoma (HL) but carries risks of bleomycin lung injury and radiation toxicity. Brentuximab vedotin (BV) is approved with AVD for stage III-IV HL, but carries increased risks of peripheral neuropathy (PN) and neutropenic fever, likely due to overlapping toxicity between BV and vinblastine. We therefore evaluated BV in combination with AD for 4 or 6 cycles based on interim positron emission tomography response. Thirty-four patients with nonbulky stage I-II HL were enrolled. Risk was early favorable in 53% and unfavorable in 47%. The overall and complete response rates (CRRs) were 100% and 97%, respectively, with a 5-year progression-free survival (PFS) of 91%. No differences in outcome were observed based on stage (I vs II) or risk status (early favorable vs unfavorable). The most common adverse events were nausea (85%), peripheral sensory neuropathy (59%), and fatigue (56%). There were no cases of grade-4 neutropenia or neutropenic fever, and no patient received granulocyte-colony stimulating factor. Most cases of PN were grade 1, and no patient experienced grade ≥3 PN. BV-AD produced a high CRR and durable PFS with most patients requiring 4 cycles of therapy. Compared with BV-AVD, the toxicity profile appeared improved, with predominantly grade 1 reversible PN and no case of grade 4 neutropenia or neutropenic fever. This regimen warrants further study in HL and may serve as a backbone for the addition of novel agents. This trial is registered on clinicaltrials.gov (NCT02505269). (© 2023 by The American Society of Hematology. Licensed under Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0), permitting only noncommercial, nonderivative use with attribution. All other rights reserved.)
Databáze:	MEDLINE
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