Brentuximab vedotin and AVD followed by involved-site radiotherapy in early stage, unfavorable risk Hodgkin lymphoma
| Autor: | Stephanie L. Verwys, Anas Younes, Audrey Hamilton, Gianna N. McArthur, Zhigang Zhang, Steven M. Horwitz, Paul M. Barr, Joachim Yahalom, Craig H. Moskowitz, Susan J. McCall, Matthew J. Matasar, Philip Caron, Andrew D. Zelenetz, Maria Lia Palomba, John F. Gerecitano, Ariela Noy, Jonathan W. Friedberg, Joanna C. Yang, Alexandra G. Jacob, Carla Casulo, Louis S. Constine, April Chiu, Paul A. Hamlin, Anita Kumar, Carol S. Portlock, David J. Straus, Nicholas VanderEls, Alison J. Moskowitz, Pamela Drullinsky, Heiko Schöder |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Immunoconjugates Adolescent Clinical Trials and Observations Dacarbazine medicine.medical_treatment Immunology Pilot Projects Vinblastine Biochemistry Gastroenterology 03 medical and health sciences Young Adult 0302 clinical medicine Internal medicine Antineoplastic Combined Chemotherapy Protocols Medicine Humans Brentuximab vedotin Pneumonitis Neoplasm Staging Brentuximab Vedotin Intention-to-treat analysis business.industry Cell Biology Hematology Chemoradiotherapy Middle Aged medicine.disease Prognosis Hodgkin Disease Radiation therapy Doxorubicin 030220 oncology & carcinogenesis Female business Febrile neutropenia 030215 immunology medicine.drug Follow-Up Studies |
| Zdroj: | Blood. 128(11) |
| ISSN: | 1528-0020 |
| Popis: | This multicenter pilot study assessed the safety and efficacy of brentuximab vedotin (BV) and AVD (adriamycin, vinblastine, and dacarbazine) followed by 30 Gy involved site radiation therapy (ISRT). Patients with newly diagnosed, early stage classical Hodgkin lymphoma (HL) with unfavorable-risk features were treated with 4 cycles of BV and AVD. Patients who achieved a negative positron emission tomography (PET) scan (Deauville score of 1-3) received 30 Gy ISRT. Thirty patients received treatment and were assessable for toxicity. Twenty-nine patients completed 4 cycles of BV + AVD, and 25 patients BV + AVD + 30 Gy ISRT. No clinically significant noninfectious pneumonitis was observed. Serious adverse events (≥grade 3) were reported in 4 patients, including febrile neutropenia, peripheral neuropathy, and hypertension. After 2 and 4 cycles of BV + AVD, 90% (26 of 29) and 93% (27 or 29) of patients achieved a negative PET scan, respectively. Two patients with biopsy-proven primary refractory HL were treated off-study. All 25 patients who completed BV + AVD + ISRT achieved a complete response. With a median follow-up of 18.8 months, by intent to treat, the 1-year progression-free survival is 93.3% (95% confidence interval, 84-102). Overall, the treatment was well-tolerated with no evidence of significant pulmonary toxicity. The majority of patients (≥90%) achieved negative interim PET scans after 2 and 4 cycles of BV + AVD. Excluding the 2 primary refractory patients, all patients are disease free, suggesting that this is a highly active treatment program even in patients with substantial disease bulk. This trial was registered at www.clinicaltrials.gov as #NCT01868451. |
| Databáze: | OpenAIRE |
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