Brentuximab Vedotin in Transplant-Naïve Relapsed/Refractory Hodgkin Lymphoma: Experience in 30 Patients.
BACKGROUND
Hodgkin lymphoma (HL) is characterized by the presence of CD30-positive Hodgkin Reed-Sternberg cells. Approximately 30%-40% of patients with advanced disease are refractory to frontline therapy or will relapse after first-line treatment. The standard management of these patients is salvage chemotherapy followed by high-dose chemotherapy and autologous stem cell transplant (ASCT). The best prognostic factor is the status of disease before ASCT; in particular, the normalization of positron emission tomography (PET) scan. Brentuximab vedotin (BV) has shown a high overall response rate in refractory/relapsed HL after ASCT, whereas few data are available regarding its role before ASCT.


METHODS
A multicenter, retrospective, observational study was conducted. The primary endpoint of the study was the effectiveness of BV as single agent in patients with relapsed/refractory, ASCT-naïve HL, determined by the conversion of PET status from positive to negative; secondary endpoints were safety, capacity to proceed to ASCT, survival, and progression-free status.


RESULTS
Thirty patients with relapsed/refractory HL- and PET-positive disease after conventional chemotherapy salvage treatments were treated with a median of 4 cycles of BV. Normalization of PET findings (Deauville score ≤2) occurred in 9 of 30 patients (30%). Those nine patients proceeded to ASCT.


CONCLUSIONS
These data suggest that BV can normalize PET status in a subset of HL patients refractory to conventional chemotherapy salvage treatments, such as ifosfamide-containing regimens, cytarabine- and platinum-containing regimens, prior to ASCT.
Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy pierluigi.zinzani@unibo.it.
Pier Luigi
PL
Zinzani
Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy.
Cinzia
C
Pellegrini
Department of Biomedicine and Prevention, University of Rome "Tor Vergata," Rome, Italy.
Maria
M
Cantonetti
Division of Hematology, "Spedali Civili," Brescia, Italy.
Alessandro
A
Re
Hematology-Oncology and Stem Cell Transplantation Unit, Fondazione "G. Pascale," IRCCS, Naples, Italy.
Antonello
A
Pinto
Division of Hematology and Transplantation, Azienda Ospedaliera "Cardinal Panico," Tricase, Italy.
Vincenzo
V
Pavone
Division of Hematology, Azienda Ospedaliera "Careggi," Florence, Italy.
Luigi
L
Rigacci
Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy.
Melania
M
Celli
Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy.
Alessandro
A
Broccoli
Institute of Hematology "L. e A. Seràgnoli," University of Bologna, Bologna, Italy.
Lisa
L
Argnani
Department of Cellular Biotechnologies and Hematology, "Sapienza" University, Rome, Italy.
Alessandro
A
Pulsoni
D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000079963:Brentuximab Vedotin; D005260:Female; D006689:Hodgkin Disease / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D018796:Immunoconjugates / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D049268:Positron-Emission Tomography; D012008:Recurrence; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D018796:Immunoconjugates; D000079963:Brentuximab Vedotin
Brentuximab vedotin; Hodgkin lymphoma; Positron emission tomography; Salvage treatment; Transplant