Two variants of an adjusted regimen used in the treatment classical Hodgkin lymphoma (cHL) achieved comparable rates of complete response and remission to the historical standard and will be further evaluated, according to a study published in Lancet Oncology.1
Escalated bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (eBEACOPP) has shown high clinical activity among patients with cHL but is associated with significant toxicity. The purpose of this study was to assess the benefit of brentuximab vedotin, an effective and well-tolerated agent for relapsed cHL, when added to eBEACOPP.
For this phase 2 study (ClinicalTrials.gov Identifier: NCT01569204), researchers enrolled 104 patients with newly diagnosed advanced cHL and assigned them to 1 of 2 treatment arms: brentuximab vedotin, etoposide, doxorubicin, cyclophosphamide, procarbazine, and prednisone (BrECAPP; 52 patients) or brentuximab vedotin, etoposide, doxorubicin, cyclophosphamide, dacarbazine, and dexamethasone (BrECADD; 52 patients).
After a median follow-up of 17 months, 86% (95% CI, 73%-94%) and 94% (95% CI, 83%-99%) of patients in the BrECAPP arm had a complete response after chemotherapy and complete remission as their final treatment outcome, respectively.
Among patients in the BrECADD arm, 88% (95% CI, 77%-96%) of patients reached both complete response and complete remission.
Thirty-two and 26 serious adverse events (AE) were reported in the BrECAPP and BrECADD arms, respectively, of which the most common was hematological toxicity (89% of patients). Frequently reported AEs included grade 3 to 4 organ AEs and grade 1 to 3 peripheral neuropathy. No patients died during the follow-up period.
Patients treated with BrECAPP or BrECADD had outcomes similar as to those of eBEACOPP. The authors noted that BrECADD — because of its favorable safety profile — will be directly compared with eBEACOPP in an ongoing trial. They concluded that “[t]he question of whether conventional chemotherapy can be further reduced and replaced by combinations of novel drugs will be the subject of future studies.”
- Eichenauer DA, Plutschow A, Kreissl S, et al. Incorporation of brentuximab vedotin into first-line treatment of advanced classical Hodgkin’s lymphoma: final analysis of a phase 2 randomised trial by the German Hodgkin Study Group. Lancet Oncol. 2017 Nov 10. doi: 10.1016/S1470-2045(17)30696-4 [Epub ahead of print]