Brentuximab vedotin with dacarbazine or nivolumab as frontline cHL therapy for older patients ineligible for chemotherapy

Author(s): Jonathan W. Friedberg; 1; Rodolfo Bordoni; 2; Dipti Patel-Donnelly; 3; Timothy Larson; 4; Jerome Goldschmidt; 5; Ralph Boccia; 6; Vivian J. M. Cline; 7; Adrija Mamidipalli; 8; Jingmin Liu; 8; Alev Akyol; 9; Christopher A. Yasenchak10
Source: Blood (2024) 143 (9): 786–795.

Dr. Maen Hussein's Thoughts

A non-chemotherapy option for frail patients with advanced cHL. Brentuximab and nivolumab seems to be promising for those patients.

ABSTRACT

Older patients with advanced-stage classical Hodgkin lymphoma (cHL) have inferior outcomes compared with younger patients, potentially due to comorbidities and frailty. This noncomparative phase 2 study enrolled patients aged ≥60 years with cHL unfit for conventional chemotherapy to receive frontline brentuximab vedotin (BV; 1.8 mg/kg) with dacarbazine (DTIC; 375 mg/m2) (part B) or nivolumab (part D; 3 mg/kg). In parts B and D, 50% and 38% of patients, respectively, had ≥3 general comorbidities or ≥1 significant comorbidity. Of the 22 patients treated with BV-DTIC, 95% achieved objective response, and 64% achieved complete response (CR). With a median follow-up of 63.6 months, median duration of response (mDOR) was 46.0 months. Median progression-free survival (mPFS) was 47.2 months; median overall survival (mOS) was not reached. Of 21 patients treated with BV-nivolumab, 86% achieved objective response, and 67% achieved CR. With 51.6 months of median follow-up, mDOR, mPFS, and mOS were not reached. Ten patients (45%) with BV-DTIC and 16 patients (76%) with BV-nivolumab experienced grade ≥3 treatment-emergent adverse events; sensory peripheral neuropathy (PN; 27%) and neutropenia (9%) were most common with BV-DTIC, and increased lipase (24%), motor PN (19%), and sensory PN (19%) were most common with BV-nivolumab. Despite high median age, inclusion of patients aged ≤88 years, and frailty, these results demonstrate safety and promising durable efficacy of BV-DTIC and BV-nivolumab combinations as frontline treatment, suggesting potential alternatives for older patients with cHL unfit for initial conventional chemotherapy. This trial was registered at www.clinicaltrials.gov as #NCT01716806.

Author Affiliations

1Wilmot Cancer Institute, University of Rochester, Rochester, NY; 2Georgia Cancer Specialists, Marietta, GA; 3Virginia Cancer Specialists, Fairfax, VA; 4Minnesota Oncology PA, Minneapolis, MN; 5Oncology and Hematology Associates of SW Virginia, Blacksburg, VA; 6Center for Cancer and Blood Disorders, Bethesda, MD; 7Texas Oncology, Austin, TX; 8Seagen Inc, Bothell, WA; 9Bristol Myers Squibb, Princeton, NJ; 10Willamette Valley Cancer Institute and Research Center/US Oncology Research, Eugene, OR

Leave a Comment

Your email address will not be published. Required fields are marked *

Related Articles