Safety and efficacy of brentuximab vedotin for Hodgkin lymphoma recurring after allogeneic stem cell transplant
Menée sur 25 patients atteints d'un lymphome hodgkinien ayant récidivé après une greffe allogénique de cellules souches, cettte étude évalue la toxicité et l'efficacité du brentuximab vedotin
Hodgkin lymphoma (HL) relapsing after allogeneic stem cell transplant (alloSCT) presents a major clinical challenge. We evaluated brentuximab vedotin, a CD30-directed antibody-drug conjugate, in 25 HL patients (median age 32 years; range, 20-56) with recurrent disease after alloSCT (11 unrelated donors). Patients were > 100 days post-alloSCT, had no active graft versus host disease, and received a median of 9 (range, 5-19) prior regimens. Nineteen (76%) had refractory disease immediately before enrollment. Patients received 1.2 or 1.8 mg/kg brentuximab vedotin intravenously every 3 weeks (median 8 cycles; range, 1-16). Overall and complete response rates were 50% and 38%, respectively, among 24 evaluable patients. Median time to response was 8.1 weeks, median progression-free survival was 7.8 months, and the median overall survival was not reached. Cough, fatigue, and pyrexia (52% each), nausea and peripheral sensory neuropathy (48% each), and dyspnea (40%) were the most frequent adverse events. The most common adverse events ≥ Grade 3 were neutropenia (24%), anemia (20%), thrombocytopenia (16%), and hyperglycemia (12%). Cytomegalovirus was detected in 5 patients (potentially clinically significant in one). These results support the potential utility of brentuximab vedotin for selected patients with HL relapsing after alloSCT. (Trials registered with www.clinicaltrials.gov as NCT01026233, NCT01026415, and NCT00947856.)