For patients with relapsed or refractory Hodgkin’s lymphoma (HL), treatment with Adcetris® (brentuximab vedotin) after autologous stem cell transplant may improve survival. The Lancet published these findings online.
Hodgkin’s lymphoma is a cancer of the lymph system. It typically begins in the lymph nodes in one region of the body and then spreads throughout the lymph system. Disease is considered relapsed when it returns after treatment and a period of improvement and refractory when it’s resistant to treatment. Some patients with relapsed or refractory HL can be effectively treated with high doses of chemotherapy and stem cell transplant. Additional treatment options are limited for patients in whom stem cell transplant isn’t effective.
High-dose chemotherapy followed by autologous stem-cell transplantation is standard of care for patients with relapsed or refractory HL. For autologous stem cell transplantation, stem cells are collected from the patient before high-dose chemotherapy is delivered. The stem cells are collected form the bone marrow or peripheral blood, processed, frozen, and stored. Stem cells that are collected from the patient are referred to as autologous stem cells. (When stem cells come from another person, the procedure is known as allogeneic stem cell transplantation.)
Researchers recently evaluated whether using the targeted chemotherapy drug Adcetris after autologous stem cell transplantation could improve progression-free survival in relapsed or refractory HL. The goal of using Adcetris this way is to kill any remaining cancer cells in the body. This approach is known as consolidation therapy.
Researchers from North American and Europe designed a Phase III clinical trial to determine if Adcetris could improve progression-free survival in patients with Hodgkin’s lymphoma who had undergone an autologous stem cell transplant. The study included 329 patients with relapsed or refractory Hodgkin’s lymphoma. A total of 165 patients were assigned to receive 16 cycles of Adcetris, and 164 patients received 16 cycles of a placebo (inactive substitute). Treatment was given intravenously every three weeks, beginning 30–45 days after autologous stem cell transplant.
Patients receiving Adcetris appeared to have a significantly improved progression-free survival compared with those receiving placebo. The Adcetris group had an approximately 1.5-year longer median progression-free survival compared with the placebo group: 3.5 years versus 2 years, respectively.
Frequent side effects in the Adcetris group included peripheral neuropathy and neutropenia. Slightly more patients in the Adcetris group had died compared with the placebo group: 28 of 167 patients versus 25 of 160 patients, respectively (or 17% versus 16%).
These findings suggest that treatment with Adcetris after autologous stem cell transplantation improves progression-free survival in patients with relapsed or refractory HL. Consolidation therapy with Adcetris may give these patients an important treatment option.
Reference: Moskowitz CH, Nademanee A, Masszi T, et al.
Brentuximab vedotin as consolidation therapy after autologous stem-cell transplantation in patients with Hodgkin’s lymphoma at risk of relapse or progression (AETHERA): a randomised, double-blind, placebo-controlled, phase 3 trial. The Lancet [online publication]. March 18, 2015.