Safety and efficacy of brentuximab vedotin for Hodgkin lymphoma recurring after allogeneic stem cell transplantation

• Published in: Blood Vol. 120; no. 3; pp. 560 - 568
• Main Authors: Gopal, Ajay K., Ramchandren, Radhakrishnan, O'Connor, Owen A., Berryman, Robert B., Advani, Ranjana H., Chen, Robert, Smith, Scott E., Cooper, Maureen, Rothe, Achim, Matous, Jeffrey V., Grove, Laurie E., Zain, Jasmine
• Format: Journal Article
• Language: English
• Published: Washington, DC Elsevier Inc 19.07.2012; Americain Society of Hematology; American Society of Hematology
• Subjects: Adult; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - adverse effects; Biological and medical sciences; Brentuximab Vedotin; Clinical Trials and Observations; Combined Modality Therapy; Female; Graft vs Host Disease - mortality; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation - adverse effects; Hodgkin Disease - drug therapy; Hodgkin Disease - mortality; Humans; Immunoconjugates - administration & dosage; Immunoconjugates - adverse effects; Infections - mortality; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymphoid Neoplasia; Male; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - mortality; Prospective Studies; Transplantation, Homologous; Treatment Outcome; Young Adult; Allogeneic hematopoietic stem cell transplantation; Hematology; Lymphoproliferative syndrome; Stem cell; Treatment efficiency; Hematopoietic cell; Homograft; Graft; Hodgkin disease; Malignant hemopathy; Lymphoma; Cancer
• ISSN: 0006-4971; 1528-0020; 1528-0020
• DOI: 10.1182/blood-2011-12-397893

Hodgkin lymphoma (HL) relapsing after allogeneic stem cell transplantation (alloSCT) presents a major clinical challenge. In the present investigation, we evaluated brentuximab vedotin, a CD30-directed Ab-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 after alloSCT, had no active GVHD, 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 of brentuximab vedotin IV 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 1). These results support the potential utility of brentuximab vedotin for selected patients with HL relapsing after alloSCT. These trials are registered with www.clinicaltrials.gov as NCT01026233, NCT01026415, and NCT00947856.