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Brentuximab vedotin plus doxorubicin and dacarbazine in nonbulky limited-stage classical Hodgkin lymphoma

医学 布仑妥昔单抗维多汀 内科学 中性粒细胞减少症 达卡巴嗪 发热性中性粒细胞减少症 胃肠病学 长春碱 ABVD公司 不利影响 养生 外科 淋巴瘤 肿瘤科 化疗 长春新碱 环磷酰胺 霍奇金淋巴瘤
作者
Jeremy S. Abramson,Elizabeth Bengston,Robert Redd,Jeffrey A. Barnes,Tak Takvorian,Lubomir Sokol,Frederick Lansigan,Philippe Armand,Bijal Shah,Eric Jacobsen,Rosalba Martignetti,E Turba,Sara Metzler,Victoria Patterson,Ann S. LaCasce,Celeste M. Bello
出处
期刊:Blood Advances [American Society of Hematology]
卷期号:7 (7): 1130-1136 被引量:11
标识
DOI:10.1182/bloodadvances.2022008420
摘要

ABVD (Adriamycin, bleomycin, vinblastine, dacarbazine) with or without radiation has been the standard treatment for limited-stage Hodgkin lymphoma (HL) but carries risks of bleomycin lung injury and radiation toxicity. Brentuximab vedotin (BV) is approved with AVD for stage III-IV HL, but carries increased risks of peripheral neuropathy (PN) and neutropenic fever, likely due to overlapping toxicity between BV and vinblastine. We therefore evaluated BV in combination with AD for 4 or 6 cycles based on interim positron emission tomography response. Thirty-four patients with nonbulky stage I-II HL were enrolled. Risk was early favorable in 53% and unfavorable in 47%. The overall and complete response rates (CRRs) were 100% and 97%, respectively, with a 5-year progression-free survival (PFS) of 91%. No differences in outcome were observed based on stage (I vs II) or risk status (early favorable vs unfavorable). The most common adverse events were nausea (85%), peripheral sensory neuropathy (59%), and fatigue (56%). There were no cases of grade-4 neutropenia or neutropenic fever, and no patient received granulocyte-colony stimulating factor. Most cases of PN were grade 1, and no patient experienced grade ≥3 PN. BV-AD produced a high CRR and durable PFS with most patients requiring 4 cycles of therapy. Compared with BV-AVD, the toxicity profile appeared improved, with predominantly grade 1 reversible PN and no case of grade 4 neutropenia or neutropenic fever. This regimen warrants further study in HL and may serve as a backbone for the addition of novel agents. This trial is registered on clinicaltrials.gov (NCT02505269).
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