ORLANDO, FL—Cysteine-cysteine thymus and activation related chemokine (TARC) levels correlated with PET-normalization in patients with relapsed/refractory Hodgkin lymphoma treated with brentuximab vedotin, a study reported at the 57th American Society of Hematology (ASH) Annual Meeting.1
In addition, post-brentuximab vedotin TARC level was predictive of favorable post-transplant event-free survival, Alison J. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center in New York, NY, told meeting attendees.
This is the largest series to date to evaluate the prognostic and predictive significance of TACE in this patient population.
In the study, patients who failed 1 line of therapy were treated with 2 cycles of brentuximab vedotin 1.2 mg/kg/week, for 3 weeks, followed by 1 week off.
“Those who achieved PET-normalization proceeded directly to consolidation with autologous stem cell transplantation (ASCT),” she said, while “those with persistent abnormalities on PET received augmented ICE [ifosfamide, carboplatin, and etoposide] prior to consideration for ASCT.”
Interleukin (IL)-6, IL-10, tumor necrosis factor-α (TNF-α), interferon-γ (IFN-γ), and TARC were measured at baseline and after 2 cycles of brentuximab vedotin by multiplex ELISA array.
Of the 45 patients enrolled, 37 (82%) had serum samples available both at baseline and after 2 cycles of brentuximab vedotin for analysis.
At baseline, abnormal levels were detected in IL-6 (32%), IL-10 (8%), TNF-α (78%), IFN-γ (97%), and TARC (97%). Elevated baseline IFN-γ (P = .003) and IL-10 (P = .049) were found to correlate with presence of extranodal sites of disease, while elevated IL-10 (P = .019) and TNF-α (P = .019) correlated with the presence of B-symptoms.
The percent change in TARC from baseline to post-treatment predicted for PET-normalization following treatment with brentuximab vedotin (OR 5.82; 95% CI: 1.18-43.74).
Lower TARC levels post-brentuximab vedotin “was significantly associated with improved event-free survival,” Dr. Moskowitz said. At 2 years, event-free survival was 94% for patients with TARC levels less than 1026.7 pg/mL, compared with 67% for those with TARC levels greater than 1026.7 pg/mL (P = .044).
“No other factors correlated with response to therapy, event-free survival, or overall survival,” she added. “Continued incorporation of TARC evaluation in prospective clinical trials for Hodgkin lymphoma is warranted to better define its role in predicting PET-normalization and prognosis.”
1. Moskowitz AJ, Cho S, Fleisher M, et al. TARC predicts PET-normalization and event free survival in relapsed/refractory Hodgkin lymphoma patients treated with brentuximab vedotin. Oral presentation at: 57th American Society of Hematology (ASH) Annual Meeting; December 6, 2015, Orlando, FL.