In a late-stage clinical trial, patients with Hodgkin lymphoma who received brentuximab vedotin after transplantation lived longer without disease progression than patients who received only supportive care. This is the first time a study demonstrated that adding a maintenance therapy after transplant can improve outcomes. The study was presented at the 56th annual meeting of the American Society of Hematology, in San Francisco, California.
High dose chemotherapy followed by autologous transplantation of blood-forming stem cells to produce new, healthy blood cells has been the standard of care the past 20 years in patients with Hodgkin lymphoma who relapsed or did not respond to initial therapy. This treatment approach typically cures approximately half of patients. For those patients who remain at risk of disease progression after transplantation, there is currently no standard therapy.
“Immense progress has been made to reduce complications for transplant patients,” said the study’s leader, Craig H. Moskowitz, MD, clinical director of the Division of Hematologic Oncology at Memorial Sloan Kettering Cancer Center in New York, New York. “For most people, a transplant can cure disease. But despite our best efforts, improvements in outcomes have plateaued and new therapies are needed.”
Brentuximab vedotin is an antibody that targets the CD30 protein, found on Hodgkin lymphoma cells. A total of 327 patients were randomized to receive either the drug or best supportive care after transplantation. All patients had either relapsed or failed to respond to at least one prior therapy but were in remission or had stable, nonprogressing disease after salvage chemotherapy prior to transplantation.
After a median follow-up of 2 years, patients who received brentuximab vedotin had a 20% improvement without disease progression compared to those who did not receive the drug (progression-free survival was 65% vs. 45%); 88% of patients who received brentuximab vedotin are still alive. Adverse events occurred in less than 15% of patients and included peripheral sensory neuropathy, upper respiratory tract infection, neutropenia, and fatigue.
“The results of this trial have the potential to change current practice,” said Moskowitz. “I am excited about the prospect of bringing this new therapy to all patients with hard-to-treat Hodgkin lymphoma.”