A F Herrera1, J Palmer2, P Martin3, S Armenian4, N-C Tsai2, N Kennedy1, F Sahebi1, T Cao1, L E Budde1, M Mei1, T Siddiqi1, L Popplewell1, S T Rosen1, L W Kwak1, A Nademanee1, S J Forman1, R Chen5. 1. Department of Hematology and Hematopoietic Cell Transplantation, Division of Biostatistics, City of Hope, Duarte, USA. 2. Department of Information Sciences, Division of Biostatistics, City of Hope, Duarte, USA. 3. Department of Hematology/Oncology, Weill Cornell Medical College, New York, USA. 4. Department of Population Sciences, City of Hope, Duarte, USA. 5. Department of Hematology and Hematopoietic Cell Transplantation, Division of Biostatistics, City of Hope, Duarte, USA. Electronic address: rchen@coh.org.
Abstract
Background: We previously demonstrated that brentuximab vedotin (BV) used as second-line therapy in patients with Hodgkin lymphoma is a tolerable and effective bridge to autologous hematopoietic cell transplantation (AHCT). Here, we report the post-AHCT outcomes of patients treated with second-line standard/fixed-dose BV and an additional cohort of patients where positron-emission tomography adapted dose-escalation of second-line BV was utilized. Patients and methods: Patients on the dose-escalation cohort received 1.8 mg/kg of BV intravenously every 3 weeks for two cycles. Patients in complete remission (CR) after two cycles received two additional cycles of BV at 1.8 mg/kg, while patients with stable disease or partial response were escalated to 2.4 mg/kg for two cycles. All patients, regardless of treatment cohort, proceeded directly to AHCT or received additional pre-AHCT therapy at the discretion of the treating physician based on remission status after second-line BV. Results: Of the 20 patients enrolled to the BV dose-escalation cohort, 8 patients underwent BV dose-escalation. BV escalation was well-tolerated, but no patients who were escalated converted to CR. Of 56 evaluable patients treated across cohorts, the overall response rate (ORR) to second-line BV was 75% with 43% CR. Twenty-eight (50%) patients proceeded directly to AHCT without post-BV chemotherapy, and a total of 50 patients proceeded to AHCT. Thirteen patients received consolidative post-AHCT therapy with either radiation, BV, or a PD-1 inhibitor. After AHCT, the 2-year progression-free survival (PFS) and overall survival were 67% and 93%, respectively. The 2-year PFS among patients in CR at the time of AHCT (n = 37) was 71% compared with 54% in patients not in CR (p = 0.12). The 2-year PFS in patients who proceeded to AHCT directly after receiving BV alone was 77%. Conclusions: Second-line BV is an effective bridge to AHCT that produces responses of sufficient depth to provide durable remission in conjunction with AHCT (clinicaltrials.gov: NCT01393717).
Background: We previously demonstrated that brentuximab vedotin (BV) used as second-line therapy in patients with Hodgkin lymphoma is a tolerable and effective bridge to autologous hematopoietic cell transplantation (AHCT). Here, we report the post-AHCT outcomes of patients treated with second-line standard/fixed-dose BV and an additional cohort of patients where positron-emission tomography adapted dose-escalation of second-line BV was utilized. Patients and methods: Patients on the dose-escalation cohort received 1.8 mg/kg of BV intravenously every 3 weeks for two cycles. Patients in complete remission (CR) after two cycles received two additional cycles of BV at 1.8 mg/kg, while patients with stable disease or partial response were escalated to 2.4 mg/kg for two cycles. All patients, regardless of treatment cohort, proceeded directly to AHCT or received additional pre-AHCT therapy at the discretion of the treating physician based on remission status after second-line BV. Results: Of the 20 patients enrolled to the BV dose-escalation cohort, 8 patients underwent BV dose-escalation. BV escalation was well-tolerated, but no patients who were escalated converted to CR. Of 56 evaluable patients treated across cohorts, the overall response rate (ORR) to second-line BV was 75% with 43% CR. Twenty-eight (50%) patients proceeded directly to AHCT without post-BV chemotherapy, and a total of 50 patients proceeded to AHCT. Thirteen patients received consolidative post-AHCT therapy with either radiation, BV, or a PD-1 inhibitor. After AHCT, the 2-year progression-free survival (PFS) and overall survival were 67% and 93%, respectively. The 2-year PFS among patients in CR at the time of AHCT (n = 37) was 71% compared with 54% in patients not in CR (p = 0.12). The 2-year PFS in patients who proceeded to AHCT directly after receiving BV alone was 77%. Conclusions: Second-line BV is an effective bridge to AHCT that produces responses of sufficient depth to provide durable remission in conjunction with AHCT (clinicaltrials.gov: NCT01393717).
Authors: Julia Driessen; Marie José Kersten; Lydia Visser; Anke van den Berg; Sanne H Tonino; Josée M Zijlstra; Pieternella J Lugtenburg; Franck Morschhauser; Martin Hutchings; Sandy Amorim; Thomas Gastinne; Marcel Nijland; Gerben J C Zwezerijnen; Ronald Boellaard; Henrica C W de Vet; Anne I J Arens; Roelf Valkema; Roberto D K Liu; Esther E E Drees; Daphne de Jong; Wouter J Plattel; Arjan Diepstra Journal: Leukemia Date: 2022-10-14 Impact factor: 12.883
Authors: Matthew G Mei; Hun Ju Lee; Joycelynne M Palmer; Robert Chen; Ni-Chun Tsai; Lu Chen; Kathryn McBride; D Lynne Smith; Ivana Melgar; Joo Y Song; Kimberley-Jane Bonjoc; Saro Armenian; Mary Nwangwu; Peter P Lee; Jasmine Zain; Liana Nikolaenko; Leslie Popplewell; Auayporn Nademanee; Ammar Chaudhry; Steven Rosen; Larry Kwak; Stephen J Forman; Alex F Herrera Journal: Blood Date: 2022-06-23 Impact factor: 25.476
Authors: Alex F Herrera; Joycelynne Palmer; Vikram Adhikarla; Dave Yamauchi; Erasmus K Poku; James Bading; Paul Yazaki; Savita Dandapani; Matthew Mei; Robert Chen; Thai Cao; Nicole Karras; Pamela McTague; Auayporn Nademanee; Leslie Popplewell; Firoozeh Sahebi; John E Shively; Jennifer Simpson; D Lynne Smith; Joo Song; Ricardo Spielberger; Ni-Chun Tsai; Sandra H Thomas; Stephen J Forman; David Colcher; Anna M Wu; Jeffrey Wong; Eileen Smith Journal: Blood Adv Date: 2021-12-14