‘Survival Advantage’ Seen with Brentuximab Vedotin in Stage III or IV Hodgkin Lymphoma

Patients with previously untreated stage III or IV classic Hodgkin lymphoma who received first-line therapy with brentuximab vedotin, a CD30-directed antibody–drug conjugate, plus doxorubicin, vinblastine, and dacarbazine, as compared with doxorubicin, bleomycin, vinblastine, and dacarbazine, had a “survival advantage,” according to ECHELON I study results.

The data are from a median of six years of follow-up in the study. The primary endpoint, modified progression-free survival (PFS) after five years of follow-up, was reported in 2021 and showed long-term PFS benefits.

The current study, published in The New England Journal of Medicine, reported on the key secondary endpoint, overall survival (OS) in the intention-to-treat population, after six years of follow-up.

Patients were randomized 1:1 to receive up to six cycles of brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (n=664) or doxorubicin, bleomycin, vinblastine, and dacarbazine (n=670).

At a median follow-up of 73 months, 39 patients in the brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine group and 64 in the doxorubicin, bleomycin, vinblastine, and dacarbazine group had died (hazard ratio [HR], 0.59; 95% CI, 0.40-0.88; P=.009). The six-year OS estimates were 93.9% (95% CI, 91.6-95.5) in the brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine group and 89.4% (95% CI, 86.6-91.7) in the doxorubicin, bleomycin, vinblastine, and dacarbazine group.

PFS was longer with brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine than with doxorubicin, bleomycin, vinblastine, and dacarbazine (HR, 0.68; 95% CI, 0.53-0.86). Fewer patients in the brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine group than in the doxorubicin, bleomycin, vinblastine, and dacarbazine group received subsequent therapy, including transplant, and fewer secondary cancers were reported with brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (23 vs 32 patients).

“Patients who received [brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine] for the treatment of stage III or IV Hodgkin lymphoma had a survival advantage over those who received [doxorubicin, bleomycin, vinblastine, and dacarbazine],” the authors concluded.

This study was funded by Takeda Development Center Americas and Seagen.

Reference

Ansell SM, Radford J, Connors JM, et al. Overall survival with brentuximab vedotin in stage III or IV Hodgkin’s lymphoma. N Engl J Med. 2022. doi:10.1056/NEJMoa2206125