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For those with Hodgkin lymphoma, brentuximab vedotin may increase overall survival

The study's findings were presented by Stephen Ansell, M.D., Ph.D., at the ASCO Annual Meeting in Chicago in 2022 and were later printed in the New England Journal of Medicine. 

Hodgkin’s lymphoma is a type of cancer that affects the lymphatic system, which is part of the body’s germ-fighting immune system. The white blood cells called lymphocytes grow out of control, causing swollen lymph nodes and growths throughout the body.

According to a study conducted by scientists at the Mayo Clinic Comprehensive Cancer Center, adding brentuximab vedotin to the current standard of chemotherapy treatment improves overall survival in patients with Hodgkin’s lymphoma when compared to chemotherapy alone.

Dr. Ansell said that research now demonstrates, in contrast to earlier theories, choosing an early therapy that includes brentuximab vedotin improves overall survival in patients with advanced stage Hodgkin lymphoma, regardless of any medications given later in the course of care.

“Our randomized study showed that the addition of an antibody-drug conjugate, brentuximab vedotin, to standard chemotherapy in patients with advanced stage classical Hodgkin lymphoma improved overall survival for patients with Hodgkin Lymphoma when compared to patients who received standard chemotherapy alone, says Dr. Ansell. Brentuximab plus AVD chemotherapy was previously reported to improve progression-free survival in patients with classical Hodgkin lymphoma, so its impact on overall survival was not completely surprising,” says Dr. Ansell. 

A+AVD was given to 664 patients, whereas ABVD was given to 670 patients. 39 patients in the A+AVD group and 64 in the ABVD group had passed away at the median follow-up of 73.0 months (hazard ratio, 0.59; 95 percent confidence interval [CI], 0.40 to 0.88; P=0.009). The 6-year overall survival estimates for the A+AVD group were 93.9 percent (95% CI, 91.6 to 95.5) and for the ABVD group were 89.4 percent (86.6 to 91.7). With A+AVD, progression-free survival was greater than with ABVD (hazard ratio for disease progression or death, 0.68; 95 percent CI, 0.53 to 0.86). Fewer patients in the A+AVD group than in the ABVD group underwent additional treatment, including transplantation, and A+AVD patients reported fewer second malignancies (in 23 vs. 32 patients).

While individuals who relapse are often treated effectively with additional therapies, comparative trials of different drug combinations in the past have not been able to demonstrate an overall survival advantage. Although the effect of brentuximab vedotin + AVD chemotherapy on overall survival is somewhat unexpected, it demonstrates that the use of new drugs in the initial treatment of Hodgkin lymphoma patients has a lasting effect, according to Dr. Ansell.

The toxicities of brentuximab vedotin over the long term were also examined by Dr. Ansell and his associates. They discovered that the neuropathy brought on by the drug’s addition to the regimen improved with time. The addition of the additional drug did not have a deleterious effect on the number of subsequent pregnancies.

“Surprisingly, second malignancies including other lymphomas were less frequently seen in the brentuximab vedotin +AVD arm of the trial,” says Dr. Ansell.

For those with Hodgkin lymphoma, brentuximab vedotin may increase overall survival

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