Brentuximab vedotin with chemotherapy for stage III/IV classical Hodgkin lymphoma: 3-year update of the ECHELON-1 study
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- 5 March 2020
- journal article
- research article
- Published by American Society of Hematology in Blood
- Vol. 135 (10), 735-742
- https://doi.org/10.1182/blood.2019003127
Abstract
The phase 3 ECHELON-1 study demonstrated that brentuximab vedotin (A) with AVD (A+AVD) exhibited superior modified PFS versus ABVD for the frontline treatment of patients with stage III/IV classical Hodgkin lymphoma (cHL) (NCT01712490; 2011-005450-60). Maturing data from positron emission tomography (PET)-adapted trials highlight potential limitations of PET-adapted approaches, including toxicities with dose intensification and higher-than-expected relapse rates in PET2(−) patients. We present here an update of the ECHELON-1 study, including an exploratory analysis of 3-year PFS per investigator. 1334 patients with stage III or IV cHL were randomized 1:1 to receive six cycles of A+AVD (n = 664) or ABVD (n = 670). Interim PET scan after cycle 2 (PET2) was required. At a median follow-up of 37 months, 3-year PFS rates were 83.1% with A+AVD and 76.0% with ABVD; 3-year PFS rates in PET2(−) patients aged <60 years were 87.2% versus 81.0%, respectively. A beneficial trend in PET2(+) patients aged <60 years on A+AVD was also observed, with a 3-year PFS rate of 69.2% versus 54.7% with ABVD. The benefit of A+AVD in the intent-to-treat population appeared independent of disease stage and prognostic risk factors. Upon continued follow-up, 78% of patients with peripheral neuropathy (PN) on A+AVD had either complete resolution or improvement compared with 83% on ABVD. These data highlight that A+AVD provides a durable efficacy benefit compared with ABVD for frontline stage III/IV cHL which is consistent across key subgroups regardless of patient status at PET2, without need for treatment intensification or exposure to bleomycin.This publication has 16 references indexed in Scilit:
- Five-year follow-up of SWOG S0816: limitations and values of a PET-adapted approach with stage III/IV Hodgkin lymphomaBlood, 2019
- Long-Term Follow-up of SWOG S0816: Response-Adapted Therapy for Stage III/IV Hodgkin Lymphoma Demonstrates Limitations of PET-Adapted ApproachBlood, 2018
- Early Chemotherapy Intensification With Escalated BEACOPP in Patients With Advanced-Stage Hodgkin Lymphoma With a Positive Interim Positron Emission Tomography/Computed Tomography Scan After Two ABVD Cycles: Long-Term Results of the GITIL/FIL HD 0607 TrialJournal of Clinical Oncology, 2018
- Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin’s LymphomaThe New England Journal of Medicine, 2018
- Adapted Treatment Guided by Interim PET-CT Scan in Advanced Hodgkin’s LymphomaThe New England Journal of Medicine, 2016
- Eight Cycles of ABVD Versus Four Cycles of BEACOPPescalatedPlus Four Cycles of BEACOPPbaselinein Stage III to IV, International Prognostic Score ≥ 3, High-Risk Hodgkin Lymphoma: First Results of the Phase III EORTC 20012 Intergroup TrialJournal of Clinical Oncology, 2016
- US Intergroup Trial of Response-Adapted Therapy for Stage III to IV Hodgkin Lymphoma Using Early Interim Fluorodeoxyglucose–Positron Emission Tomography Imaging: Southwest Oncology Group S0816Journal of Clinical Oncology, 2016
- Randomized Phase III Trial of ABVD Versus Stanford V With or Without Radiation Therapy in Locally Extensive and Advanced-Stage Hodgkin Lymphoma: An Intergroup Study Coordinated by the Eastern Cooperative Oncology Group (E2496)Journal of Clinical Oncology, 2013
- Randomized Comparison of ABVD and MOPP/ABV Hybrid for the Treatment of Advanced Hodgkin’s Disease: Report of an Intergroup TrialJournal of Clinical Oncology, 2003
- Chemotherapy of Advanced Hodgkin's Disease with MOPP, ABVD, or MOPP Alternating with ABVDThe New England Journal of Medicine, 1992