Brentuximab vedotin and AVD followed by involved-site radiotherapy in early stage, unfavorable risk Hodgkin lymphoma

Anita Kumar, Carla Casulo, Joachim Yahalom, Heiko Schöder, Paul M. Barr, Philip Caron, April Chiu, Louis S. Constine, Pamela Drullinsky, Jonathan W. Friedberg, John F. Gerecitano, Audrey Hamilton, Paul A. Hamlin, Steven M. Horwitz, Alexandra G. Jacob, Matthew J. Matasar, Gianna N. McArthur, Susan J. McCall, Alison J. Moskowitz, Ariela NoyMaria L. Palomba, Carol S. Portlock, David J. Straus, Nicholas VanderEls, Stephanie L. Verwys, Joanna Yang, Anas Younes, Andrew D. Zelenetz, Zhigang Zhang, Craig Moskowitz

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

This multicenter pilot study assessed the safety and efficacy of brentuximab vedotin (BV) and AVD (adriamycin, vinblastine, and dacarbazine) followed by 30 Gy involved site radiation therapy (ISRT). Patients with newly diagnosed, early stage classical Hodgkin lymphoma (HL) with unfavorable-risk features were treated with 4 cycles of BV and AVD. Patients who achieved a negative positron emission tomography (PET) scan (Deauville score of 1-3) received 30 Gy ISRT. Thirty patients received treatment and were assessable for toxicity. Twenty-nine patients completed 4 cycles of BV + AVD, and 25 patients BV + AVD + 30 Gy ISRT. No clinically significant noninfectious pneumonitis was observed. Serious adverse events(≥grade 3) were reported in 4 patients, including febrile neutropenia, peripheral neuropathy, and hypertension. After 2 and 4 cycles of BV + AVD, 90%(26 of 29) and 93%(27 or 29) of patients achieved a negative PET scan, respectively. Two patients with biopsy-proven primary refractory HL were treated off-study. All 25 patients who completed BV + AVD + ISRT achieved a complete response. With a median follow-up of 18.8 months, by intent to treat, the 1-year progression-free survival is 93.3% (95% confidence interval, 84-102). Overall, the treatment was well-tolerated with no evidence of significant pulmonary toxicity. The majority of patients (≥90%) achieved negative interim PET scans after 2 and 4 cycles of BV + AVD. Excludingthe 2 primary refractory patients, all patients are disease free, suggesting that this is a highly active treatment program even in patients with substantial disease bulk.

Original languageEnglish (US)
Pages (from-to)1458-1464
Number of pages7
JournalBlood
Volume128
Issue number11
DOIs
StatePublished - Sep 15 2016
Externally publishedYes

Fingerprint

Dacarbazine
Vinblastine
Radiotherapy
Hodgkin Disease
Doxorubicin
Positron emission tomography
Refractory materials
Toxicity
Positron-Emission Tomography
Patient treatment
Biopsy
cAC10-vcMMAE
Febrile Neutropenia
Peripheral Nervous System Diseases
Multicenter Studies
Disease-Free Survival
Pneumonia

ASJC Scopus subject areas

  • Biochemistry
  • Immunology
  • Hematology
  • Cell Biology

Cite this

Brentuximab vedotin and AVD followed by involved-site radiotherapy in early stage, unfavorable risk Hodgkin lymphoma. / Kumar, Anita; Casulo, Carla; Yahalom, Joachim; Schöder, Heiko; Barr, Paul M.; Caron, Philip; Chiu, April; Constine, Louis S.; Drullinsky, Pamela; Friedberg, Jonathan W.; Gerecitano, John F.; Hamilton, Audrey; Hamlin, Paul A.; Horwitz, Steven M.; Jacob, Alexandra G.; Matasar, Matthew J.; McArthur, Gianna N.; McCall, Susan J.; Moskowitz, Alison J.; Noy, Ariela; Palomba, Maria L.; Portlock, Carol S.; Straus, David J.; VanderEls, Nicholas; Verwys, Stephanie L.; Yang, Joanna; Younes, Anas; Zelenetz, Andrew D.; Zhang, Zhigang; Moskowitz, Craig.

In: Blood, Vol. 128, No. 11, 15.09.2016, p. 1458-1464.

Research output: Contribution to journalArticle

Kumar, A, Casulo, C, Yahalom, J, Schöder, H, Barr, PM, Caron, P, Chiu, A, Constine, LS, Drullinsky, P, Friedberg, JW, Gerecitano, JF, Hamilton, A, Hamlin, PA, Horwitz, SM, Jacob, AG, Matasar, MJ, McArthur, GN, McCall, SJ, Moskowitz, AJ, Noy, A, Palomba, ML, Portlock, CS, Straus, DJ, VanderEls, N, Verwys, SL, Yang, J, Younes, A, Zelenetz, AD, Zhang, Z & Moskowitz, C 2016, 'Brentuximab vedotin and AVD followed by involved-site radiotherapy in early stage, unfavorable risk Hodgkin lymphoma', Blood, vol. 128, no. 11, pp. 1458-1464. https://doi.org/10.1182/blood-2016-03-703470
Kumar, Anita ; Casulo, Carla ; Yahalom, Joachim ; Schöder, Heiko ; Barr, Paul M. ; Caron, Philip ; Chiu, April ; Constine, Louis S. ; Drullinsky, Pamela ; Friedberg, Jonathan W. ; Gerecitano, John F. ; Hamilton, Audrey ; Hamlin, Paul A. ; Horwitz, Steven M. ; Jacob, Alexandra G. ; Matasar, Matthew J. ; McArthur, Gianna N. ; McCall, Susan J. ; Moskowitz, Alison J. ; Noy, Ariela ; Palomba, Maria L. ; Portlock, Carol S. ; Straus, David J. ; VanderEls, Nicholas ; Verwys, Stephanie L. ; Yang, Joanna ; Younes, Anas ; Zelenetz, Andrew D. ; Zhang, Zhigang ; Moskowitz, Craig. / Brentuximab vedotin and AVD followed by involved-site radiotherapy in early stage, unfavorable risk Hodgkin lymphoma. In: Blood. 2016 ; Vol. 128, No. 11. pp. 1458-1464.
@article{00f00ce52e3347d29fd2320658975443,
title = "Brentuximab vedotin and AVD followed by involved-site radiotherapy in early stage, unfavorable risk Hodgkin lymphoma",
abstract = "This multicenter pilot study assessed the safety and efficacy of brentuximab vedotin (BV) and AVD (adriamycin, vinblastine, and dacarbazine) followed by 30 Gy involved site radiation therapy (ISRT). Patients with newly diagnosed, early stage classical Hodgkin lymphoma (HL) with unfavorable-risk features were treated with 4 cycles of BV and AVD. Patients who achieved a negative positron emission tomography (PET) scan (Deauville score of 1-3) received 30 Gy ISRT. Thirty patients received treatment and were assessable for toxicity. Twenty-nine patients completed 4 cycles of BV + AVD, and 25 patients BV + AVD + 30 Gy ISRT. No clinically significant noninfectious pneumonitis was observed. Serious adverse events(≥grade 3) were reported in 4 patients, including febrile neutropenia, peripheral neuropathy, and hypertension. After 2 and 4 cycles of BV + AVD, 90{\%}(26 of 29) and 93{\%}(27 or 29) of patients achieved a negative PET scan, respectively. Two patients with biopsy-proven primary refractory HL were treated off-study. All 25 patients who completed BV + AVD + ISRT achieved a complete response. With a median follow-up of 18.8 months, by intent to treat, the 1-year progression-free survival is 93.3{\%} (95{\%} confidence interval, 84-102). Overall, the treatment was well-tolerated with no evidence of significant pulmonary toxicity. The majority of patients (≥90{\%}) achieved negative interim PET scans after 2 and 4 cycles of BV + AVD. Excludingthe 2 primary refractory patients, all patients are disease free, suggesting that this is a highly active treatment program even in patients with substantial disease bulk.",
author = "Anita Kumar and Carla Casulo and Joachim Yahalom and Heiko Sch{\"o}der and Barr, {Paul M.} and Philip Caron and April Chiu and Constine, {Louis S.} and Pamela Drullinsky and Friedberg, {Jonathan W.} and Gerecitano, {John F.} and Audrey Hamilton and Hamlin, {Paul A.} and Horwitz, {Steven M.} and Jacob, {Alexandra G.} and Matasar, {Matthew J.} and McArthur, {Gianna N.} and McCall, {Susan J.} and Moskowitz, {Alison J.} and Ariela Noy and Palomba, {Maria L.} and Portlock, {Carol S.} and Straus, {David J.} and Nicholas VanderEls and Verwys, {Stephanie L.} and Joanna Yang and Anas Younes and Zelenetz, {Andrew D.} and Zhigang Zhang and Craig Moskowitz",
year = "2016",
month = "9",
day = "15",
doi = "10.1182/blood-2016-03-703470",
language = "English (US)",
volume = "128",
pages = "1458--1464",
journal = "Blood",
issn = "0006-4971",
publisher = "American Society of Hematology",
number = "11",

}

TY - JOUR

T1 - Brentuximab vedotin and AVD followed by involved-site radiotherapy in early stage, unfavorable risk Hodgkin lymphoma

AU - Kumar, Anita

AU - Casulo, Carla

AU - Yahalom, Joachim

AU - Schöder, Heiko

AU - Barr, Paul M.

AU - Caron, Philip

AU - Chiu, April

AU - Constine, Louis S.

AU - Drullinsky, Pamela

AU - Friedberg, Jonathan W.

AU - Gerecitano, John F.

AU - Hamilton, Audrey

AU - Hamlin, Paul A.

AU - Horwitz, Steven M.

AU - Jacob, Alexandra G.

AU - Matasar, Matthew J.

AU - McArthur, Gianna N.

AU - McCall, Susan J.

AU - Moskowitz, Alison J.

AU - Noy, Ariela

AU - Palomba, Maria L.

AU - Portlock, Carol S.

AU - Straus, David J.

AU - VanderEls, Nicholas

AU - Verwys, Stephanie L.

AU - Yang, Joanna

AU - Younes, Anas

AU - Zelenetz, Andrew D.

AU - Zhang, Zhigang

AU - Moskowitz, Craig

PY - 2016/9/15

Y1 - 2016/9/15

N2 - This multicenter pilot study assessed the safety and efficacy of brentuximab vedotin (BV) and AVD (adriamycin, vinblastine, and dacarbazine) followed by 30 Gy involved site radiation therapy (ISRT). Patients with newly diagnosed, early stage classical Hodgkin lymphoma (HL) with unfavorable-risk features were treated with 4 cycles of BV and AVD. Patients who achieved a negative positron emission tomography (PET) scan (Deauville score of 1-3) received 30 Gy ISRT. Thirty patients received treatment and were assessable for toxicity. Twenty-nine patients completed 4 cycles of BV + AVD, and 25 patients BV + AVD + 30 Gy ISRT. No clinically significant noninfectious pneumonitis was observed. Serious adverse events(≥grade 3) were reported in 4 patients, including febrile neutropenia, peripheral neuropathy, and hypertension. After 2 and 4 cycles of BV + AVD, 90%(26 of 29) and 93%(27 or 29) of patients achieved a negative PET scan, respectively. Two patients with biopsy-proven primary refractory HL were treated off-study. All 25 patients who completed BV + AVD + ISRT achieved a complete response. With a median follow-up of 18.8 months, by intent to treat, the 1-year progression-free survival is 93.3% (95% confidence interval, 84-102). Overall, the treatment was well-tolerated with no evidence of significant pulmonary toxicity. The majority of patients (≥90%) achieved negative interim PET scans after 2 and 4 cycles of BV + AVD. Excludingthe 2 primary refractory patients, all patients are disease free, suggesting that this is a highly active treatment program even in patients with substantial disease bulk.

AB - This multicenter pilot study assessed the safety and efficacy of brentuximab vedotin (BV) and AVD (adriamycin, vinblastine, and dacarbazine) followed by 30 Gy involved site radiation therapy (ISRT). Patients with newly diagnosed, early stage classical Hodgkin lymphoma (HL) with unfavorable-risk features were treated with 4 cycles of BV and AVD. Patients who achieved a negative positron emission tomography (PET) scan (Deauville score of 1-3) received 30 Gy ISRT. Thirty patients received treatment and were assessable for toxicity. Twenty-nine patients completed 4 cycles of BV + AVD, and 25 patients BV + AVD + 30 Gy ISRT. No clinically significant noninfectious pneumonitis was observed. Serious adverse events(≥grade 3) were reported in 4 patients, including febrile neutropenia, peripheral neuropathy, and hypertension. After 2 and 4 cycles of BV + AVD, 90%(26 of 29) and 93%(27 or 29) of patients achieved a negative PET scan, respectively. Two patients with biopsy-proven primary refractory HL were treated off-study. All 25 patients who completed BV + AVD + ISRT achieved a complete response. With a median follow-up of 18.8 months, by intent to treat, the 1-year progression-free survival is 93.3% (95% confidence interval, 84-102). Overall, the treatment was well-tolerated with no evidence of significant pulmonary toxicity. The majority of patients (≥90%) achieved negative interim PET scans after 2 and 4 cycles of BV + AVD. Excludingthe 2 primary refractory patients, all patients are disease free, suggesting that this is a highly active treatment program even in patients with substantial disease bulk.

UR - http://www.scopus.com/inward/record.url?scp=84988328541&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988328541&partnerID=8YFLogxK

U2 - 10.1182/blood-2016-03-703470

DO - 10.1182/blood-2016-03-703470

M3 - Article

C2 - 27458003

AN - SCOPUS:84988328541

VL - 128

SP - 1458

EP - 1464

JO - Blood

JF - Blood

SN - 0006-4971

IS - 11

ER -