Advertisement


Stephen M. Ansell, PhD, MD, on Hodgkin Lymphoma: An Updated Analysis on First-Line Brentuximab Vedotin Plus Chemotherapy

2022 ASCO Annual Meeting

Advertisement

Stephen M. Ansell, PhD, MD, of Mayo Clinic, discusses updated data from the ECHELON-1 trial, which showed that, when administered to patients with stage III or IV classical Hodgkin lymphoma, the combination of brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) vs doxorubicin, bleomycin, vinblastine, and dacarbazine resulted in a 41% reduction in the risk of death. These outcomes, says Dr. Ansell, confirm A+AVD as a preferred option for previously untreated disease (Abstract 7503).



Transcript

Disclaimer: This video transcript has not been proofread or edited and may contain errors.
Hodgkin lymphoma is a disease that commonly affects younger patients, but there is also a peak of patients in the older age group that have this disease. And it's proven to be one of the success stories in treatment of patients with cancer. Many patients with Hodgkin lymphoma have a very successful outcome with combination chemotherapy. ABVD chemotherapy has been the standard for decades and has actually been quite difficult to beat, particularly when one looks at overall survival. In the past, strategies have looked at ways to decrease toxicity by leaving out drugs that can cause lung toxicity, such as bleomycin. Other strategies have looked at intensifying therapy, treatments such as escalated BEACOPP. And these have shown that it may improve outcomes, particularly as far as progression-free survival is concerned, but none of these have really been able to impact the overall survival of patients. And the feeling has generally been that if you can salvage people with subsequent treatments, using high dose therapy and stem cell transplantation, you can actually result in a similar outcome, as far as overall survival is concerned. So, echelon one trial, the trial that was reported at this meeting, compared the use of a new targeted novel agent, as many people are aware, Brentuximab vedotin, it's a CD 30 antibody drug conjugate, in combination with AVD chemotherapy, against that standard, the ABVD chemotherapy. And just over 1300 patients were randomized in a one to one fashion. And the outcomes of those two cohorts of patients, treated for six cycles of therapy, were compared over time. Now, this data has been reported in a number of different time points. Initially, what was called the modified progression-free survival was reported, which showed an advantage to the Brentuximab AVD arm. Subsequently, regular progression-free survival showed a significant improvement, when compared to the standard. But the data presented now showed a 41% decrease in the likelihood of death from Hodgkin lymphoma, with the treatment with Brentuximab vedotin plus AVD chemotherapy. So, I think, quite frankly, this is a significant advance and moving the field forward. A few things that were very interesting about the study, when we actually looked at causes of death, there were more people passing away from Hodgkin lymphoma in the ABVD arm and fewer in the Brentuximab vedotin plus AVD arm. Now obviously, that would be expected, but there were fewer second malignancies, interestingly, in the Brentuximab vedotin AVD chemotherapy. And of particular note was, there were fewer other lymphomas that developed, suggesting that the Brentuximab vedotin may actually target a stem cell, or an earlier precursor cell, preventing those second malignancies. Additional data that looked at other toxicities that one is concerned about; Pregnancies, persistence of peripheral neuropathy, really were quite favorable showing that Brentuximab vedotin AVD chemotherapy is well tolerated and can be administered, and some of the toxicity seen actually subsequently resolve. So, when you take that all together and you say, "What does this data really show?" I think it shows that Brentuximab vedotin AVD chemotherapy, in advanced stage classical Hodgkin lymphoma patients, is a therapy with a better outcome than ABVD chemotherapy, and really now is the preferred frontline treatment for patients with this disease. I think the other thing that really is notable about this, we always believe that you could always turn around and salvage people subsequently with a subsequent strategy and treatment. This would suggest that what you do the first time actually impacts people overall, because when additional subsequent therapy was compared between the two arms, there was no real significant difference. So, taken together, that data would really say that the use of Brentuximab vedotin in combination with chemotherapy improves the outcomes of patients overall, and is now the preferred treatment for advanced stage patients.

Related Videos

Gynecologic Cancers

Ursula A. Matulonis, MD, and Domenica Lorusso, MD, PhD, on Gynecologic Cancers: New Findings on Trabectedin vs Clinician’s Choice Chemotherapy

Ursula A. Matulonis, MD, of Dana-Farber Cancer Institute, and Domenica Lorusso, MD, PhD, of Italy’s Gemelli University Hospital, discuss phase III data from the MITO23 trial on single-agent trabectedin vs clinician’s choice of chemotherapy in patients with recurrent ovarian, primary peritoneal, or fallopian tube cancers of BRCA-mutated or BRCAness phenotype. Although trabectedin has demonstrated antitumor activity in relapsed platinum-sensitive disease, it does not appear to improve survival outcomes when compared with standard chemotherapy in the BRCA-mutated population (Abstract LBA5504).

Breast Cancer

Stephanie Walker on Increasing the Participation of Black Women With Metastatic Breast Cancer in Clinical Trials

Stephanie Walker, a former nurse and current activist with the Metastatic Breast Cancer Alliance, discusses findings from the BECOME project (Black Experience of Clinical Trials and Opportunities for Meaningful Engagement). They show that, even though Black patients comprise between 4% and 6% of all clinical trial participants, Black women with metastatic breast cancer are willing to consider taking part if steps were taken to increase their awareness, build trust through clear communication with health-care providers, involve people of shared racial/ethnic identity and health experience, and help patients find and access trials (Abstract 1014).

Head and Neck Cancer
Supportive Care

Carryn M. Anderson, MD, on Head and Neck Cancer: New Data on Avasopasem Manganese for Oral Mucositis

Carryn M. Anderson, MD, of the University of Iowa Hospital, discusses phase III results of the ROMAN trial of avasopasem manganese for patients with severe oral mucositis who are receiving chemoradiotherapy for locally advanced, nonmetastatic head and neck cancer. Compared with placebo, avasopasem manganese improved severe oral mucositis (Abstract 6005).

Prostate Cancer

Alicia K. Morgans, MD, MPH, and Michael S. Hofman, MBBS, on Prostate Cancer: New Data on Lutetium-177–PSMA-617 (LuPSMA) vs Cabazitaxel

Alicia K. Morgans, MD, MPH, of Dana-Farber Cancer Institute, and Michael S. Hofman, MBBS, of Peter MacCallum Cancer Centre, University of Melbourne, discuss follow-up results on LuPSMA vs cabazitaxel in patients with metastatic castration-resistant prostate cancer progressing after docetaxel treatment. The findings suggest that LuPSMA is a suitable option for this population, with fewer adverse events, higher response rates, improved patient-reported outcomes, and similar overall survival compared with cabazitaxel (Abstract 5000).

Michael J. Overman, MD, and Takayuki Yoshino, PhD, MD, on Colorectal Cancer: Phase III Data on Panitumumab or Bevacizumab Plus mFOLFOX6

Michael J. Overman, MD, of The University of Texas MD Anderson Cancer Center, and Takayuki Yoshino, PhD, MD, of the National Cancer Center Hospital East, Japan, discuss results from the PARADIGM trial, the first prospective study to test the superiority of panitumumab vs bevacizumab in combination with standard doublet first-line chemotherapy for patients with RAS wild-type and left-sided metastatic colorectal cancer. The study showed that panitumumab improved overall survival in combination with mFOLFOX6, which may establish a standard first-line combination regimen for this population (Abstract LBA1).

Advertisement

Advertisement




Advertisement