The following is a summary of “Brentuximab vedotin plus nivolumab after autologous haematopoietic stem-cell transplantation for adult patients with high-risk classic Hodgkin lymphoma: a multicentre, phase 2 trial” published in the January, 2023 issue of Haematology by Herrera, et al.
In high-risk relapsed or refractory classic Hodgkin lymphoma patients, consolidation with brentuximab vedotin following autologous hematopoietic stem-cell transplantation (HSCT) improves progression-free survival compared to placebo. Researchers tested brentuximab vedotin and nivolumab in high-risk recurrent or refractory classic Hodgkin lymphoma patients post-autologous HSCT. Five US sites hosted phase 2 experiments. All patients were 18 or older, had high-risk relapsed or refractory classic Hodgkin lymphoma, an ECOG performance level of 0-2, and acceptable organ and bone marrow function to be included. Participants received intravenous brentuximab vedotin (1/8 mg/kg) and nivolumab (3 mg/kg) on day 1 of each 21-day cycle for a maximum of 8 cycles starting 30-60 days following autologous HSCT.
Nivolumab dosage could not be reduced. 0.5 mg/kg of brentuximab vedotin is possible. If the consumption of one drug is stopped due to toxic effects, the other can still be taken. All patients’ primary outcome was 18-month progression-free survival. Between May 3, 2017, and July 13, 2019, 59 people were registered and treated. Patients received a median of 8 cycles of brentuximab vedotin with nivolumab after 54 days (IQR 46-58) post-autologous HSCT (8–8). 34 (58%) of 59 patients were male; 29 (49%) completed all 8 cycles of brentuximab vedotin + nivolumab; 45 (76%) completed at least one drug. Follow-up averaged 29.9 months (interquartile range, 24.6-34.8). All 59 patients had 94% (95% CI 84-98) progression-free survival after 18 months.
About 17 [29%] of 59 patients required corticosteroids due to immune-related side effects, along with neutropenia (25 [42%]) and peripheral sensory neuropathy (31 [53%]). Treatment caused no deaths. Post-autologous HSCT patients with high-risk relapsed or refractory classic Hodgkin lymphoma responded well to brentuximab vedotin and nivolumab. Combination immunotherapy for typical Hodgkin lymphoma needs further study to reduce side effects, especially in high-risk patients who need more intensive treatment to avoid relapse.
The study was funded by Myers Squibb, the Leukaemia and Lymphoma Society, the Lymphoma Research Foundation, and the National Cancer Institute of the National Institutes of Health.