4.7 Article

Brentuximab vedotin in combination with nivolumab in relapsed or refractory Hodgkin lymphoma: 3-year study results

Journal

BLOOD
Volume 138, Issue 6, Pages 427-438

Publisher

AMER SOC HEMATOLOGY
DOI: 10.1182/blood.2020009178

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Funding

  1. Seagen Inc
  2. Bristol-Myers Squibb
  3. Emmet and Toni Stephenson Leukemia & Lymphoma Society Scholar Award
  4. Lymphoma Research Foundation Larry and Denise Mason Clinical Investigator Career Development Award

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This study evaluated the combination of BV and Nivo as first salvage therapy for r/r cHL patients, showing high objective response rate and progression-free survival without additional toxicity concerns. Some patients were able to directly proceed to transplant after study treatment, indicating durable efficacy and impressive outcomes.
This phase 1-2 study evaluated brentuximab vedotin (BV) combined with nivolumab (Nivo) as first salvage therapy in patients with relapsed/refractory (r/r) classical Hodgkin lymphoma (cHL). In parts 1 and 2, patients received staggered dosing of BV andNivo in cycle 1, followed by same-day dosing in cycles 2 to 4. In part 3, both study drugs were dosed, same day, for all 4 cycles. At end of study treatment, patients could undergo autologous stem cell transplantation (ASCT) per investigator discretion. The objective response rate (ORR; N = 91) was 85%, with 67% achieving a complete response (CR). At a median follow-up of 34.3 months, the estimated progression-free survival (PFS) rate at 3 years was 77% (95% confidence interval [CI], 65% to 86%) and 91% (95% CI, 79% to 96%) for patients undergoing ASCT directly after study treatment. Overall survival at 3 years was 93% (95% CI, 85% to 97%). The most common adverse events (AEs) prior to ASCT were nausea (52%) and infusion-related reactions (43%), all grade 1 or 2. A total of 16 patients (18%) had immune-related AEs that required systemic corticosteroid treatment. Peripheral blood immune signatures were consistent with an activated T-cell response. Median gene expression of CD30 in tumors was higher in patients who responded compared with those who did not. Longer-term follow-up of BV and Nivo as a first salvage regimen shows durable efficacy and impressive PFS, especially in patients who proceeded directly to transplant, without additional toxicity concerns.

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