Combining BeEAM with Brentuximab Vedotin for High-Dose Therapy in CD30 Positive Lymphomas before Autologous Transplantation-A Phase I Study.

Christian Rausch, Ulrike Bacher, Manuela Rabaglio, Corinne Vorburger, Anke Klingenberg, Yara Banz, Michael Daskalakis, Thomas Pabst
Author Information
  1. Christian Rausch: Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland.
  2. Ulrike Bacher: Department of Hematology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland. ORCID
  3. Manuela Rabaglio: Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland. ORCID
  4. Corinne Vorburger: Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland.
  5. Anke Klingenberg: Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland.
  6. Yara Banz: Institute of Pathology, University of Bern, 3008 Bern, Switzerland.
  7. Michael Daskalakis: Department of Hematology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland. ORCID
  8. Thomas Pabst: Department of Medical Oncology, Inselspital, University Hospital Bern, University of Bern, 3010 Bern, Switzerland. ORCID

Abstract

The prognosis for patients with CD30+ lymphomas (Hodgkin lymphoma and various T-cell lymphomas) relapsing after autologous stem cell transplantation (ASCT) is critical. Brentuximab vedotin (BV), an ADC targeting CD30, is an obvious candidate for inclusion into high-dose chemotherapy (HDCT) regimens to improve outcomes. This single center phase I trial investigated 12 patients with CD30+ lymphoma (AITL: = 5; relapsed HL: = 7; median of two previous treatment lines) undergoing ASCT. In a 3 + 3 dose escalation design, 12 patients received a single BV dose at three dose levels (DL) (0.9/1.2/1.8 mg/kg b.w.) prior to standard BeEAM. All patients were treated as planned; no dose limiting toxicities (DLTs) occurred at DL 1 and 2. At DL 3, one DLT (paralytic ileus, fully recovering) occurred. Grade III febrile neutropenia occurred in one patient, and two others had septic complications, all fully recovering. Median hospitalization was 23 days. Hematologic recovery was normal. Six of twelve (50%) patients achieved CR. PFS and OS at 1 year were 67% ( = 8/12) and 83% ( = 10/12), respectively. The addition of brentuximab to standard BeEAM HDCT seems to be safe. We observed a CR rate of 75% post-ASCT in a highly pretreated population. The efficacy of this novel HDCT combination with BV at a 1.8 mg/kg dose level needs to be explored in larger studies.

Keywords

References

  1. Ann Oncol. 2019 Apr 1;30(4):612-620 [PMID: 30657848]
  2. J Oncol Pharm Pract. 2023 Apr 28;:10781552231168951 [PMID: 37116870]
  3. Bone Marrow Transplant. 2022 Jun;57(6):990-997 [PMID: 35444232]
  4. Int J Diabetes Dev Ctries. 2023 Feb;43(1):120-124 [PMID: 35875342]
  5. Lancet Haematol. 2020 Sep;7(9):e660-e670 [PMID: 32853585]
  6. Eur J Haematol. 2007 Jul;79(1):32-8 [PMID: 17598836]
  7. N Engl J Med. 2010 Nov 4;363(19):1812-21 [PMID: 21047225]
  8. Ann Hematol. 2017 Mar;96(3):421-429 [PMID: 28011985]
  9. Blood. 2016 Sep 22;128(12):1562-6 [PMID: 27432875]
  10. Eur J Haematol. 2018 Sep;101(3):326-331 [PMID: 29799642]
  11. J Clin Oncol. 2007 Feb 10;25(5):579-86 [PMID: 17242396]
  12. Sci Rep. 2021 Jul 7;11(1):14071 [PMID: 34234243]
  13. Cancers (Basel). 2022 Feb 17;14(4): [PMID: 35205772]
  14. Therapie. 2019 Jun;74(3):343-346 [PMID: 30177280]
  15. J Clin Oncol. 2012 Jun 20;30(18):2183-9 [PMID: 22454421]
  16. Leuk Lymphoma. 2018 Nov;59(11):2580-2587 [PMID: 29164977]
  17. Cancers (Basel). 2020 Oct 08;12(10): [PMID: 33050054]
  18. Ann Oncol. 2008 Jul;19(7):1312-1319 [PMID: 18356139]
  19. Lancet. 2015 May 9;385(9980):1853-62 [PMID: 25796459]
  20. Br J Haematol. 2004 Mar;124(5):645-52 [PMID: 14871252]
  21. Bone Marrow Transplant. 2003 Oct;32(7):673-9 [PMID: 13130314]
  22. J Clin Oncol. 2012 Jun 20;30(18):2190-6 [PMID: 22614995]
  23. Br J Haematol. 2019 Mar;184(5):797-807 [PMID: 30548583]
  24. Blood. 2014 Nov 6;124(19):3029-31 [PMID: 25377565]
  25. Haematologica. 2019 Apr;104(4):e151-e153 [PMID: 30381303]
  26. Lancet. 2019 Jan 19;393(10168):229-240 [PMID: 30522922]
  27. Lancet Oncol. 2018 Feb;19(2):257-266 [PMID: 29276022]
  28. Lancet. 2002 Jun 15;359(9323):2065-71 [PMID: 12086759]
  29. J Clin Oncol. 2012 Sep 1;30(25):3093-9 [PMID: 22851556]
  30. Ann Oncol. 2022 Mar;33(3):288-298 [PMID: 34921960]
  31. AACE Clin Case Rep. 2020 Jan 22;6(2):e98-e100 [PMID: 32524020]
  32. Blood. 2011 Sep 22;118(12):3419-25 [PMID: 21816830]
  33. J Clin Oncol. 2013 Jun 1;31(16):1970-6 [PMID: 23610113]

Grants

  1. Clinical TAKEDA IISR Study Grant Activation (IISR-2014-100841, X25034)/Takeda Global, Takeda Switzerland

Word Cloud

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