Brentuximab vedotin and chemotherapy in relapsed/refractory Hodgkin lymphoma: a propensity score-matched analysis.
Julia Driessen, Fer de Wit, Alex F Herrera, Pier Luigi Zinzani, Ann S LaCasce, Peter D Cole, Craig H Moskowitz, Ramón García-Sanz, Michael Fuchs, Horst Müller, Peter Borchmann, Armando Santoro, Heiko Schöder, Josée M Zijlstra, Barbara A Hutten, Alison J Moskowitz, Marie José Kersten
Author Information
Julia Driessen: Department of Hematology, Amsterdam UMC, University of Amsterdam, and LYMMCARE Amsterdam, Amsterdam, The Netherlands. ORCID
Fer de Wit: Department of Hematology, Amsterdam UMC, University of Amsterdam, and LYMMCARE Amsterdam, Amsterdam, The Netherlands. ORCID
Alex F Herrera: Department of Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA. ORCID
Pier Luigi Zinzani: IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli," Bologna, Italy. ORCID
Ann S LaCasce: Division of Hematologic Malignancies, Dana-Farber Cancer Institute, Boston, MA. ORCID
Peter D Cole: Rutgers Cancer Institute of New Jersey, Rutgers University, New Brunswick, NJ. ORCID
Craig H Moskowitz: Sylvester Comprehensive Cancer Center, University of Miami Health System, Miami, FL.
Ramón García-Sanz: Department of Hematology, Hospital Universitario de Salamanca, CIBERONC, CIC-IBMCC, Universidad Salamanca, Salamanca, Spain. ORCID
Michael Fuchs: German Hodgkin Study Group and Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, University of Cologne, Cologne, Germany.
Horst Müller: German Hodgkin Study Group and Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, University of Cologne, Cologne, Germany.
Peter Borchmann: German Hodgkin Study Group and Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Düsseldorf, University of Cologne, Cologne, Germany.
Armando Santoro: Department of Biomedical Sciences, Humanitas University, IRCCS Humanitas Research Hospital, Humanitas Cancer Center, Milan, Italy. ORCID
Heiko Schöder: Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY. ORCID
Josée M Zijlstra: Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands. ORCID
Barbara A Hutten: Department of Epidemiology and Data Science, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands. ORCID
Alison J Moskowitz: Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.
Marie José Kersten: Department of Hematology, Amsterdam UMC, University of Amsterdam, and LYMMCARE Amsterdam, Amsterdam, The Netherlands.
ABSTRACT: Several single-arm studies have explored the inclusion of brentuximab vedotin (BV) in salvage chemotherapy followed by autologous stem cell transplantation (ASCT) for relapsed/refractory (R/R) classical Hodgkin lymphoma (cHL). However, no head-to-head comparisons with standard salvage chemotherapy have been performed. This study presents a propensity score-matched analysis encompassing individual patient data from 10 clinical trials to evaluate the impact of BV in transplant-eligible patients with R/R cHL. We included 768 patients, of whom 386 were treated with BV with or without chemotherapy (BV cohort), whereas 382 received chemotherapy alone (chemotherapy cohort). Propensity score matching resulted in balanced cohorts of 240 patients each. No significant differences were observed in pre-ASCT complete metabolic response (CMR) rates (P = .69) or progression free survival (PFS; P = .14) between the BV and chemotherapy cohorts. However, in the BV vs chemotherapy cohort, patients with relapsed disease had a significantly better 3-year PFS of 80% vs 70%, respectively (P = .02), whereas there was no difference for patients with primary refractory disease (56% vs 62%, respectively; P = .67). Patients with stage IV disease achieved a significantly better 3-year PFS in the BV cohort (P = .015). Post-ASCT PFS was comparable for patients achieving a CMR after BV monotherapy and those receiving BV followed by sequential chemotherapy (P = .24). Although 3-year overall survival was higher in the BV cohort (92% vs 80%, respectively; P < .001), this is likely attributed to the use of other novel therapies in later lines for patients experiencing progression, given that studies in the BV cohort were conducted more recently. In conclusion, BV with or without salvage chemotherapy appears to enhance PFS in patients with relapsed disease but not in those with primary refractory cHL.
