BMJ 2015;350:h1533 doi: 10.1136/bmj.h1533 (Published 20 March 2015)

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Research News

RESEARCH NEWS New treatment approach shows promise for relapsed Hodgkin’s lymphoma Jacqui Wise London

Adults with hard to treat Hodgkin’s lymphoma who were given brentuximab vedotin immediately after stem cell transplantation survived without the disease progressing for twice as long as those given placebo, a phase III randomised controlled trial published in the Lancet shows.1 Brentuximab vedotin, the first new drug for Hodgkin’s lymphoma in over 30 years, is an antibody attached to a powerful chemotherapy drug that targets the CD30 protein on Hodgkin’s lymphoma cells. It has recently been approved for relapsed or refractory Hodgkin’s lymphoma in 50 countries.

Advances in chemotherapy and radiotherapy treatment have substantially improved the prognosis of patients with Hodgkin’s lymphoma, with long term tumour control of 70-80% and overall survival of 80-90%. Patients who relapse or do not respond to the initial treatment are usually given high dose chemotherapy followed by autologous stem cell transplantation. In these patients, however, the prognosis is poor, and fewer than half survive in the long term.

USA, said, “No medication available today has had such dramatic results in patients with hard to treat Hodgkin lymphoma.

“The bottom line is that brentuximab vedotin is a very effective drug in poor risk Hodgkin lymphoma and it spares patients from the harmful effects of further traditional chemotherapy by breaking down inside the cell, resulting in less toxicity.” In an accompanying commentary Andreas Engert, of the University Hospital of Cologne, Germany, said, “AETHERA is a positive study establishing a promising new treatment approach for patients with Hodgkin’s lymphoma at high risk for relapse.” But he said that more work was needed to establish which patients are at highest risk of relapse and who should receive consolidation treatment with brentuximab vedotin.

The AETHERA study randomised 329 patients with relapsed or refractory Hodgkin’s lymphoma who had undergone stem cell transplantation to receiving 16 cycles of brentuximab vedotin infusions once every three weeks or placebo.

At two years’ follow-up the cancer had not progressed at all in 65% of patients (95% confidence interval 57 to 72) who were receiving the active treatment, compared with 45% (37 to 52) in the placebo group. Median progression-free survival was 42.9 months in the treatment group and 24.1 months in the placebo group.

The study, funded by Seattle Genetics and Takeda Pharmaceuticals International, found that brentuximab vedotin was generally well tolerated. The most common side effects were peripheral neuropathy (67% v 13%) and neutropenia (35% v 12%). Craig Moskowitz, the study leader and professor of medicine at Memorial Sloan Kettering Cancer Center in New York City,

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1

Moskowitz CH, Nademanee A, Masszi T, et al; AETHERA Study Group. Brentuximab vedotin as consolidation therapy after autologous stem cell transplantation in patients with Hodgkin’s lymphoma at risk of relapse or progression (AETHERA): a randomised, double blind, placebo controlled, phase 3 trial. Lancet 2015; published online 19 March, doi:10.1016/S0140-6736(15)60165-9.

Cite this as: BMJ 2015;350:h1533 © BMJ Publishing Group Ltd 2015

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New treatment approach shows promise for relapsed Hodgkin's lymphoma.

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