Critical Hodgkin's Lymphoma cancer study published in the New England Journal of Medicine
John Theurer Cancer Center oncologist, Tatyana Feldman, M.D. is co-author
HACKENSACK, N.J., Jan. 18, 2018 /PRNewswire-USNewswire/ -- John Theurer Cancer Center at Hackensack Meridian Health Hackensack University Medical Center participated in a pivotal clinical trial for Hodgkin's Lymphoma.
Tatyana Feldman, M.D., director of John Theurer Cancer Center's T-cell Program at Hackensack University Medical Center, is a co-author of the study, presented at the 59th Annual Meeting of the American Society of Hematology at plenary session and published in the New England Journal of Medicine.
"The addition of brentuximab vedotin to AVD combination chemotherapy -- supported with G-CSF to alleviate myelotoxicity -- merits consideration as first-line treatment for advanced Hodgkin's lymphoma," said Dr. Feldman.
Phase II trial data shows that a treatment regimen incorporating the anti-CD30 antibody–drug conjugate brentuximab vedotin is more effective than standard therapy with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) when used as a frontline therapy in patients with advanced Hodgkin lymphoma. Brentuximab vedotin, doxorubicin, vinblastine, and dacarbazine (A+AVD) reduced the risk for disease progression, death, or non-complete response and use of subsequent anticancer therapy by a significant 23 percent compared with ABVD.
The ECHELON-1 researchers who conducted the randomized, multicenter, open-label study describe this result as "clinically meaningful."
At a median 24.9 months of follow-up, the independently adjudicated 2-year modified progression-free survival rates were 82.1 percent among the 664 patients with previously untreated stage III or IV classic Hodgkin lymphoma who received A+AVD, and 77.2 percent in the 670 who received ABVD, a difference that was statistically significant.
Overall survival at two years was also better with A+AVD than with ABVD, although not significantly so, at 96.6 percent versus 94.9 percent.
Further analyses showed that the benefits of A+AVD extended across the majority of prespecified subgroups, with men, patients from North America, those with involvement of more than one extranodal site, an International Prognostic Score indicating a high-risk of treatment failure (scores of four to seven), or stage IV disease, and patients younger than 60 years of age benefitting most.
While both groups completed a similar number of treatments cycles (5.5–5.7), the rates of neutropenia (58 vs 45 percent), febrile neutropenia (19 vs 8 percent), and peripheral neuropathy (67 vs 43 percent) were higher in the A+AVD group than in the ABVD group.
However, they point out that, among the patients who received A+AVD, the rate of febrile neutropenia was lower among the 83 patients who received primary prophylaxis with granulocyte colony-stimulating factor (G-CSF) than among those who did not (11 vs 21 percent), and peripheral neuropathy resolved or improved in 67 percent of cases.
Pulmonary toxicity of grade 3 or higher was reported in less than 1% of patients in the A+AVD and in 3% of those in the ABVD group.
The researchers note that seven of nine deaths that occurred during treatment in the A+AVD group were associated with neutropenia (six had not received G-CSF and one had pre-existing neutropenia), while 11 of 13 deaths in the ABVD group were associated with pulmonary-related toxicity.
Given that older patients are at high-risk from bleomycin-associated pulmonary toxicity, results of the ECHELON-1 trial are particularly significant considering the opportunity A+AVD provides to administer a treatment to older patients that is at least equivalent in its effectiveness to ABVD, and to do so safely.
The study, "Brentuximab Vedotin with Chemotherapy for Stage III or IV Hodgkin's Lymphoma," was led by Joseph M. Connors, M.D., medical oncologist from the BC Cancer Agency, University of British Columbia, Canada.
ABOUT JOHN THEURER CANCER CENTER AT HACKENSACK UNIVERSITY MEDICAL CENTER
John Theurer Cancer Center at Hackensack University Medical Center is New Jersey's largest and most comprehensive center dedicated to the diagnosis, treatment, management, research, screenings, and preventive care as well as survivorship of patients with all types of cancers. The 14 specialized divisions covering the complete spectrum of cancer care have developed a close-knit team of medical, research, nursing, and support staff with specialized expertise that translates into more advanced, focused care for all patients. Each year, more people in the New Jersey/New York metropolitan area turn to John Theurer Cancer Center for cancer care than to any other facility in New Jersey. Housed within Hackensack University Medical Center, a 775-bed not-for-profit teaching, tertiary care, and research hospital, John Theurer Cancer Center provides state-of-the-art technological advances, compassionate care, research innovations, medical expertise, and a full range of aftercare services that distinguish John Theurer Cancer Center from other facilities. For additional information, please visit www.jtcancercenter.org.
SOURCE John Theurer Cancer Center
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