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Five-Year Outcomes for Frontline Brentuximab Vedotin with CHP for CD30 Expressing Peripheral T-Cell Lymphomas

Michelle A. Fanale, Steven M. Horwitz, Andres Forero-Torres, Nancy L. Bartlett, Ranjana H. Advani, Barbara Pro, Robert W. Chen, Andrew Davies, Tim Illidge, Mayur Uttarwar, Shih-Yuan Lee, Hong Ren, Dana A. Kennedy and Andrei R. Shustov

Key points

  • 100% response rate (92% CR) in 26 patients treated with frontline BV+CHP. After ~5 years, 50% remained in CR (PFS 37.8+ to 66.0+ months).

  • 18 of 19 patients (95%) with treatment-emergent PN reported resolution or improvement in symptoms; 9 had resolution of all PN events.

Abstract

This phase 1 study evaluated frontline brentuximab vedotin in combination with cyclophosphamide, doxorubicin, and prednisone (BV+CHP; 6 cycles, then up to 10 cycles of brentuximab vedotin monotherapy) in 26 patients with CD30-positive peripheral T-cell lymphoma, including 19 with systemic anaplastic large cell lymphoma. All patients (100%) achieved an objective response, with a complete remission rate of 92%, and none received a consolidative stem cell transplant. After a median observation period of 59.6 months (range, 4.6 to 66.0 months) from first dose, neither the median progression-free survival (PFS) nor the median overall survival (OS) was reached. No progression or death was observed beyond 35 months. The estimated 5 year PFS and OS rates were 52% and 80%, respectively. Eighteen of 19 patients (95%) with treatment-emergent peripheral neuropathy reported resolution or improvement of symptoms. Thirteen patients (50%) remained in remission at end of study, with PFS ranging from 37.8+ to 66.0+ months. Eight of these 13 patients received the maximum 16 cycles of study treatment. These final results demonstrate durable remissions in 50% of patients treated with frontline BV+CHP, suggesting a potentially curative treatment option for some patients. This trial was registered at www.clinicaltrials.gov as # NCT01309789.

  • Submitted December 18, 2017.
  • Accepted February 25, 2018.