624. Hodgkin Lymphoma and T/NK Cell Lymphoma—Clinical Studies: Hodgkin Lymphoma—Chemotherapy and PET Studies


Sequential Brentuximab Vedotin (Bv) before and after Adriamycin, Vinblastine, and Dacarbazine (Bv-AVD) for Older Patients with Untreated Classical Hodgkin Lymphoma (cHL): Final Results from a Multicenter Phase II Study

Andrew M. Evens, et al.

The authors of the study conclude:

Bv-AVD incorporating Bv sequentially before and after chemotherapy represents among the best-reported outcomes to date for untreated older cHL pts. Efforts to maintain these robust remission and survival rates, but with less toxicity, should be a focus of ongoing investigation. This should include response-adapted design and integration of other novel agents (eg, checkpoint inhibitors), especially for pts with advanced ages and/or multiple co-morbidities.



A Pilot Study of Brentuximab Vedotin and AVD Chemotherapy Followed By 20 Gy Involved-Site Radiotherapy in Early Stage, Unfavorable Risk Hodgkin Lymphoma

Anita Kumar, et al.

The authors of the study conclude:

BV+AVD x 4 cycles followed by 20Gy ISRT is an effective treatment program for early stage, unfavorable risk HL, including a high proportion of patients with bulky disease. As with 4 cycles of escalated BEACOPP tested in the GHSG HD11 clinical trial, 20Gy ISRT appears to be adequate consolidation after BV+AVD x 4 cycles. A third cohort of this pilot study is currently accruing in which patients receive BV+AVD x 4 cycles followed by 30Gy consolidation volume radiation. There is also a planned 4th cohort with no radiotherapy for PET-negative patients after 4 cycles of BV+AVD. After completion of the 4 cohorts, we plan to recommend the therapeutic strategy with the greatest efficacy and least toxicity to be further studied in a larger, randomized prospective study for early stage, bulky HL. Updated response data for all patients will be presented at the meeting.



Advanced-Stage Hodgkin Lymphoma in the East of England Cancer Network: A 10-Year Comparative Analysis of Outcomes for Patients Treated with ABVD or Escalated BEACOPP in the Non-Trial Setting Compared with Age-Matched Patients Treated in the Multinational RATHL Trial

James Russell, et al.

The authors of the study conclude:

Our data support recently published European data showing that first-line HL patients treated in the non-trial setting achieve similar outcomes to those treated in contemporary clinical trials. Our data also reflect prospective trial results which show a first-remission PFS, but not OS, advantage for advanced-stage HL patients treated with escBEACOPP compared with ABVD, but suggest that higher-risk patients might benefit disproportionately from more intensive first-line therapy with escBEACOPP. However, improved access to more effective salvage treatments for relapsed/refractory patients may have diminished any OS benefit from the use of first-line escBEACOPP in higher-risk patients.



PET-Based Response after 2 Cycles of Brentuximab Vedotin in Combination with AVD for First-Line Treatment of Unfavorable Early-Stage Hodgkin Lymphoma: First Analysis of the Primary Endpoint of Breach, a Randomized Phase II Trial of Lysa-FIL-EORTC Intergroup

Luc-Matthieu Fornecker, et al.

The authors of the study conclude:

This randomized, multicentric, open-label phase II trial aimed to evaluate the efficacy of BV in combination with AVD chemotherapy based on PET response after 2 cycles for previously untreated, unfavorable early-stage HL. The primary objective was met with an improvement of the negative-PET rate with BV-AVD regimen. This first analysis highlighted an increased toxicity with BV-AVD regimen compared to ABVD, with a higher rate of grade 3-4 AEs and SAEs during the first 2 cycles of treatment.



Early Interim PET in Patients with Advanced-Stage Hodgkin’s Lymphoma Treated within the Phase 3 GHSG HD18 Study

Peter Borchmann, et al.

The authors of the study conclude:

The Deauville score after 2xeBEACOPP is associated with many clinical risk factors at baseline. For patients treated with 6xeBEACOPP followed by irradiation of PET-positive residuals, iDS 3 does not indicate an increased risk of treatment failure and is associated with long-term outcomes identical to those after clearly negative PET-2 (iDS 1-2). DS 4 at PET-2 adds some prognostic information to the baseline risk factors, but 3-year outcomes do not suggest a need for treatment intensification beyond standard therapy. Based on these results, the GHSG has decided to adopt the more widely used cutoff of iDS 4 for PET positivity. Thereby, about 75% of patients could take advantage of the abbreviated treatment with only 4 cycles of eBEACOPP in a PET-2-guided approach as defined in the HD18 study.



Phase II Study of Brentuximab Vedotin Plus Ibrutinib for Patients with Relapsed/Refractory Hodgkin Lymphoma

Robert W. Chen, et al.

The authors of the study conclude:

The combination of BV + ibrutinib is well tolerated. Although the ORR of 69% maybe similar to BV alone, the CR of 46% and disease control rate of 100% appears promising. Especially encouraging is the 1 PR and 1 CR seen in patients previously exposed to BV. The study has met the interim analysis endpoint and warrants further accrual to investigate the final CR rate.