A phase I/II trial of brentuximab vedotin plus rituximab as frontline therapy for patients with immunosuppression-associated CD30+ and/or EBV + lymphomas. Issue 14 (6th December 2021)

• Record Type: Journal Article
• Authors: Pearse, William B.; Petrich, Adam M.; Gordon, Leo I.; Karmali, Reem; Winter, Jane N.; Ma, Shuo; Kaplan, Jason B.; Behdad, Amir; Klein, Andreas; Jovanovic, Borko; Helenowski, Irene; Smith, Sonali M.; Evens, Andrew M.; Pro, Barbara
• Is Part Of: Leukemia & lymphoma. Volume 62:Issue 14(2021)
• Page Start: 3493
• Page End: 3500
• Publication Date: 2021-12-06
• Subjects: Chemotherapeutic approaches -- lymphoma and Hodgkin disease -- antibody-based immunotherapy; Leukemia -- Periodicals; Lymphomas -- Periodicals; 616.99419
• DOI: 10.1080/10428194.2021.1957867
• Languages: English
• ISSNs: 1042-8194

Abstract

Abstract: Treatment strategies for post-transplant lymphoproliferative disorders (PTLD) consist of response-adapted risk-stratified methods using immunosuppression reduction, immunotherapy, and chemotherapy. We investigated the efficacy of Brentuximab vedotin given concurrently with Rituximab (BV + R) once weekly for four weeks, followed by optional consolidation, and up to one year of maintenance. Among 20 assessable patients, BV + R therapy resulted in an overall response rate of 75% (95% CI 51 to 91, p = 0.044) with 60% achieving a complete response. Median time to best response was 28 days. Two-year progression-free survival and overall survival rates were 75 and 90%, respectively. Most common severe grade 3/4 treatment-related toxicities included neutropenia (40%), hypertension (30%), infection (25%), and peripheral neuropathy (15%). BV + R is a novel and effective therapeutic strategy that achieved rapid and durable remissions in previously untreated PTLD patients; however, this treatment platform requires further modification due to the high rates of treatment-related toxicity. Key points: Brentuximab vedotin + Rituximab showed ORR and CR rates of 75 and 60% in patients with immunosuppression-associated lymphoid malignancies High rates of treatment delay were attributed to treatment-related toxicity; further dosing optimization of this regimen is required