Adcetris Most Effective in Chemo-sensitive Patients, or as Consolidation Therapy After Stem Cell Transplant, Study Finds

Treatment with Adcetris (brentuximab vedotin) is most effective in people with relapsed or refractory Hodgkin’s lymphoma who have chemotherapy-sensitive disease, and when used as consolidation therapy immediately after stem cell transplant, a study found.

The findings were presented at the 2019 European Society for Medical Oncology (ESMO) Congress, held Sep. 27 to Oct. 1 in Barcelona, Spain, in a poster titled “Prognostic Factors Influencing Outcome After Therapy With Brentuximab Vedotin in Patients with Relapsed or Refractory Hodgkin’s Lymphoma.”

Adcetris is an antibody-drug conjugate that works by binding to CD30, a protein found at the surface of malignant cancer cells. Once bound, it releases a toxic compound called monomethyl auristatin E that kills cancer cells.

It is approved for multiple lymphoma types, including advanced classical Hodgkin’s lymphoma (cHL). The therapy has been used to treat people newly diagnosed with cHL, patients at risk of their disease returning or worsening after a stem cell transplant, and those with cHL who failed a stem cell transplant.

Clinical studies have shown that Adcetris improves the prognosis and survival of Hodgkin’s lymphoma patients with refractory disease. But prognostic factors influencing responses to treatment and outcomes have not been explored.

To address that, a team led by Veselina Goranova-Marinova, MD, PhD, from the Medical University of Plovdiv, reviewed the clinical records of 64 people with Hodgkin’s lymphoma who were treated with Adcetris in six hematology clinics in Bulgaria.

Patients had received a median of four prior therapies (range 2 to 12), and 30 (46.9%) had received at least three prior lines of therapy. Autologous stem cell transplant — using the patient’s own stem cells — was performed in 45 individuals (70.3%).

The analysis showed that, despite being heavily treated, more than half of the patients (60.9%) responded to Adcetris. There were 39.1% complete responses. An additional 10.9% achieved stable disease after treatment.

At the time of the analysis, more than half of the patients were still alive, and the median time to disease worsening or death was 14 months.

Researchers noted that partial or complete responses were higher among patients who had responded to their chemotherapy regimen — deemed chemo-sensitive — before the stem cell transplant, those who had received a stem cell transplant, and patients who started Adcetris as a consolidation therapy within three months of their transplant.

However, the only factor predicting longer event-free survival — the time patients live without disease progression or complications — was the response to Adcetris. While individuals achieving stable disease or experiencing disease progression lived without an event for a median of seven months, more than half of those with partial or complete response to Adcetris remained event-free.

Adcetris “improves the therapeutic response and prolongs progression-free survival in the patients with Hodgkin’s lymphoma who previously had really bad prognosis,” the researchers said.

It was “most effective in patients with chemosensitive disease, and when used as consolidation therapy early, by [the third] month after [autologous stem cell transplant],” they concluded.