Jurnal Internasional Brentuximab vedotin, doxorubicin, vinblastine, dan dacarbazine untuk limfoma Hodgkin klasik tahap terbatas yang nonbulky
Brentuximab vedotin plus AVD without consolidated radiation is an effective therapy for nonbulky restricted HL stages.
Peripheral neuropathy and neutropenic fever appear to be increased with brentuximab-AVD compared with consolidated radiation. Expected toxicity from ABVD only.  Abstract Abstract
“data-icon-position =” “data-hide-link-title =” 0 “>
Doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) with or without radiation is standard therapy for limited-stage Hodgkin lymphoma (HL) but has risks. Bleomycin-induced lung injury and radiation toxicity. Vedotin Brentuximab is very active in recurring HL and was recently approved with doxorubicin, vinblastine, and dacarbazine (AVD) for stage III / IV HL which were previously untreated. We evaluated brentuximab-AVD for nonbulky HL stage I / II in a phase 2 multicenter study. Patients received an initial cycle of vedotine brentuximab monotherapy on days 1 and 15, followed by exploratory positron emission tomography / computed tomographic scanning. Patients then received brentuximab-AVD for 4 to 6 cycles based on a temporary positron emission tomography / tomographic scan after cycle 2. Thirty-four patients were enrolled with an average age of 36 years (range, 20-75 years). The initial risk is favorable at 62% and unprofitable at 38%. The best complete response rate is 100%. At a median follow-up of 38 months, development-free survival and overall survival were 94% and 97%, respectively. The most common side effects were peripheral sensory neuropathy (79%), neutropenia (76%), fatigue (74%), and nausea (71%). The most common grade 3/4 toxicity is neutropenia (62%), febrile neutropenia (35%), and peripheral sensory neuropathy (24%). One elderly patient died of neutropenic sepsis in the first brentuximab-AVD cycle. Reduction of the Brentuximab dose is needed in 38% of patients, mostly for peripheral neuropathy. In conclusion, brentuximab-AVD without bleomycin or radiation produces a high complete response rate, with most patients only needing 4 total cycles of therapy. Because the toxicity is higher than expected from AVD alone, this method may not be suitable for early stage patients with a very good prognosis. This court was registered at www.clinicaltrials.gov as # NCT01534078 .
- Submitted 24 April 2019.
- Received June 1, 2019.
- © 2019 by The American Society of Hematology