Brentuximab vedotin with chemotherapy for stage III/IV classical Hodgkin lymphoma: 3-year update of the ECHELON-1 study Journal Article


Authors: Straus, D. J.; Długosz-Danecka, M.; Alekseev, S.; Illés, Á; Picardi, M.; Lech-Maranda, E.; Feldman, T.; Smolewski, P.; Savage, K. J.; Bartlett, N. L.; Walewski, J.; Ramchandren, R.; Zinzani, P. L.; Hutchings, M.; Connors, J. M.; Radford, J.; Munoz, J.; Kim, W. S.; Advani, R.; Ansell, S. M.; Younes, A.; Miao, H.; Liu, R.; Fenton, K.; Forero-Torres, A.; Gallamini, A.
Article Title: Brentuximab vedotin with chemotherapy for stage III/IV classical Hodgkin lymphoma: 3-year update of the ECHELON-1 study
Abstract: The phase 3 ECHELON-1 study demonstrated that brentuximab vedotin (A) with doxorubicin, vinblastine, and dacarbazine (AVD; A+AVD) exhibited superior modified progression-free survival (PFS) vs doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) for frontline treatment of patients with stage III/IV classical Hodgkin lymphoma (cHL). Maturing positron emission tomography (PET)-adapted trial data highlight potential limitations of PET-adapted approaches, including toxicities with dose intensification and higher-than-expected relapse rates in PET scan after cycle 2 (PET2)-negative (PET2-) patients. We present an update of the ECHELON-1 study, including an exploratory analysis of 3-year PFS per investigator. A total of 1334 patients with stage III or IV cHL were randomized 1:1 to receive 6 cycles of A+AVD (n = 664) or ABVD (n = 670). Interim PET2 was required. At median follow-up of 37 months, 3-year PFS rates were 83.1% with A+AVD and 76.0% with ABVD; 3-year PFS rates in PET2- patients aged <60 years were 87.2% vs 81.0%, respectively. A beneficial trend in PET2+ patients aged <60 years on A+AVD was also observed, with a 3-year PFS rate of 69.2% vs 54.7% with ABVD. The benefit of A+AVD in the intent-to-treat population appeared independent of disease stage and prognostic risk factors. Upon continued follow-up, 78% of patients with peripheral neuropathy on A+AVD had either complete resolution or improvement compared with 83% on ABVD. These data highlight that A+AVD provides a durable efficacy benefit compared with ABVD for frontline stage III/IV cHL, consistent across key subgroups regardless of patient status at PET2, without need for treatment intensification or bleomycin exposure. This trial was registered at www.clinicaltrials.gov as #NCT01712490 (EudraCT no. 2011-005450-60). © 2020 by The American Society of Hematology.
Journal Title: Blood
Volume: 135
Issue: 10
ISSN: 0006-4971
Publisher: American Society of Hematology  
Date Published: 2020-03-05
Start Page: 735
End Page: 742
Language: English
DOI: 10.1182/blood.2019003127
PUBMED: 31945149
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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  1. David J Straus
    245 Straus
  2. Anas Younes
    246 Younes