Response to brentuximab vedotin versus physician's choice by CD30 expression and large cell transformation status in patients with mycosis fungoides: An ALCANZA sub-analysis Journal Article
| Authors: | Kim, Y. H.; Prince, H. M.; Whittaker, S.; Horwitz, S. M.; Duvic, M.; Bechter, O.; Sanches, J. A.; Stadler, R.; Scarisbrick, J.; Quaglino, P.; Zinzani, P. L.; Wolter, P.; Eradat, H.; Pinter-Brown, L. C.; Ortiz-Romero, P. L.; Akilov, O. E.; Trotman, J.; Taylor, K.; Weichenthal, M.; Walewski, J.; Fisher, D.; McNeeley, M.; Gru, A. A.; Brown, L.; Palanca-Wessels, M. C.; Lisano, J.; Onsum, M.; Bunn, V.; Little, M.; Trepicchio, W. L.; Dummer, R. |
| Article Title: | Response to brentuximab vedotin versus physician's choice by CD30 expression and large cell transformation status in patients with mycosis fungoides: An ALCANZA sub-analysis |
| Abstract: | Introduction: Mycosis fungoides (MF), the most common type of cutaneous T-cell lymphoma, can lead to disfiguring lesions, debilitating pruritus and frequent skin infections. This study assessed response to brentuximab vedotin in patients with MF in the phase III ALCANZA study. Methods: Baseline CD30 levels and large-cell transformation (LCT) status were centrally reviewed in patients with previously-treated CD30-positive MF using ≥2 skin biopsies obtained at screening; eligible patients required ≥1 biopsy with ≥10% CD30 expression. Patients were categorised as CD30min < 10% (≥1 biopsy with <10% CD30 expression), or CD30min ≥ 10% (all biopsies with ≥10% CD30 expression) and baseline LCT present or absent. Efficacy analyses were the proportion of patients with objective response lasting ≥4 months (ORR4) and progression-free survival (PFS). Results: Clinical activity with brentuximab vedotin was observed across all CD30 expression levels in patients with ≥1 biopsy showing ≥10% CD30 expression. Superior ORR4 was observed with brentuximab vedotin versus physician's choice in patients: with CD30min < 10% (40.9% versus 9.5%), with CD30min ≥ 10% (57.1% versus 10.3%), with LCT (64.7% versus 17.6%) and without LCT (38.7% versus 6.5%). Brentuximab vedotin improved median PFS versus physician's choice in patients: with CD30min < 10% (16.7 versus 2.3 months), with CD30min ≥ 10% (15.5 versus 3.9 months), with LCT (15.5 versus 2.8 months) and without LCT (16.1 versus 3.5 months). Safety profiles were generally comparable across subgroups. Conclusion: These exploratory analyses demonstrated that brentuximab vedotin improved rates of ORR4 and PFS versus physician's choice in patients with CD30-positive MF and ≥1 biopsy showing ≥10% CD30 expression, regardless of LCT status. Clinical trial registration: Clinicaltrials.gov, NCT01578499. © 2021 The Authors |
| Keywords: | adult; clinical article; controlled study; human tissue; treatment response; drug efficacy; drug safety; systemic therapy; cancer radiotherapy; methotrexate; cancer staging; antigen expression; progression free survival; skin biopsy; randomized controlled trial; peripheral neuropathy; fever; cutaneous t-cell lymphoma; multicenter study; cancer cell; cell membrane; physician; safety; phase 3 clinical trial; lymphocytic infiltration; malignant transformation; mycosis fungoides; hypertriglyceridemia; efficacy; progression-free survival; post hoc analysis; objective response; adverse event; large cell transformation; bexarotene; anaplastic large cell lymphoma; overall response rate; antibody-drug conjugate; brentuximab vedotin; cd30; human; male; female; priority journal; article; tumor necrosis factor receptor superfamily member 8; large-cell transformation; antigen blood level; golgi stain |
| Journal Title: | European Journal of Cancer |
| Volume: | 148 |
| ISSN: | 0959-8049 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2021-05-01 |
| Start Page: | 411 |
| End Page: | 421 |
| Language: | English |
| DOI: | 10.1016/j.ejca.2021.01.054 |
| PUBMED: | 33794441 |
| PROVIDER: | scopus |
| PMCID: | PMC9347228 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 3 May 2021 -- Source: Scopus |
