Ranjana Advani, MD, Professor of Medicine and Oncology, Stanford University, discusses the movement of brentuximab vedotin combined with CHOP to the front-line.

Brentuximab is currently approved for Hodgkin lymphoma and anaplastic large cell lymphoma. Brentuximab vedotin will not be beneficial for all subtypes of lymphoma, Advani says, but will be for CD30-positive lymphomas. This is an exciting potential development because about 30% of other T-cell lymphomas also express CD30.

Advani looking forward to the large randomized trial evaluating CHOP chemotherapy plus placebo compared to CHOP plus brentuximab.

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Dr. Advani Discusses Front-Line Brentuximab

Ranjana Advani, MD, Professor of Medicine and Oncology, Stanford University, discusses CD30 as a target and the use of brentuximab vedotin in anaplastic large-cell lymphoma (ALCL).

The expression of CD30 in ALCL makes it attractive to study for targeted therapies, Advani says. The antibody drug conjugate brentuximab vedotin targets CD30 and is approved by the FDA for relapsed or refractory ALCL. The agent has demonstrated an overall response rate in excess of 80%, including some extremely durable responses.

Ranjana Advani, MD, Professor of Medicine and Oncology, Stanford University, discusses targeting CD30 as a target and the use of brentuximab vedotin in anaplastic large-cell lymphoma.

Dr. Advani Discusses CD30 as a Target in ALCL

Ranjana Advani, MD, Professor of Medicine and Oncology, Stanford University, details the difference between EPOCH-R and R-CHOP chemotherapy.

Dose-adjusted EPOCH-R is an infusion chemotherapy that uses similar drugs to R-CHOP. In preliminary data, patients overcame poor prognostic significance of Bcl-2 overexpression.

While the results of upcoming trials will give more information, Advani says, dose-adjusted EPOCH-R has become the standard of care in patients with primary mediastinal B-cell lymphoma. In this disease, treatment with R-CHOP usually requires radiotherapy as well but with EPOCH-R alone, cure rates are well above 90% and no radiotherapy is needed.

Dr. Advani on EPOCH-R in B Cell Lymphoma

Ranjana Advani, MD, Professor of Medicine and Oncology, Stanford University, discusses outcomes for patients with anaplastic large-cell lymphoma (ALCL).

Though the prognosis for patients with ALK-positive ALCL is better than those with ALK-negative ALCL, the International Prognostic Index (IPI) remains an important factor. Patients with high IPI will not do as well as patients with low IPI, regardless of whether they are ALK-positive or ALK-negative. In fact, Advani says, all ALCL patients, treated with all regimens (CHOP chemotherapy and etoposide-containing chemotherapy) do better than other T-cell lymphoma patients. Patients treated with contemporary chemotherapy regimens containing etoposide such as CHOE, EPOCH, and Japanese regimen all demonstrate the highest outcomes, some as high as 70%, Advani says. Even in transplant studies, ALCL presents better outcomes. This begs the question as to whether the disease type or the treatment regimens trigger such robust results.

Ranjana Advani, MD, Professor of Medicine and Oncology, Stanford University, discusses outcomes for patients with anaplastic large-cell lymphoma.

Ranjana Advani, MD

Articles

Dr. Advani Discusses Front-Line Brentuximab

Dr. Advani Discusses CD30 as a Target in ALCL

Dr. Advani on EPOCH-R in B Cell Lymphoma

Dr. Advani Discusses Outcomes in ALCL