Syed Rizvi, MD, an assistant professor in the Department of Internal Medicine at UT Southwestern Medical Center, discusses the limitations of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in Hodgkin lymphoma.

ABVD has been a standard of care for patients with Hodgkin lymphoma for many years, explains Rizvi.

However, around 30% of patients do not respond to ABVD and require an alternative treatment strategy, says Rizvi.

Early identification of patients who are unlikely to respond to ABVD will help optimize patients’ treatment, says Rizvi.

Moreover, developing refined therapies that elicit extended progression-free survival and overall survival should remain an area of ongoing research in Hodgkin lymphoma, concludes Rizvi.

Videos

Syed Rizvi, MD, discusses the limitations of doxorubicin, bleomycin, vinblastine, and dacarbazine in Hodgkin lymphoma.

Dr. Rizvi on the Limitations of ABVD in Hodgkin Lymphoma

Syed Rizvi, MD, an assistant professor in the Department of Internal Medicine at UT Southwestern Medical Center, discusses research efforts exploring brentuximab vedotin (Adcetris) combinations in patients with Hodgkin lymphoma.

Brentuximab vedotin was initially approved for patients with classical Hodgkin lymphoma following autologous hematopoietic stem cell transplantation (HCST) or after failure of 2 prior regimens, if not candidates for HSCT. The agent is also approved for use as consolidation therapy for patients with Hodgkin lymphoma at high risk of relapse or progression following autologous HSCT. Most recently, in March 2018, the FDA 

approved brentuximab vedotin for use in combination with chemotherapy as a frontline treatment

 for adult patients with stage III or stage IV classical Hodgkin lymphoma.

The agent is also being evaluated in conjunction with checkpoint inhibition, specifically nivolumab (Opdivo), in a phase II trial (NCT01716806), says Rizvi. The results of this trial are greatly anticipated in the field, according to Rizvi. Results will shed light on whether patients with high-risk disease will benefit from this combination treatment, concludes Rizvi.

Syed Rizvi, MD, discusses research efforts exploring brentuximab vedotin combinations in patients with Hodgkin lymphoma.

Dr. Rizvi on Brentuximab Vedotin Combinations in Hodgkin Lymphoma

Syed Rizvi, MD, an assistant professor in the Department of Internal Medicine at UT Southwestern Medical Center, discusses the 4-year follow-up data from the ECHELON-1 trial in Hodgkin lymphoma.

The 4-year follow-up data from the ECHELON-1 trial solidified a benefit in progression-free survival with the combination of brentuximab vedotin (Adcetris) plus doxorubicin, vincristine, and dacarbazine (A+AVD) versus AVD plus bleomycin (ABVD) in PET2-positive patients with Hodgkin lymphoma, says Rizvi.

With these data, the skepticism regarding the effectiveness of the combination is not as prevalent as it once was, notes Rizvi. Nonetheless, the A+AVD regimen is not without adverse events. Common AEs with the regimen include neutropenia and febrile neutropenia. However, less lung toxicity is observed with A+AVD, concludes Rizvi.

Syed Rizvi, MD, discusses the 4-year follow-up data from the ECHELON-1 trial in Hodgkin lymphoma.

Dr. Rizvi on the ECHELON-1 Trial Follow-Up in Hodgkin Lymphoma

Syed Rizvi, MD, an assistant professor in the Department of Internal Medicine at UT Southwestern Medical Center, discusses treatment considerations in stage III/IV Hodgkin lymphoma.

The age of the patient, their smoking history, the condition of their lungs, and a history of lung disease, neuropathy or predisposition therein are all important factors to consider in treatment selection, says Rizvi.

Doxorubicin, vincristine, dacarbazine (AVD), and bleomycin was the standard chemotherapy for frontline treatment in North America, says Rizvi. In March 2018, the FDA approved brentuximab vedotin (Adcetris) plus AVD (A+AVD) for up-front use, allowing for treatment to be tailored according to a patient’s comorbidities. As such, nonsmokers or those who have no history of cytopenia are typically treated with A+AVD, concludes Rizvi.

Syed Rizvi, MD

Articles

Dr. Rizvi on the Limitations of ABVD in Hodgkin Lymphoma

Dr. Rizvi on Brentuximab Vedotin Combinations in Hodgkin Lymphoma

Dr. Rizvi on the ECHELON-1 Trial Follow-Up in Hodgkin Lymphoma

Dr. Rizvi on Treatment Considerations in Stage III/IV Hodgkin Lymphoma