Dr. Kuruvilla on Findings From the KEYNOTE-204 Trial in Hodgkin Lymphoma

John Kuruvilla, MD, FRCPC, clinician investigator, Cancer Clinical Research Unit, Princess Margaret Cancer Centre, discusses findings from the phase 3 KEYNOTE-204 trial in Hodgkin lymphoma.

In the phase 3 trial, patients who had relapsed following autologous stem cell transplant (ASCT) or were ineligible for ASCT were randomized to pembrolizumab (Keytruda) or brentuximab vedotin (Adcetris). Progression-free survival (PFS) served as the primary end point of the trial.

At a median follow-up of 24.7 months, the median PFS was 13.2 months with pembrolizumab versus 8.3 months with brentuximab vedotin, translating to a 35% reduction in the risk of progression or death (HR, 0.65; 95% CI, 0.48-0.88; P =.00271). The benefit was observed in all subgroups, including patients with no ASCT (HR, 0.61), primary refractory disease (HR, 0.52), prior brentuximab vedotin exposure (HR, 0.34), and no prior exposure to brentuximab vedotin (HR, 0.67). Per investigator assessment, PFS was longer with pembrolizumab versus brentuximab vedotin, at 19.2 months versus 8.2 months, respectively (HR, 0.49; 95% CI, 0.36-0.67).

The adverse effect (AE) profiles of both drugs were consistent with past experiences, says Kuruvilla. Grade 3 to 5 treatment-related AEs occurred in 19.6% of patients in the pembrolizumab arm versus 25.0% of patients in the brentuximab arm.