Utilization of Brentuximab Vedotin in Hodgkin Lymphoma

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The agent brentuximab vedotin consists of an anti-CD30 antibody conjugated to the antimitotic agent MMAE. In August 2011, the FDA approved brentuximab vedotin as a treatment for patients with Hodgkin lymphoma who relapsed after treatment with autologous stem cell transplant. Treatment with brentuximab vedotin in this space results in response rate of nearly 80% with some durable remissions, Jonathan W. Friedberg, MD, explains.

Several clinical trials are currently exploring chemotherapy in combination with brentuximab vedotin as a treatment for Hodgkin lymphoma in the salvage setting. Interestingly, Friedberg notes, some researchers are suggesting that brentuximab vedotin may eventually replace the ICE chemotherapy regimen in this setting. For patients who fail chemotherapy, treatment with brentuximab vedotin is a reasonable option prior to transplant in order to achieve a negative PET scan, Friedberg states.

Due to the high single agent response rates with brentuximab vedotin, a phase II study is currently exploring this agent as a replacement for salvage chemotherapy, Craig H. Moskowitz, MD, states. In the trial, patients receive six doses of brentuximab vedotin followed by transplantation for those who experience a complete response. The concept behind this trial, Moskowitz points out, is to cure patients with the least amount of treatment as possible.

However, at this point, it remains unclear whether a negative PET scan following treatment with brentuximab vedotin will be as predictive of outcome as a negative scan following chemotherapy or radiation, Friedberg suggests. As a result, the standard outside of a clinical trial for the front-line salvage treatment of Hodgkin lymphoma should remain chemotherapy followed by brentuximab vedotin as a second-line option, panelists believe.