KEY TAKEAWAYS
- The phase 3 trial aimed to compare the long-term overall survival of patients with stage III or IV Hodgkin’s lymphoma who received either A+AVD or ABVD.
- 664 patients received A+AVD, while 670 patients received ABVD in a ratio of 1:1 for up to six cycles.
- The outcome showed that A+AVD resulted in significantly higher progression-free survival rates and better long-term overall survival estimates at 6 years.
- Second malignancies were reported in fewer patients in the A+AVD group, and further therapies such as transplantation were less common in this group.
- A+AVD as first-line therapy for patients with stage III or IV Hodgkin’s lymphoma resulted in better long-term overall survival estimates than ABVD.
Atrial comparing first-line therapy with the CD30-directed antibody-drug conjugate brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A+AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) showed long-term progression-free survival benefits with a 5-year follow-up. Data from a median of 6 years of follow-up have shown promise in overall survival, as shown by an interim analysis. Patients were assigned to receive either A+AVD or ABVD in a ratio of 1:1 for up to six cycles. Modified progression-free survival was used as the primary endpoint, and its results have been previously reported. Overall survival was the key secondary endpoint. Threat levels were also evaluated.
A total of 674 patients were given A+AVD, while 670 were given ABVD Of the patients followed for a median of 73.0 months, 39 in the A+AVD group and 64 in the ABVD group had passed away (hazard ratio, 0.59; 95% CI, 0.40 to 0.88; P = 0.009). Overall survival estimates at 6 years were 93.9% (95% CI, 91.6 to 95.5) for those who received A+AVD against 89.4% (95% CI, 86.6 to 91.7) for those who received ABVD. Compared to ABVD, A+AVD resulted in a significantly higher progression-free survival rate (95% confidence interval [CI]: 0.68 to 0.86). Second malignancies were reported in 23 patients against 32 patients who had ABVD, and other therapies, such as transplantation, were less common in the A+AVD group. Since febrile neutropenia was more common after receiving A+AVD, a granulocyte colony-stimulating factor was suggested as primary prevention. While more patients with A+AVD than ABVD experienced peripheral neuropathy, by the time of the last follow-up, most patients in both groups had shown a resolution or improvement in their symptoms. Patients with stage III or IV Hodgkin’s lymphoma treated with A+AVD had better survival rates than those treated with ABVD.
Source:https://pubmed.ncbi.nlm.nih.gov/35830649/
Clinical Trial:https://clinicaltrials.gov/ct2/show/NCT01712490
Ansell SM, Radford J, Connors JM, Długosz-Danecka M, Kim WS, Gallamini A, Ramchandren R, Friedberg JW, Advani R, Hutchings M, Evens AM, Smolewski P, Savage KJ, Bartlett NL, Eom HS, Abramson JS, Dong C, Campana F, Fenton K, Puhlmann M, Straus DJ; ECHELON-1 Study Group. Overall Survival with Brentuximab Vedotin in Stage III or IV Hodgkin’s Lymphoma. N Engl J Med. 2022 Jul 28;387(4):310-320. doi: 10.1056/NEJMoa2206125. Epub 2022 Jul 13. PMID: 35830649.
