Brentuximab Vedotin Combined With Chemotherapy in Patients With Newly Diagnosed Early-Stage, Unfavorable-Risk Hodgkin Lymphoma

作者：Anita Kumar, Carla Casulo, Ranjana H. Advani, Elizabeth Budde, Paul M. Barr, Connie Lee Batlevi, Philip Caron, Louis S. Constine, Savita Dandapani, Esther Drill, Pamela Drullinsky, Jonathan W. Friedberg, Clare Grieve, Audrey Hamilton, Paul A. Hamlin, Richard T. Hoppe, Steven M. Horwitz, Ashlee Joseph, Niloufer Khan, Leana Laraque, Matthew J. Matasar, Alison J. Moskowitz, Ariela Noy, Maria Lia Palomba, Heiko Schöder, David J. Straus, Shreya Vemuri, Joanna C. Yang, Anas Younes, Andrew D. Zelenetz, Joachim Yahalom, Craig H. Moskowitz · 发表于：Journal of Clinical Oncology · 年份：2021 · DOI：10.1200/jco.21.00108 · 被引用次数：58 · 研究领域：Lymphoma Diagnosis and Treatment、Radiopharmaceutical Chemistry and Applications、Head and Neck Cancer Studies

PURPOSE: To improve curability and limit long-term adverse effects for newly diagnosed early-stage (ES), unfavorable-risk Hodgkin lymphoma. METHODS: In this multicenter study with four sequential cohorts, patients received four cycles of brentuximab vedotin (BV) and doxorubicin, vinblastine, and dacarbazine (AVD). If positron emission tomography (PET)-4-negative, patients received 30-Gy involved-site radiotherapy in cohort 1, 20-Gy involved-site radiotherapy in cohort 2, 30-Gy consolidation-volume radiotherapy in cohort 3, and no radiotherapy in cohort 4. Eligible patients had ES, unfavorable-risk disease. Bulk disease defined by Memorial Sloan Kettering criteria (> 7 cm in maximal transverse or coronal diameter on computed tomography) was not required for cohorts 1 and 2 but was for cohorts 3 and 4. The primary end point was to evaluate safety for cohort 1 and to evaluate complete response rate by PET for cohorts 2-4. RESULTS: Of the 117 patients enrolled, 116 completed chemotherapy, with the median age of 32 years: 50% men, 98% stage II, 86% Memorial Sloan Kettering-defined disease bulk, 27% traditional bulk (> 10 cm), 52% elevated erythrocyte sedimentation rate, 21% extranodal involvement, and 56% > 2 involved lymph node sites. The complete response rate in cohorts 1-4 was 93%, 100%, 93%, and 97%, respectively. With median follow-up of 3.8 years (5.9, 4.5, 2.5, and 2.2 years for cohorts 1-4), the overall 2-year progression-free and overall survival were 94% and 99%, respec...