Page 78 - Haematologica May 2022

Ferrata Storti Foundation
Haematologica 2022 Volume 107(5):1086-1094
Older patients (aged ≥60 years) with previously untreated advanced-stage classical Hodgkin lymphoma: a detailed analysis from the phase III ECHELON-1 study
Andrew M. Evens,1 Joseph M. Connors,2 Anas Younes,3° Stephen M. Ansell,4 Won Seog Kim,5 John Radford,6 Tatyana Feldman,7 Joseph Tuscano,8
Kerry J. Savage,2 Yasuhiro Oki,9 Andrew Grigg,10 Christopher Pocock,11 Monika Dlugosz-Danecka,12 Keenan Fenton,13 Andres Forero-Torres,13 Rachael Liu,14 Hina Jolin,14 Ashish Gautam14 and Andrea Gallamini15
1Division of Blood Disorders, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA; 2BC Cancer Center for Lymphoid Cancer and Department of Medical Oncology, Vancouver, BC, Canada; 3Memorial Sloan Kettering Cancer Center, New York, NY, USA; 4Mayo Clinic, Rochester, NY, USA; 5Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea; 6University of Manchester and the Christie NHS Foundation Trust Manchester Academic Health Science Center, Manchester, UK; 7John Theurer Cancer Center, Hackensack, NJ, USA; 8UC Davis Cancer Center, Sacramento, CA, USA; 9Genentech, South San Francisco, CA, USA; 10Olivia Newton-John Cancer Wellness and Research Center, Austin Health and Department of Clinical Haematology, Austin Hospital, Heidelberg, Australia; 11Haematology, East Kent Hospitals, Canterbury, UK; 12Maria Sklodowska-Curie National Research Institute of Oncology, Krakow, Poland; 13Seagen Inc., Bothell, WA, USA; 14Millennium Pharmaceuticals, Inc., Cambridge, MA, USA, a wholly owned subsidiary of Takeda Pharmaceutical Company Limited and 15Research and Innovation Department,
A. Lacassagne Cancer Center, Nice, France
°Current affiliation: Haematology (Early and Late Stage) Oncology R&D, AstraZeneca, New York, NY, USA
ABSTRACT
Effective and tolerable treatments are needed for older patients with classical Hodgkin lymphoma. We report results for older patients with classical Hodgkin lymphoma treated in the large phase III ECHELON-1 study of frontline brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A+AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). Modified progression-free survival per independent review facility for older versus younger patients (aged ≥60 vs. <60 years) was a pre-specified subgroup analysis; as the ECHE- LON-1 study was not powered for these analyses, reported P-values are descriptive. Of 1,334 enrolled patients, 186 (14%) were aged ≥60 years (A+AVD: n=84, ABVD: n=102); results below refer to this age group. Modified progression-free survival per independent review facility was similar in the two arms at 24 months (A+AVD: 70.3% [95% confidence interval (CI): 58.4–79.4], ABVD: 71.4% [95% CI: 60.5–79.8], hazard ratio (HR)=1.00 [95% CI: 0.58–1.72], P=0.993). After a median follow-up of 60.9 months, 5-year progression-free survival per investigator was 67.1% with A+AVD versus 61.6% with ABVD (HR=0.820 [95% CI: 0.494–1.362], P=0.443). Comparing A+AVD versus ABVD, grade 3/4 peripheral neuropathy occurred in 18% versus 3%; any-grade febrile neu- tropenia in 37% versus 17%; and any-grade pulmonary toxicity in 2% versus 13%, respectively, with three (3%) pulmonary toxicity-related deaths in patients receiving ABVD (none in those receiving A+AVD). Altogether, A+AVD showed overall similar efficacy to ABVD with sur- vival rates in both arms comparing favorably to those of prior series in older patients with advanced-stage classical Hodgkin lymphoma. Compared to ABVD, A+AVD was associated with higher rates of neu- ropathy and neutropenia, but lower rates of pulmonary-related toxicity. Trials registered at ClinicalTrials.gov identifiers: NCT01712490; EudraCT number: 2011-005450-60.
Hodgkin Lymphoma
Correspondence:
ANDREW M. EVENS
ae378@cinj.rutgers.edu
Received: February 1, 2021. Accepted: June 17, 2021. Pre-published: June 24, 2021.
https://doi.org/10.3324/haematol.2021.278438 ©2022 Ferrata Storti Foundation
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