HL-507 First-Line brentuximab vedotin plus chemotherapy improves overall survival in patients with stage III/IV classical Hodgkin Lymphoma: an updated analysis of ECHELON-1
Straus, D. Radford, John A Connors, J. Kim, W. S. Gallamini, A. Ramchandren, R. Friedberg, J. Advani, R. Hutchings, M. Evens, A.
Straus, D.
Radford, John A
Connors, J.
Kim, W. S.
Gallamini, A.
Ramchandren, R.
Friedberg, J.
Advani, R.
Hutchings, M.
Evens, A.
Citations
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Abstract
Context: Overall survival (OS) benefi t from upfront treatment
with new over existing approaches has never been shown in fi rst line (1L) classical Hodgkin lymphoma (cHL). With newer therapies
for relapsed/refractory disease, demonstrating improved OS with 1L
therapy has been challenging. In ECHELON-1 (NCT01712490),
5-year follow- up analyses supported a long-term progression-free
survival (PFS) benefi t with 1L brentuximab vedotin, doxorubicin,
vinblastine, and dacarbazine (A+AVD) vs doxorubicin, bleomycin,
vinblastine, and dacarbazine (ABVD) in patients with stage Ill/
IV cHL. A+AVD had a manageable long-term safety profi le, with
fewer second malignancies and more pregnancies reported vs ABVD
(Connors et al, NEJM 2018; Straus et al, Lancet Haematol 2021).
We report a prespecifi ed OS analysis after approximately 6 years’
follow-up. Interventions: Patients were randomized 1:1 to receive
up to 6 cycles of A+AVD (n=664) or ABVD (n=670) on day 1 and 15, every 28 days. Main Outcomes Measures: OS was the key
prespecifi ed secondary endpoint. Results: At a median follow-up
of 73 months, 39 and 64 deaths occurred in A+AVD and ABVD
arms, respectively; OS signifi cantly favored A+AVD (hazard ratio
[HR] 0.590; 95% confi dence interval [Cl] 0.396–0.879; p =
0.009). Estimated 6-year OS rates (95% Cl) were 93.9% (91.6–
95.5) vs 89.4% (86.6–91.7) with A+AVD vs ABVD, respectively,
with a consistently higher OS across prespecifi ed subgroups. The
6-year PFS estimate was 82.3% (79.1–85.0) vs 74.5% (70.8–77.7)
with A+AVD vs ABVD, respectively (HR 0.678 [95% Cl 0.532–
0.863]). Overall, A+AVD and ABVD had comparable long-term
safety profi les. By the last follow-up, 86% (379/443) of treatment related peripheral neuropathy cases in the A+AVD arm and 87%
(249/286) in the ABVD arm either completely resolved (72% vs
79%, respectively) or were improving (14% vs 8%, respectively).
Fewer second malignancies (23 vs 32) and more pregnancies (49 vs
28) were reported in the A+AVD vs ABVD arm, respectively. No
new safety signals were identifi ed. Conclusions: In this updated
analysis, A+AVD treatment resulted in a 41% reduction in risk of
death vs ABVD, with a manageable safety profi le. These outcomes
are important in advancing treatment of patients with previously
untreated stage Ill/IV cHL.
Description
Date
2022
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Straus D, Radford J, Connors J, Kim WS, Gallamini A, Ramchandren R, et al. HL-507 First-Line Brentuximab Vedotin Plus Chemotherapy Improves Overall Survival in Patients With Stage III/IV Classical Hodgkin Lymphoma: An Updated Analysis of ECHELON-1. Clin Lymphoma Myeloma Leuk. 2022 Oct;22 Suppl 2:S350. PubMed PMID: 36164033. Epub 2022/09/28. eng.