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    Overall survival with brentuximab vedotin in stage III or IV Hodgkin's Lymphoma

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    Authors
    Ansell, S. M.
    Radford, John A
    Connors, J. M.
    Długosz-Danecka, M.
    Kim, W. S.
    Gallamini, A.
    Ramchandren, R.
    Friedberg, J. W.
    Advani, R.
    Hutchings, M.
    Evens, A. M.
    Smolewski, P.
    Savage, K. J.
    Bartlett, N. L.
    Eom, H. S.
    Abramson, J. S.
    Dong, C.
    Campana, F.
    Fenton, K.
    Puhlmann, M.
    Straus, D. J.
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    Affiliation
    Division of Hematology, Mayo Clinic, Rochester, MN
    Issue Date
    2022
    
    Metadata
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    Abstract
    Background: Five-year follow-up in a trial involving patients with previously untreated stage III or IV classic Hodgkin's lymphoma showed long-term progression-free survival benefits with first-line therapy with brentuximab vedotin, a CD30-directed antibody-drug conjugate, plus doxorubicin, vinblastine, and dacarbazine (A+AVD), as compared with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD). A planned interim analysis indicated a potential benefit with regard to overall survival; data from a median of 6 years of follow-up are now available. Methods: We randomly assigned patients in a 1:1 ratio to receive up to six cycles of A+AVD or ABVD. The primary end point, modified progression-free survival, has been reported previously. The key secondary end point was overall survival in the intention-to-treat population. Safety was also assessed. Results: A total of 664 patients were assigned to receive A+AVD and 670 to receive ABVD. At a median follow-up of 73.0 months, 39 patients in the A+AVD group and 64 in the ABVD group had died (hazard ratio, 0.59; 95% confidence interval [CI], 0.40 to 0.88; P = 0.009). The 6-year overall survival estimates were 93.9% (95% CI, 91.6 to 95.5) in the A+AVD group and 89.4% (95% CI, 86.6 to 91.7) in the ABVD group. Progression-free survival was longer with A+AVD than with ABVD (hazard ratio for disease progression or death, 0.68; 95% CI, 0.53 to 0.86). Fewer patients in the A+AVD group than in the ABVD group received subsequent therapy, including transplantation, and fewer second cancers were reported with A+AVD (in 23 vs. 32 patients). Primary prophylaxis with granulocyte colony-stimulating factor was recommended after an increased incidence of febrile neutropenia was observed with A+AVD. More patients had peripheral neuropathy with A+AVD than with ABVD, but most patients in the two groups had resolution or amelioration of the event by the last follow-up. Conclusions: Patients who received A+AVD for the treatment of stage III or IV Hodgkin's lymphoma had a survival advantage over those who received ABVD.
    Citation
    Ansell SM, Radford J, Connors JM, Długosz-Danecka M, Kim WS, Gallamini A, et al. Overall Survival with Brentuximab Vedotin in Stage III or IV Hodgkin's Lymphoma. The New England journal of medicine. 2022 Jul 13. PubMed PMID: 35830649. Epub 2022/07/14. eng.
    Journal
    New England Journal of Medicine
    URI
    http://hdl.handle.net/10541/625427
    DOI
    10.1056/NEJMoa2206125
    PubMed ID
    35830649
    Additional Links
    https://dx.doi.org/10.1056/NEJMoa2206125
    Type
    Article
    Language
    en
    ae974a485f413a2113503eed53cd6c53
    10.1056/NEJMoa2206125
    Scopus Count
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