Event-free survival rate higher in pediatric patients, but no difference seen in the percentage of patients receiving involved-site radiation therapy
THURSDAY, Nov. 3, 2022 (HealthDay News) — For children with high-risk Hodgkin lymphoma, the addition of brentuximab vedotin to standard chemotherapy results in improved three-year event-free survival, with no increase in toxic effects, according to a study published in the Nov. 3 issue of the New England Journal of Medicine.
Sharon M. Castellino, M.D., from Emory University School of Medicine in Atlanta, and colleagues conducted an open-label randomized phase 3 trial involving 587 patients aged 2 to 21 years with previously untreated Hodgkin lymphoma of stage IIB with bulk tumor or stage IIIB, IVA, or IVB. Patients were assigned to brentuximab vedotin with doxorubicin, vincristine, etoposide, prednisone, and cyclophosphamide (brentuximab vedotin group) or the standard pediatric regimen of doxorubicin, bleomycin, vincristine, etoposide, prednisone, and cyclophosphamide (standard-care group) for five cycles.
The researchers found that three-year event-free survival was 92.1 and 82.5 percent in the brentuximab vedotin and standard-care groups, respectively (hazard ratio for event or death, 0.41). There was no substantial difference observed between the groups in the percentage of patients who received involved-site radiation therapy (53.4 and 56.8 percent in the brentuximab vedotin and standard-care groups, respectively). The groups had similar toxic effects. Overall survival at three years was 99.3 and 98.5 percent in the brentuximab vedotin and standard-care groups, respectively.
“The substitution of brentuximab vedotin for bleomycin with chemotherapy in children with Hodgkin’s lymphoma improved disease control at three years but did not improve overall survival and appeared not to reduce the reliance on radiation therapy,” write the authors of an accompanying editorial.
Brentuximab vedotin was supplied by Seagen.
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