The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.
J Clin Oncol. 2012 Jun 20;30(18):2183-9. doi: 10.1200/JCO.2011.38.0410. Epub 2012 Mar 26.
Brentuximab vedotin is an antibody-drug conjugate (ADC) that selectively delivers monomethyl auristatin E, an antimicrotubule agent, into CD30-expressing cells. In phase I studies, brentuximab vedotin demonstrated significant activity with a favorable safety profile in patients with relapsed or refractory CD30-positive lymphomas.
In this multinational, open-label, phase II study, the efficacy and safety of brentuximab vedotin were evaluated in patients with relapsed or refractory Hodgkin's lymphoma (HL) after autologous stem-cell transplantation (auto-SCT). Patients had histologically documented CD30-positive HL by central pathology review. A total of 102 patients were treated with brentuximab vedotin 1.8 mg/kg by intravenous infusion every 3 weeks. In the absence of disease progression or prohibitive toxicity, patients received a maximum of 16 cycles. The primary end point was the overall objective response rate (ORR) determined by an independent radiology review facility.
The ORR was 75% with complete remission (CR) in 34% of patients. The median progression-free survival time for all patients was 5.6 months, and the median duration of response for those in CR was 20.5 months. After a median observation time of more than 1.5 years, 31 patients were alive and free of documented progressive disease. The most common treatment-related adverse events were peripheral sensory neuropathy, nausea, fatigue, neutropenia, and diarrhea.
The ADC brentuximab vedotin was associated with manageable toxicity and induced objective responses in 75% of patients with relapsed or refractory HL after auto-SCT. Durable CRs approaching 2 years were observed, supporting study in earlier lines of therapy.
Brentuximab vedotin 是一种抗体药物偶联物(ADC),可将单甲基澳瑞他汀 E(一种微管抑制剂)选择性递送至 CD30 表达的细胞内。在 I 期研究中,Brentuximab vedotin 在复发或难治性 CD30 阳性淋巴瘤患者中表现出显著的活性和良好的安全性。
在这项多中心、开放性、II 期研究中,评估了 Brentuximab vedotin 在自体造血干细胞移植(auto-SCT)后复发或难治性霍奇金淋巴瘤(HL)患者中的疗效和安全性。患者经中心病理复查证实为 CD30 阳性 HL。共有 102 例患者接受静脉输注 1.8mg/kg 的 Brentuximab vedotin,每 3 周 1 次。在没有疾病进展或不可耐受毒性的情况下,患者最多接受 16 个周期的治疗。主要终点是由独立影像学评估机构确定的总客观缓解率(ORR)。
客观缓解率为 75%,完全缓解(CR)率为 34%。所有患者的中位无进展生存期为 5.6 个月,CR 患者的中位缓解持续时间为 20.5 个月。在中位观察时间超过 1.5 年后,31 例患者存活且无疾病进展。最常见的治疗相关不良事件是周围感觉神经病变、恶心、疲劳、中性粒细胞减少和腹泻。
Brentuximab vedotin 这种 ADC 药物与可管理的毒性相关,在 auto-SCT 后复发或难治性 HL 患者中诱导了 75%的患者获得客观缓解。观察到接近 2 年的持久 CR,支持在更早的治疗线中进行研究。