1Institute of Hematology L. and A. Seràgnoli, S. Orsola-Malpighi Hospital, Bologna, Italy.
Haematologica. 2013 Aug;98(8):1232-6. doi: 10.3324/haematol.2012.083048. Epub 2013 May 3.
Clinical trial results indicate that brentuximab vedotin brings considerable promise for the treatment of patients with relapsed or refractory Hodgkin's lymphoma. A retrospective multicenter study was conducted on 65 heavily pretreated patients who underwent therapy through a Named Patient Program in Italy (non trial-setting). The primary study endpoint was the objective response rate; secondary endpoints were safety, overall survival and progression-free survival. The best overall response rate (70.7%), including 21.5% complete responses, was observed at the first restaging after the third cycle of treatment. After a median follow up of 13.2 months, the overall survival rate at 20 months was 73.8% while the progression-free survival rate at 20 months was 24.2%. Globally nine patients are in continuous complete response with a median follow up of 14 months (range, 10-19 months). Four patients proceeded to autotransplantation and nine to allotransplantation. The most frequent extra-hematologic toxicity was peripheral neuropathy, observed in 21.5% of cases (9 patients with grade 1/2 and 5 patients with grade 3/4); neurological toxicity led to discontinuation of treatment in three patients and to dose reduction in four. In general the treatment was well tolerated and toxicities, both hematologic and extra-hematologic, were manageable. This report indicates and confirms that brentuximab vedotin as a single agent is effective and safe also when used in standard, everyday clinical practice outside a clinical trial. Best overall responses were recorded after three or four cycles and showed that brentuximab vedotin provides an effective bridge to further therapeutic interventions.
临床试验结果表明,本妥昔单抗维迪昔单抗为复发或难治性霍奇金淋巴瘤患者的治疗带来了很大希望。一项回顾性多中心研究对 65 名在意大利通过上市后临床研究项目(非临床试验环境)接受治疗的既往大量治疗的患者进行了研究。主要研究终点为客观缓解率;次要终点为安全性、总生存期和无进展生存期。在治疗第 3 周期后的首次复查时观察到最佳总体缓解率(70.7%),包括 21.5%的完全缓解。中位随访 13.2 个月后,20 个月时总生存率为 73.8%,20 个月时无进展生存率为 24.2%。总体上,9 例患者持续完全缓解,中位随访时间为 14 个月(范围为 10-19 个月)。4 例患者进行了自体移植,9 例患者进行了异体移植。最常见的血液学以外的毒性是周围神经病,见于 21.5%的病例(9 例为 1/2 级,5 例为 3/4 级);神经毒性导致 3 例患者停止治疗,4 例患者减少剂量。总体而言,该治疗方案耐受性良好,血液学和血液学以外的毒性均可控制。本报告表明并证实,本妥昔单抗维迪昔单抗作为单一药物在临床试验之外的标准日常临床实践中使用也是有效和安全的。在接受 3 或 4 个周期治疗后观察到最佳总体缓解,表明本妥昔单抗维迪昔单抗为进一步的治疗干预提供了有效的桥梁。