Angelopoulou Maria K, Vassilakopoulos Theodoros P, Batsis Ioannis, Sakellari Ioanna, Gkirkas Konstantinos, Pappa Vasiliki, Giannoulia Panagiota, Apostolidis Ioannis, Apostolopoulos Christos, Roussou Paraskevi, Panayiotidis Panayiotis, Dimou Maria, Kyrtsonis Marie-Christine, Palassopoulou Maria, Vassilopoulos Georgios, Moschogiannis Maria, Kalpadakis Christina, Margaritis Dimitrios, Spyridonidis Alexander, Michalis Eurydiki, Anargyrou Konstantinos, Repousis Panagiotis, Hatzimichael Eleutheria, Bousiou Zoi, Poulakidas Elias, Grentzelias Dimitrios, Harhalakis Nikolaos, Pangalis Gerassimos A, Anagnostopoulos Achilles, Tsirigotis Panagiotis
Department of Hematology, Laikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Hematology and Bone Marrow Transplantation Department, General Hospital of Thessaloniki Papanikolaou, Thessaloniki, Greece.
Hematol Oncol. 2018 Feb;36(1):174-181. doi: 10.1002/hon.2383. Epub 2017 Feb 20.
This retrospective study aimed to describe the Hellenic experience on the use of brentuximab vedotin (BV) in relapsed/refractory (R/R) Hodgkin lymphoma (HL) given within its indication. From June 2011 to April 2015, ninety-five patients with R/R HL, who received BV in 20 centers from Greece, were analyzed. Their median age was 33 years, and 62% were males. Sixty-seven patients received BV after autologous stem cell transplantation failure, whereas 28 patients were treated with BV without a prior autologous stem cell transplantation, due to advanced age/comorbidities or chemorefractory disease. The median number of prior treatments was 4 and 44% of the patients were refractory to their most recent therapy. The median number of BV cycles was 8 (range, 2-16), and the median time to best response was the fourth cycle. Fifty-seven patients achieved an objective response: twenty-two (23%), a complete response (CR), and 35 patients (37%), a partial, for an overall response rate of 60%. Twelve patients (13%) had stable disease, and the remaining twenty-six (27%) had progressive disease as their best response. At a median follow-up of 11.5 months, median progression-free survival and overall survival were 8 and 26.5 months, respectively. Multivariate analysis showed that chemosensitivity to treatment administered before BV was associated with a significantly increased probability of achieving response to BV (P = .005). Bulky disease (P = .01) and response to BV (P <.001) were significant for progression-free survival, while refractoriness to most recent treatment (P = .04), bulky disease (P = .005), and B-symptoms (P = .001) were unfavorable factors for overall survival. Among the 22 CRs, 5 remain in CR with no further treatment after BV at a median follow-up of 13 months. In conclusion, our data indicate that BV is an effective treatment for R/R HL patients even outside clinical trials. Whether BV can cure a fraction of patients remains to be seen.
本回顾性研究旨在描述希腊在复发/难治性（R/R）霍奇金淋巴瘤（HL）患者中使用本妥昔单抗（BV）的经验，这些患者均在其适应证范围内接受治疗。2011年6月至2015年4月，对来自希腊20个中心接受BV治疗的95例R/R HL患者进行了分析。他们的中位年龄为33岁，62%为男性。67例患者在自体干细胞移植失败后接受BV治疗，而28例患者因年龄较大/合并症或化疗难治性疾病未进行自体干细胞移植而接受BV治疗。既往治疗的中位次数为4次，44%的患者对其最近一次治疗无效。BV治疗周期的中位数为8次（范围为2 - 16次），最佳反应的中位时间为第4个周期。57例患者获得客观反应：22例（23%）完全缓解（CR），35例（37%）部分缓解，总缓解率为60%。12例患者（13%）疾病稳定，其余26例（27%）最佳反应为疾病进展。中位随访11.5个月时，无进展生存期和总生存期的中位数分别为8个月和26.5个月。多因素分析显示，BV治疗前对化疗的敏感性与对BV治疗产生反应的概率显著增加相关（P = 0.005）。大包块疾病（P = 0.01）和对BV的反应（P < 0.001）对无进展生存期有显著影响，而对最近一次治疗的难治性（P = 0.04）、大包块疾病（P = 0.005）和B症状（P = 0.001）是总生存期的不利因素。在22例CR患者中，中位随访13个月时，5例在接受BV治疗后未进一步治疗仍处于CR状态。总之，我们的数据表明，即使在临床试验之外，BV也是R/R HL患者的有效治疗方法。BV是否能治愈一部分患者仍有待观察。
