Division of Oncology, Department of Medicine, Washington University School of Medicine, 660 S. Euclid, Box 8056, St. Louis, MO, 63110, USA.
Curr Hematol Malig Rep. 2020 Feb;15(1):9-19. doi: 10.1007/s11899-020-00561-w.
The recent development of brentuximab vedotin (BV), an antibody-drug conjugate targeting CD30-positive cells, has led to therapeutic advances in the treatment of T cell lymphomas. In this review, we discuss key studies of BV in peripheral T cell lymphoma (PTCL) and cutaneous T cell lymphoma (CTCL) and highlight important questions for further investigation.
Monotherapy with BV has proven to be effective and well tolerated in patients with relapsed/refractory (R/R) CD30-positive CTCL. BV has shown significant activity in R/R PTCL as well, with particularly durable responses in patients with anaplastic large cell lymphoma (ALCL). In a landmark phase III study (ECHELON-2), BV + CHP demonstrated superior progression-free and overall survival relative to CHOP as frontline therapy for patients with CD30-expressing PTCL, representing the first randomized trial demonstrating an overall survival benefit in PTCL. Though BV is overall well tolerated, peripheral neuropathy remains a clinically significant adverse effect. BV is a major therapeutic advance in the treatment of patients with R/R CTCL and of those with PTCL in both the R/R and frontline settings. Key ongoing areas of investigation include optimization of CD30 expression as a predictive biomarker as well as the role of BV in consolidation therapy.
靶向 CD30 阳性细胞的抗体药物偶联物 Brentuximab vedotin（BV）的最新发展，推动了 T 细胞淋巴瘤治疗的进展。本文讨论了 BV 在治疗外周 T 细胞淋巴瘤（PTCL）和皮肤 T 细胞淋巴瘤（CTCL）中的关键研究，并强调了进一步研究的重要问题。
BV 单药治疗复发/难治性（R/R）CD30 阳性 CTCL 患者已被证明是有效且耐受良好的。BV 在 R/R PTCL 中也显示出显著的活性，尤其是在间变大细胞淋巴瘤（ALCL）患者中具有持久的反应。在一项具有里程碑意义的 III 期研究（ECHELON-2）中，BV+CHP 作为 CD30 表达阳性 PTCL 的一线治疗方案，与 CHOP 相比，在无进展生存期和总生存期方面具有显著优势，这是首次在 PTCL 中证明总生存期获益的随机试验。尽管 BV 总体耐受良好，但周围神经病变仍是一个具有临床意义的不良事件。BV 是治疗 R/R CTCL 患者和 R/R 及一线治疗中 PTCL 患者的重要治疗进展。正在进行的关键研究领域包括优化 CD30 表达作为预测生物标志物，以及 BV 在巩固治疗中的作用。
