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Brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine in patients with advanced-stage, classical Hodgkin lymphoma: a prespecified subgroup analysis of high-risk patients from the ECHELON-1 study

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  • Martin Hutchings
  • John Radford
  • Stephen M Ansell
  • Árpád Illés
  • Anna Sureda
  • Joseph M Connors
  • Alice Sýkorová
  • Hirohiko Shibayama
  • Jeremy S Abramson
  • Neil S Chua
  • Jonathan W Friedberg
  • Jan Kořen
  • Ann Steward LaCasce
  • Lysiane Molina
  • Gerald Engley
  • Keenan Fenton
  • Hina Jolin
  • Rachael Liu
  • Ashish Gautam
  • Andrea Gallamini
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Approximately one-third of patients diagnosed with Hodgkin lymphoma presenting with Stage IV disease do not survive past 5 years. We present updated efficacy and safety analyses in high-risk patient subgroups, defined by Stage IV disease or International Prognostic Score (IPS) of 4-7, enrolled in the ECHELON-1 study that compared brentuximab vedotin plus doxorubicin, vinblastine, and dacarbazine (A + AVD) versus doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as first-line therapy after a median follow-up of 37.1 months. Among patients treated with A + AVD (n = 664) or ABVD (n = 670), 64% had Stage IV disease and 26% had an IPS of 4-7. Patients with Stage IV disease treated with A + AVD showed consistent improvements in PFS at 3 years as assessed by investigator (hazard ratio [HR], 0.723; 95% confidence interval [CI], 0.537-0.973; p = 0.032). Similar improvements were seen in the subgroup of patients with IPS of 4-7 (HR, 0.588; 95% CI, 0.386-0.894; p = 0.012). The most common adverse events (AEs) in A + AVD-treated versus ABVD-treated patients with Stage IV disease were peripheral neuropathy (67% vs. 40%) and neutropenia (71% vs. 55%); in patients with IPS of 4-7, the most common AEs were peripheral neuropathy (69% vs. 45%), neutropenia (66% vs. 55%), and febrile neutropenia (23% vs. 9%), respectively. Patients in high-risk subgroups did not experience greater AE incidence or severity than patients in the total population. This updated analysis of ECHELON-1 shows a favorable benefit-risk balance in high-risk patients.

Original languageEnglish
JournalHematological Oncology
Volume39
Issue number2
Pages (from-to)185-195
Number of pages11
ISSN0889-8588
DOIs
Publication statusPublished - Apr 2021

Bibliographical note

© 2021 The Authors. Hematological Oncology published by John Wiley & Sons Ltd.

    Research areas

  • ECHELON-1, brentuximab vedotin, high risk Hodgkin lymphoma, 1, ECHELON&#8208

ID: 62111497