The goal of treatment for Hodgkin lymphoma (HL) in children is similar to that of adults: cure the disease without causing long-term complications. Brentuximab vedotin (Bv) is a CD30-directed antibody-drug conjugate approved for adults with advanced HL. However, studies have found that Bv may also be a safe and effective treatment for children and adolescents with advanced HL.
This multicenter randomized phase 3 study, published in the Journal of Clinical Oncology for the 2022 ASCO Annual Meeting, compared Bv with doxorubicin, vincristine, etoposide, prednisone, and cyclophosphamide (Bv-AVE-PC) to the standard pediatric regimen of ABVE-PC containing bleomycin. Patients aged 2 to 21 years old with untreated HL, stages IIB, IIIB, IVA, and IVB were included in the study. The main objective was to examine 3-year event-free survival. Disease progression was monitored with PET-CT scans.
Ultimately, it was found that 17% of children with HL treated with ABVE-PC experienced a relapse, and 7% of those treated with Bv-AVE-PC experienced a relapse. The 3-year overall survival rate was 98.5% for the ABVE-PC arm and 99.3% for the Bv-AVE-PC arm. There were no significant differences in grade 3 or 4 adverse events. Moreover, a 59% risk reduction in event-free survival (EFS) was obtained with the Bv-AVE-PC regimen compared to the ABVE-PC regimen without an increase in toxicity and with less need for radiation therapy.
In short, healthcare providers can consider implementing Bv-AVE-PC as a safe and effective treatment option in children and adolescents with advanced HL, given its superior efficacy and risk reduction in EFS compared to ABVE-PC [1].
Source:
[1] Castellino, S. M., Pei, Q., Parsons, S. K., Hodgson, D. C., McCarten, K., Punnett, A., Horton, T. M., Dave, H. K., Cho, S. Y., Wu, Y., Henderson, T. O., Hoppe, B., Keller, F. G., Kelly, K. (2022, June). Brentuximab vedotin and association with event-free survival (EFS) in children with newly diagnosed high-risk Hodgkin lymphoma (HL): a report from the Children’s Oncology Group phase 3 study AHOD1331 (NCT 02166463) [Oral abstract session]. 2022 ASCO Annual Meeting, Chicago, IL. https://meetings.asco.org/abstracts-presentations/207243
