1. Brentuximab vedotin plus AVD for Hodgkin lymphoma: incidence and management of peripheral neuropathy in a multisite cohort.
- Author
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Bowers, Jackson, Anna, Jacob, Bair, Steven, Annunzio, Kaitlin, Epperla, Narendranath, Pullukkara, Jerrin, Gaballa, Sameh, Spinner, Michael, Li, Shuning, Messmer, Marcus, Nguyen, Joseph, Ayers, Emily, Wagner, Charlotte, Hu, Boyu, Di, Mengyang, Huntington, Scott, Furqan, Fateeha, Shah, Nirav, Chen, Christina, Ballard, Hatcher, Hughes, Mitchell, Chong, Elise, Nasta, Sunita, Barta, Stefan, Landsburg, Daniel, and Svoboda, Jakub
- Subjects
Humans ,Antineoplastic Combined Chemotherapy Protocols ,Brentuximab Vedotin ,Hodgkin Disease ,Incidence ,Peripheral Nervous System Diseases ,Retrospective Studies - Abstract
Brentuximab vedotin (BV) in combination with doxorubicin, vinblastine, and dacarbazine (AVD) is increasingly used for frontline treatment of stage III/IV classical Hodgkin lymphoma (cHL). Peripheral neuropathy (PN) was the most common and treatment-limiting side effect seen in clinical trials but has not been studied in a nontrial setting, in which clinicians may have different strategies for managing it. We conducted a multisite retrospective study to characterize PN in patients who received BV + AVD for newly diagnosed cHL. One hundred fifty-three patients from 10 US institutions were eligible. Thirty-four patients (22%) had at least 1 ineligibility criteria for ECHELON-1, including stage, performance status, and comorbidities. PN was reported by 80% of patients during treatment; 39% experienced grade (G) 1, 31% G2, and 10% G3. In total, BV was modified in 44% of patients because of PN leading to BV discontinuation in 23%, dose reduction in 17%, and temporary hold in 4%. With a median follow-up of 24 months, PN resolution was documented in 36% and improvement in 33% at the last follow-up. Two-year progression-free survival (PFS) for the advanced-stage patients was 82.7% (95% confidence interval [CI], 0.76-0.90) and overall survival was 97.4% (95% CI, 0.94-1.00). Patients who discontinued BV because of PN did not have inferior PFS. In the nontrial setting, BV + AVD was associated with a high incidence of PN. In our cohort, which includes patients who would not have been eligible for the pivotal ECHELON-1 trial, BV discontinuation rates were higher than previously reported, but 2-year outcomes remain comparable.
- Published
- 2023