EBMT 2020 | Hodgkin lymphoma remission prolongation: post-ASCT strategies
Anna Sureda, MD, PhD, Catalan Institute of Oncology, Barcelona, Spain, discusses the prolongation of remission with post-autologous stem cell transplant (post-ASCT) strategies in Hodgkin lymphoma. This interview was recorded via an online conference call with The Video Journal of Hematological Oncology (VJHemOnc).
Transcript (edited for clarity)
Basically, this presentation has the scientific background on the fact that although autologous stem cell transplant is the standard of care for those patients that are primary refractory or that relapsed after first-line therapy, the reality is that autologous stem cell transplantation is not able to cure 100% of these patients. There have been some prognostic factors identified before autologous stem cell transplantation that allow us to segregate groups of patients that have a higher risk of relapse after autologous stem cell transplant...
Basically, this presentation has the scientific background on the fact that although autologous stem cell transplant is the standard of care for those patients that are primary refractory or that relapsed after first-line therapy, the reality is that autologous stem cell transplantation is not able to cure 100% of these patients. There have been some prognostic factors identified before autologous stem cell transplantation that allow us to segregate groups of patients that have a higher risk of relapse after autologous stem cell transplant. And in line with what we have been doing with other hematological malignancies, several groups have tried to find out the potential benefit of giving additional therapy after autologous stem cell transplantation in these high relapse risk group of patients.
There have been several attempts, but the one that has made it into our daily clinical practice is consolidation with brentuximab vedotin single drug. And that was basically the objective of the AETHERA trial, which is the trial that I am basically discussing in this presentation. So patient with high risk of relapse disease were randomized to receive either brentuximab vedotin single drug or a placebo very soon after autologous stem cell transplantation of up to 16 cycles. And patients that were consolidated with BV, they had a significantly better progression-free survival at two years, three years and five years follow-up.
The benefit of brentuximab vedotin in comparison to placebo was a little bit different, depending on the number of risk factors that the patient had at the time to be included in the analysis. So the difference was significantly higher in those patients with three or plus adverse prognostic factors in relation to those patients that only had one adverse prognostic factor at the time of relapse. What we can see in the label of the drug, because the AETHERA trial gave the third indication for brentuximab vedotin single drug in the setting of relapsed/refractory Hodgkin’s lymphoma, is basically looking at those patients that have more than one adverse prognostic factor at the time of autologous stem cell transplant.
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