1. Patient charactaristics:
Efficacy and safety of brentuximab vedotin in combination with bendamustine as 2nd line salvage therapy and potential “bridge” to stem cell transplantation for patients with refractory Hodgkin Lymphoma
Eshrak Shaibani, Panayotis Kaloyannidis, Mohammed Ali, Ahmed Al Shaghier, Khalid Al Anezi, Hani Al Hashmi
Department of Adult Hematology and Stem cell transplant, King Fahad Specialist Hospital, Dammam, Saudi Arabia
Treatment:
Route of administration intravenously
Hospitalization conditions outpatient basis
Administration schedule week cycles.
Doses
brentuximab mg/kg on day1
bendamustine mg/m2 on days 1&2
B& B administered cycles (med) (2-5)
Introduction:
High dose chemotherapy and autologous stem cell transplantation (autoSCT) represents the most reliable curative approach for patients (pts) with refractory or relapsed Hodgkin’s lymphoma (HL) after induction therapy. Nevertheless, the outcome of pts failed post 1st line salvage therapy is extremely poor and only 15-20% can achieve long term survival. For the majority of these pts the 2nd salvage regimen remains ineffective; therefore there is an unmet need for more effective and less toxic approaches. Brentuximab vedotin and Bendamustine have been tested as single-agents in refractory CD30+ lymphomas, demonstrating significant activity and a favorable safety profile. However, the published data of their combination (B&B) as salvage treatment are to date limited
Result:
Overall response ( > 80% , PET criteria) 4/6 (67%, all HL pts)
Progressed disease 2/6 (33%)
Toxicity (WHO≥3)
myelotoxicity 0
liver 0
kidney 0
neurological 0
infections
Aim:
To evaluate the efficacy and safety of Brentuximab vedotin & Bedamustin
(B&B) combination.ation in refractory HL
Patient charactaristics:
Number of patients
Age (med) (17-34)ys
Diagnosis HL
Previous salvage treatment
ESHAP x
auto SCT
Stage before B&B-treatment
II 2
III IV
B-symptoms 2
Effect of BB on moblization:
2/4 responders were mobilized with
Cyclophosphamide : 2 gr/m2
GCSF 10 mcg/kg
Collected CD34+ cells 4,1 & 7.7 x106/kg
Long term outcome:
Pt response to B&B Additional treatment status post B&B Time
#1 yes auto Alive/dis.free +10 mos
#2 yes auto Alive/dis.free +10mos
#3 yes auto Alive/dis.free +5mos
#4 yes allo Alive/dis.free +8 mos
#5 no palliative Alive +11mos
#6 no palliative Alive +12 mos
CONCLUSION:
Retrospective study with small series of patients
Seems that the B&B combination treatment is an efficacious and safe approach in patients with refractory HL
The B&B combination merits further investigation as salvage treatment
Refremsess:
Zinzani PL et al. Brentuximab Vedotin in Transplant-Naïve Relapsed/Refractory Hodgkin Lymphoma: Experience in 30 Patients. Oncologist 2015 Oct 23.
Ghesquières H,et al Clinical experience of bendamustine in relapsed or refractory Hodgkin lymphoma: a retrospective analysis of the French compassionate use program in 28 patients. Leuk Lymphoma Nov (11):
LaCasce A, Bociek RG, Matous J et al. Brenduximab Vedotin in with bendamustin for patients withHodgkin lymphoma who are relapsedor refractory after frondline therapy. Blood :293; Abstract