AHOD1331: brentuximab vedotin with chemotherapy in paediatric high-risk Hodgkin lymphoma
Swapping bleomycin for the antibody-drug conjugate brentuximab vedotin in children's chemotherapy for advanced Hodgkin lymphoma cut the risk of relapse or death by 59 percent with no extra toxicity.
Overview
Open-label multicentre randomised phase 3 trial: 600 patients aged 2 to 21 with untreated high-risk classical Hodgkin lymphoma were assigned to five cycles of brentuximab vedotin with doxorubicin, vincristine, etoposide, prednisone and cyclophosphamide or to standard ABVE-PC, with PET-directed involved-site radiotherapy to slow-responding lesions.
At a median follow-up of 42.1 months three-year event-free survival was 92.1 percent with brentuximab vedotin against 82.5 percent with standard care (hazard ratio 0.41). Radiotherapy use (53.4 against 56.8 percent) and toxic effects were similar; three-year overall survival was 99.3 and 98.5 percent.
- Three-year event-free survival 92.1 percent (95% CI 88.4 to 94.7) versus 82.5 percent (77.4 to 86.5); hazard ratio 0.41 (0.25 to 0.67), p < 0.001.
- Three-year overall survival 99.3 versus 98.5 percent.
- Involved-site radiotherapy given to 53.4 versus 56.8 percent; toxic effects similar.
Brentuximab vedotin with AVEPC is the new standard for high-risk paediatric Hodgkin lymphoma and led to the first paediatric approval of the drug in November 2022.
- Open-label; the trial did not reduce radiotherapy use, which later trials are testing.
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