KEYNOTE-204: pembrolizumab versus brentuximab vedotin in relapsed or refractory classical Hodgkin lymphoma
In a head-to-head trial, the PD-1 antibody pembrolizumab kept relapsed Hodgkin lymphoma at bay for longer than brentuximab vedotin, making immunotherapy the preferred choice after transplant failure or for patients who cannot have a transplant.
Overview
International randomised open-label phase 3 trial of 304 patients with relapsed or refractory classical Hodgkin lymphoma after autologous transplant or ineligible for it, assigned to pembrolizumab or brentuximab vedotin.
At the interim analysis median progression-free survival was 13.2 months with pembrolizumab against 8.3 months with brentuximab vedotin (hazard ratio 0.65), with benefit across subgroups including those with primary refractory disease; pneumonitis was more frequent with pembrolizumab and neuropathy with brentuximab vedotin.
- Median progression-free survival 13.2 months with pembrolizumab versus 8.3 months with brentuximab vedotin; hazard ratio 0.65.
- Grade 3 to 5 treatment-related adverse events in a similar proportion, with different profiles (pneumonitis versus neuropathy).
PD-1 blockade is the standard for classical Hodgkin lymphoma that has relapsed after or is unsuitable for autologous transplant, ahead of brentuximab vedotin in most patients.
- Open-label interim analysis; overall survival data were immature.
- Most patients had not received either drug before, which is now uncommon as both move into first-line therapy.
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