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一项评估 Brentuximab vedotin 治疗复发或难治性霍奇金淋巴瘤患者的关键性 II 期研究结果。

Results of a pivotal phase II study of brentuximab vedotin for patients with relapsed or refractory Hodgkin's lymphoma.

机构信息

The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030, USA.

出版信息

J Clin Oncol. 2012 Jun 20;30(18):2183-9. doi: 10.1200/JCO.2011.38.0410. Epub 2012 Mar 26.

Abstract

PURPOSE

Brentuximab vedotin is an antibody-drug conjugate (ADC) that selectively delivers monomethyl auristatin E, an antimicrotubule agent, into CD30-expressing cells. In phase I studies, brentuximab vedotin demonstrated significant activity with a favorable safety profile in patients with relapsed or refractory CD30-positive lymphomas.

PATIENTS AND METHODS

In this multinational, open-label, phase II study, the efficacy and safety of brentuximab vedotin were evaluated in patients with relapsed or refractory Hodgkin's lymphoma (HL) after autologous stem-cell transplantation (auto-SCT). Patients had histologically documented CD30-positive HL by central pathology review. A total of 102 patients were treated with brentuximab vedotin 1.8 mg/kg by intravenous infusion every 3 weeks. In the absence of disease progression or prohibitive toxicity, patients received a maximum of 16 cycles. The primary end point was the overall objective response rate (ORR) determined by an independent radiology review facility.

RESULTS

The ORR was 75% with complete remission (CR) in 34% of patients. The median progression-free survival time for all patients was 5.6 months, and the median duration of response for those in CR was 20.5 months. After a median observation time of more than 1.5 years, 31 patients were alive and free of documented progressive disease. The most common treatment-related adverse events were peripheral sensory neuropathy, nausea, fatigue, neutropenia, and diarrhea.

CONCLUSION

The ADC brentuximab vedotin was associated with manageable toxicity and induced objective responses in 75% of patients with relapsed or refractory HL after auto-SCT. Durable CRs approaching 2 years were observed, supporting study in earlier lines of therapy.

摘要

目的

Brentuximab vedotin 是一种抗体药物偶联物(ADC),可将单甲基澳瑞他汀 E(一种微管抑制剂)选择性递送至 CD30 表达的细胞内。在 I 期研究中,Brentuximab vedotin 在复发或难治性 CD30 阳性淋巴瘤患者中表现出显著的活性和良好的安全性。

患者和方法

在这项多中心、开放性、II 期研究中,评估了 Brentuximab vedotin 在自体造血干细胞移植(auto-SCT)后复发或难治性霍奇金淋巴瘤(HL)患者中的疗效和安全性。患者经中心病理复查证实为 CD30 阳性 HL。共有 102 例患者接受静脉输注 1.8mg/kg 的 Brentuximab vedotin,每 3 周 1 次。在没有疾病进展或不可耐受毒性的情况下,患者最多接受 16 个周期的治疗。主要终点是由独立影像学评估机构确定的总客观缓解率(ORR)。

结果

客观缓解率为 75%,完全缓解(CR)率为 34%。所有患者的中位无进展生存期为 5.6 个月,CR 患者的中位缓解持续时间为 20.5 个月。在中位观察时间超过 1.5 年后,31 例患者存活且无疾病进展。最常见的治疗相关不良事件是周围感觉神经病变、恶心、疲劳、中性粒细胞减少和腹泻。

结论

Brentuximab vedotin 这种 ADC 药物与可管理的毒性相关,在 auto-SCT 后复发或难治性 HL 患者中诱导了 75%的患者获得客观缓解。观察到接近 2 年的持久 CR,支持在更早的治疗线中进行研究。

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