Dana-Farber Cancer Institute, Boston, MA;
Willamette Valley Cancer Institute and Research Center/US Oncology Research, Eugene, OR;
Blood. 2015 Feb 26;125(9):1394-402. doi: 10.1182/blood-2014-09-598763. Epub 2015 Jan 8.
Several non-Hodgkin lymphoma (NHL) subtypes, including diffuse large B-cell lymphoma (DLBCL), variably express CD30. This phase 2, open-label study evaluated the efficacy of brentuximab vedotin, an anti-CD30 antibody-drug conjugate, in relapsed/refractory CD30(+) NHL. This planned subset analysis of B-cell NHLs includes 49 patients with DLBCL and 19 with other B-cell NHLs. Objective response rate was 44% for DLBCL, including 8 (17%) complete remissions (CRs) with a median duration of 16.6 months thus far (range, 2.7 to 22.7+ months). There was no statistical correlation between response and level of CD30 expression; however, all responding patients had quantifiable CD30 by computer-assisted assessment of immunohistochemistry. DLBCL patients were generally refractory to first-line (76%) and most recent therapies (82%), and 44% of these refractory patients responded (15% CRs). Patients with other B-cell lymphomas also responded: 1 CR, 2 partial responses (PRs) of 6 with gray zone, 1 CR of 6 with primary mediastinal B-cell, and 1 CR of 3 with posttransplant lymphoproliferative disorder. Adverse events were consistent with known toxicities. The combination of brentuximab vedotin with rituximab was generally well tolerated and had activity similar to brentuximab vedotin alone. Overall, significant activity with brentuximab vedotin was observed in relapsed/refractory DLBCL, and responses occurred across a range of CD30 expression. This study was registered at www.clinicaltrials.gov as #NCT01421667.
几种非霍奇金淋巴瘤(NHL)亚型,包括弥漫性大 B 细胞淋巴瘤(DLBCL),不同程度地表达 CD30。这项 2 期、开放性标签研究评估了 brentuximab vedotin(一种抗 CD30 抗体-药物偶联物)在复发/难治性 CD30(+) NHL 中的疗效。这项 B 细胞 NHL 的计划亚组分析包括 49 例 DLBCL 患者和 19 例其他 B 细胞 NHL 患者。DLBCL 的客观缓解率为 44%,包括 8 例(17%)完全缓解(CR),中位缓解持续时间迄今为 16.6 个月(范围 2.7 至 22.7+ 个月)。反应与 CD30 表达水平之间没有统计学相关性;然而,所有有反应的患者通过计算机辅助评估免疫组化都可检测到 CD30。DLBCL 患者对一线(76%)和最近的大多数治疗(82%)均有抗药性,44%的这些耐药患者有反应(15% CR)。其他 B 细胞淋巴瘤患者也有反应:1 例 CR,2 例 6 例灰色区部分缓解(PR),1 例 6 例原发性纵隔 B 细胞 CR,1 例 3 例移植后淋巴增生性疾病 CR。不良事件与已知毒性一致。brentuximab vedotin 联合利妥昔单抗一般耐受性良好,且与单独使用 brentuximab vedotin 具有相似的活性。总体而言,在复发/难治性 DLBCL 中观察到 brentuximab vedotin 具有显著活性,且反应发生在 CD30 表达的一系列范围内。这项研究在 www.clinicaltrials.gov 上注册为 #NCT01421667。