Real-World Results of Brentuximab Vedotin Containing Regimens in CD30 Positive Lymphoma: A Single-Center Retrospective Study
Authors: Liu Zhenyi , Zheng Yueyue , Liu Xiaohan , Meng Qing , Jiang Xinwen , Ji Qingli , Hu Dongmei , Zhou Minran , Ma Sai , Chunyan Chen 
Published: December 2024

Objective:

The objective of this retrospective study was to assess the effectiveness and safety of Brentuximab Vedotin (BV) in CD30-positive lymphoma.

Methods:

This study enrolled 115 patients of CD30-positive lymphoma who received BV in Qilu Hospital of Shandong University from 2020 September to 2024 July in total, including 46 classical Hodgkin lymphoma (cHL), 62 T cell lymphoma, and 7 diffuse large B-cell lymphoma (DLBCL). We evaluated the efficacy of BV by investigating therapeutic responses and the progression free survival (PFS). Then we analyzed the adverse events (AEs) according to the CTCAE5.0.

Results:

Of the 46 patients with cHL, 58.7% were male, the median age was 32 years old (range, 16-71), and 10.9% were older than 60 years old. 78.3% had advanced disease (stage III-IV). The median lactic dehydrogenase (LDH) was 264 U/L (range, 188-836). The median number of cycles treated with BV regimens was 4 (range 1-8), mainly BV combined with AVD regimen, with 21 patients receiving BV as first-line therapy and 25 patients receiving BV as second- or back-line therapy. 42 patients were evaluated for response outcome, with 69.0% achieving complete response (CR) and 16.7% achieving partial response (PR). The median follow-up time was 14.8 months, and the median PFS was not yet reached (range, 1.2- ). There were 62 cases of CD30-positive T-cell lymphomas, including 28 ALCL, 15 AITL, 9 PTCL-NOS, 5 ENKTCL, 4 MF and 1 EATL. Among the 62 patients with T cell lymphoma, 59.7% was male, the median age was 57 years old (range, 19-93), and 38.7% of patients were older than 60 years old. 74.2% had advanced disease (stage III-IV). The median LDH was 251U/L (range, 139-1685). The median number of cycles treated with BV regimens was 5 (range 1-9), mainly BV combined with CHP regimen, with 29 patients receiving BV as first-line therapy and 33 patients receiving BV as second- or back-line therapy. 57 patients were evaluated for response outcome, with 59.6% achieving CR, 12.3% achieving PR and 22.8% achieving stable disease (SD).The median follow-up time was 16.5 months, and the estimated median PFS was 38.3 months (range, 2.1-42.2). Among the 7 cases of CD30-Positive DLBCL, the median age was 44 years old, the median Performance Status (PS) score was 1, and the median International Prognostic (IPI) Score was 3, and the highest CD30 expression was 90%. Six of these patients had received prior treatment of CD20 monoclonal antibody. After BV treatment, 2 patients achieved CR and 4 patients achieved PR. The estimated median PFS reached 15.5 months.

Among the 115 patients, the most common adverse events were neutropenia (25.2% for any grade and 20.8 for grade ≥3 grade), mild hepatic insufficiency (16.5% for any grade), and pulmonary infection (17.4% for grade ≥3). A few patients developed drug rash (4.3%), hypoproteinemia (2.6%), infusion-related reactions (1.7%), nausea and vomiting (1.7%), atrial fibrillation (0.9%), and hypofibrinogenemia (0.9%). In addition, we observed peripheral neuropathy in 7.8% patients, with clinical manifestations including numbness or pain in limbs, which eventually returned to normal after discontinuation.

Conclusion:

This retrospective study confirmed the encouraging therapeutic outcomes and tolerable adverse events of Brentuximab Vedotin for the treatment of CD30 positive lymphoma, including CD30-positive cHL, CD30-positive T-cell lymphoma and CD30-positive DLBCL.