Efficacy and Tolerability of Dose-Adjusted Brentuximab Vedotin in Lymphoma: A Chinese Single-Center Retrospective Chart Review Study
Authors: Fang Tian , Ren Kexing , Zou Liqun 
Published: December 2024

Background

Brentuximab vedotin (BV), an anti-CD30 antibody-drug conjugate (ADC), received approval in China in May 2020 for the treatment of adult patients diagnosed with CD30-positive lymphoma. As there is limited data on the efficacy and tolerability in the real- world settings. Herein, we evaluated the efficacy and safety of BV in lymphoma patients at West China Hospital under real-world conditions.

Methods

We conducted a single-center, retrospective chart review real-world study involving 66 patients with lymphoma at West China Hospital who received brentuximab vedotin (BV) for the first time between August 2020 and May 2024. Clinical data were extracted from medical records. Patients who discontinued treatment due to financial or other reasons were excluded. Short-term efficacy was evaluated by objective response rate (ORR), complete response (CR), partial response (PR), stable disease (SD), and disease progression (PD). Because of the high cost of BV, a dose-adjustment approach was adopted in 37 patients. Progression-free survival (PFS) and overall survival (OS) were estimated by Kaplan-Meier method. Additionally, safety profile was assessed in the study.

Results

54 patients were eligible, all patients treated with BV completed a median of 4 cycles (range: 1-16). Among those evaluated for efficacy, 66.7% (36/54) were lymphoma patients receiving BV as first-line therapy and 33.3% (18/54) were relapsed/refractory (R/R) lymphoma patients. The overall ORR was 85.2% (CR 72.2%, PR 13.0%). After a median follow-up of 11.9 months, the 6-month PFS rate and OS rate for all patients were 87% and 100%, respectively, and the 24-month PFS rate and OS rate were 73.5% and 93.4%, respectively. Of the patients evaluated for efficacy, 63.0% (34/54) received dose-adjusted BV therapy. Among patients receiving the recommended dose of 1.8 mg/kg (including BV+CHP, BV+PD-1, BV monotherapy, and other regimens), 18 patients received a dose adjustment with an average BV dose of 1.26 mg/kg (95% CI = 1.09-1.44). Among patients receiving the recommended dose of 1.2 mg/kg (including BV+AVD), 19 patients underwent dose adjustments with an average BV dose of 0.83 mg/kg (95% CI=0.74-0.91). Kaplan-Meier survival analysis showed no effect of BV dose adjustment on PFS or OS. In addition, when considering survival outcomes for lymphoma subtypes, there were statistically significant differences in PFS (p=0.037) and OS (p=0.027) in the CHL group (n=28), TCL group (n=19), and BCL+GZL group (n=7) .BV-based treatment was generally well-tolerated, with neutropenia being the most common adverse event. No grade 4 or higher adverse events were reported. The tolerability of dose-adjusted BV was better than recommended dose.

Conclusion

BV-based regimens represent a promising treatment option for patients with CD30-expressing lymphoma in China. Our findings demonstrate significant efficacy of this regimen. Dose-adjusted BV not only alleviates the financial burden on patients but also maintains its efficacy while reducing toxicity.

Keywords: brentuximab vedotin, dose-adjusted, efficacy, lymphoma, real-world study