A Close Look at Hodgkin Lymphoma Treatment: Burke Reviews a Phase 2 Study

John M. Burke, MD, hematologist, medical oncologist, blood cancer specialist, Rocky Mountain Cancer Centers Associate Chair, US Oncology Hematology Research, Aurora, CO, discusses results from a phase 2 study which evaluated brentuximab vedotin (Adcetris), nivolumab (Opdivo), doxorubicin, and dacarbazine for the treatment of early- and advanced-stage classical Hodgkin lymphoma.

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0:09 | I have been involved in a couple of trials in Hodgkin lymphoma, and both of them used a novel regimen consisting of the antibody-drug conjugate brentuximab vedotin in combination with nivolumab, and both in combination with chemotherapy, so doxorubicin and dacarbazine. So it is a novel regimen in Hodgkin lymphoma using 2 relatively novel drugs and 2 older [chemotherapy] drugs that have been part of the standard regimen. This was all 1 big study, but we divided it into different parts. One group of patients had early-stage Hodgkin lymphoma, and the other group of patients had more advanced stage Hodgkin lymphoma.

1:00 | The early-stage patients received 4 cycles of the treatment without any radiation therapy. A kind of current way of treating early-stage Hodgkin lymphoma often is to give several cycles of [chemotherapy] followed by radiation therapy, or [we] can do it with several cycles of [chemotherapy] without radiation therapy.

1:21 | [In] this trial, we did it without the radiation therapy using these novel drugs. We got really excellent results with high responses and/or good responses in a large percentage of patients. It was interesting that the toxicity profile of this novel regimen is a little bit different from what we see with conventional chemotherapy. So we saw less in the way of neutropenia and less in the way of peripheral neuropathy with the novel regimen than we historically have seen with the conventional chemotherapy regimen, and so has a favorable toxicity profile. We did introduce some degree of immune-mediated toxicities, but overall, it seemed to be a very well-tolerated regimen and achieved good results for the patients. That is in the early-stage component of the trial.

2:11 | The advanced stage patients got 6 cycles of chemotherapy with the same novel regimen and again, also had very good outcomes. It is an interesting new regimen that we will see where it goes in the field of Hodgkin lymphoma, but it incorporates what we think of as being kind of our best drugs in the field.