ECHELON-1 Trial Shows Continued Efficacy Over Time in Hodgkin Lymphoma

Tatyana Feldman, MD, director of the T cell program at the John Theurer Cancer Center, Hackensack Meridian Health, discusses the design and efficacy of the ECHELON-1 trial investigating brentuximab vedotin (Adcetris) with chemotherapy in patients with stage III or IV Hodgkin lymphoma after a 3-year update (NCT01712490).

This study was a large, randomized, multicenter study comparing the standard of care in this setting of doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) versus brentuximab vedotin with doxorubicin, vinblastine, and dacarbazine (A+AVD) in patients with advanced stage disease. The primary end point of ECHELON-1 was modified progression-free survival (PFS), which was better in the A+AVD arm, according to Feldman.

The initial PFS rates published in the New England Journal of Medicine were about 82% with brentuximab vedotin compared with 77% with the standard of care. Feldman says that even though that may be considered a small difference, any improvement in this field matters. The toxicity profile with A+AVD was also manageable for the patients in this trial, and there were no interventions for highly toxic problems. She believes that the long-term update is holding up with what was originally reported. The 3-year PFS rates were still close to 82% and 77%, with A+AVD at 83% and ABVD at 76%, respectively.

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