Rituximab vedotin in the frontline setting
Dr Stephen Ansell - Mayo Clinic, Rochester, USA
Brentuximab vedotin is an antibody drug conjugate. It’s an anti-CD30 antibody with a chemotherapy agent attached to it which delivers the chemotherapy directly to the actual malignant cell. Results thus far with just brentuximab vedotin alone have been very promising and in patients who have Hodgkin’s lymphoma that have failed other therapies, particularly stem cell transplantation, brentuximab vedotin has been shown to be highly effective and the drug is now approved for those particular patients. So, taking that information and moving forward, the idea was to combine it with other standard therapies, not so much in relapsed patients but now in frontline. So a phase II trial, a phase I initially and subsequently expanded into phase II, utilising ABVD chemotherapy, which is the standard, in combination with brentuximab vedotin was initially started. That had very promising results although there was some toxicity with the bleomycin and the brentuximab vedotin so subsequently that was changed to AVD chemotherapy without the bleomycin and brentuximab vedotin was subsequently substituted. Results were very encouraging with very high response rates, a very high number of complete responses and so that’s now the premise as to why one wants to go into this randomised phase III trial. The trial is comparing that standard ABVD chemotherapy with AVD chemotherapy plus brentuximab vedotin.
What have you seen so far?
It’s really early stage, it is just beginning to open at multiple centres. It’s a multinational multi-centre trial. A small number of patients have been accrued so far so we are optimistic that results will mirror the previous studies seen when AVD was combined with brentuximab but more patients will need to be enrolled and then obviously the comparison will need to be made.