Oncology/Hematology > > Lymphoma– Talk of possible treatment for some clients with brentuximab plus dacarbazine or nivolumab
by Charles Bankhead, Senior Editor, MedPage Today March 6, 2024
Older clients with classical Hodgkin lymphoma inappropriate for standard chemotherapy had high rates of long lasting actions with 2 brentuximab vedotin (BV; Adcetris) routines, one that left out chemotherapy, a little potential research study revealed.
Brentuximab plus the alkylating representative dacarbazine (DTIC) produced an unbiased reaction rate (ORR) of 95% in 22 clients, whereas brentuximab plus nivolumab (Opdivo) resulted in actions in 86% of 21 clients. Two-thirds of clients attained total reactions with each routine.
Clients treated with the dacarbazine routine had a typical progression-free survival (PFS) of practically 4 years and the average had yet to be reached with the nivolumab routine after 51.6 months of follow-up, reported Jonathan Friedberg, MD, MMSc, of the University of Rochester Wilmot Cancer Institute in New York, and co-authors in Blood
“Despite a high mean age, addition of clients approximately 88 years, and frailty showed on extensive geriatric evaluation, our outcomes compare positively with our previous single-agent and mix research studies in older clients including BV,” the authors composed. “With a mean follow-up of practically 4 years, the mDOR [median duration of response] and typical PFS have actually not been reached, supporting the reasoning that some clients treated with this program might go on to be treated. Comprehensive geriatric evaluations showed comparable rates of frailty and geriatric syndromes in the BV-nivolumab associate compared to the BV-DTIC mate.”
The high action rates and resilience of actions do raise the concern of whether some clients with classical Hodgkin lymphoma, regardless of age, may be treated without basic mix chemotherapy, concurred the author of an accompanying commentary.
“Traditionally, the dogma has actually been that a remedy can just originate from some mix of an anthracycline, a vinca alkaloid, and a drug that rhymes with -carbazine,” composed Ryan C. Lynch, MD, of the University of Washington and Fred Hutchinson Cancer Center in Seattle. “Personal anecdotes along with emerging information from research studies like this recommend there might be another method.”
“Using noninvasive genotyping and flowing growth DNA might assist determine clients who are either at lower danger at standard or maybe treated far earlier throughout their treatment than expected,” Lynch continued. “Given more recent drugs and emerging innovations, we need to solve to develop the next generation of research studies with the objectives of less or, attempt I state, no chemotherapy at all, enabling us to book more harmful chemotherapy programs for just those who genuinely require it.”
Total survival for grownups with innovative classical Hodgkin lymphoma has actually enhanced significantly over the previous 2 years, Friedberg and co-authors kept in mind in their intro. Older clients have inferior results. A current analysis of Medicare clients revealed that just a 4th gotten full-course chemotherapy, half got partial programs or single-agent treatment, and the staying 4th got no treatment at all.
Full-course treatment enhances survival,
