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Brentuximab vedotin plus AVD for Hodgkin lymphoma: incidence and management of peripheral neuropathy in a multisite cohort. Blood Adv 2023 Nov 14;7(21):6630-6638

Date

08/18/2023

Pubmed ID

37595053

Pubmed Central ID

PMC10628810

DOI

10.1182/bloodadvances.2023010622

Scopus ID

2-s2.0-85177236811 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

Brentuximab vedotin (BV) in combination with doxorubicin, vinblastine, and dacarbazine (AVD) is increasingly used for frontline treatment of stage III/IV classical Hodgkin lymphoma (cHL). Peripheral neuropathy (PN) was the most common and treatment-limiting side effect seen in clinical trials but has not been studied in a nontrial setting, in which clinicians may have different strategies for managing it. We conducted a multisite retrospective study to characterize PN in patients who received BV + AVD for newly diagnosed cHL. One hundred fifty-three patients from 10 US institutions were eligible. Thirty-four patients (22%) had at least 1 ineligibility criteria for ECHELON-1, including stage, performance status, and comorbidities. PN was reported by 80% of patients during treatment; 39% experienced grade (G) 1, 31% G2, and 10% G3. In total, BV was modified in 44% of patients because of PN leading to BV discontinuation in 23%, dose reduction in 17%, and temporary hold in 4%. With a median follow-up of 24 months, PN resolution was documented in 36% and improvement in 33% at the last follow-up. Two-year progression-free survival (PFS) for the advanced-stage patients was 82.7% (95% confidence interval [CI], 0.76-0.90) and overall survival was 97.4% (95% CI, 0.94-1.00). Patients who discontinued BV because of PN did not have inferior PFS. In the nontrial setting, BV + AVD was associated with a high incidence of PN. In our cohort, which includes patients who would not have been eligible for the pivotal ECHELON-1 trial, BV discontinuation rates were higher than previously reported, but 2-year outcomes remain comparable.

Author List

Bowers JT, Anna J, Bair SM, Annunzio K, Epperla N, Pullukkara JJ, Gaballa S, Spinner MA, Li S, Messmer MR, Nguyen J, Ayers EC, Wagner CB, Hu B, Di M, Huntington SF, Furqan F, Shah NN, Chen C, Ballard HJ, Hughes ME, Chong EA, Nasta SD, Barta SK, Landsburg DJ, Svoboda J

Authors

Kaitlin Annunzio DO Assistant Professor in the Medicine department at Medical College of Wisconsin
Nirav N. Shah MD Associate Professor in the Medicine department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Antineoplastic Combined Chemotherapy Protocols
Hodgkin Disease
Humans
Incidence
Peripheral Nervous System Diseases
Retrospective Studies