Brentuximab vedotin with chemotherapy for stage 3/4 classical Hodgkin lymphoma: Three-year update of the ECHELON-1 study.

Abstract

7532 Background: The phase 3 ECHELON-1 study demonstrated that BV with AVD (A+AVD) was superior to ABVD for the frontline treatment of Stage 3/4 cHL. Maturing data from RATHL and SWOG S0816 show limitations to PET2-adapted strategies, including short and long-term toxicities in PET2+ patients (pts) switched to BEACOPP and still frequent relapse in PET2- pts. Pts in the RATHL trial with Stage 3/4 disease ≤60 yrs had a 3-yr PFS of 79.8% (82.1% PET2-); SWOG S0816 reported a 5-yr PFS of 74% (76% PET2-) in the same population. As an alternative to PET-adapted therapy, here we present a 3-year update of the ECHELON-1 study, including ITT PFS and outcomes by PET status. Methods: Pts with Stage 3/4 cHL were randomized 1:1 to receive up to six cycles of A+AVD (n=664) or ABVD (n=670). Interim PET scan after cycle 2 was conducted. All analyses of PFS are exploratory and per investigator assessment. Results: At a median follow-up of 37 months, analysis of PFS in the ITT population favors the A+AVD treatment arm (Table), with a 3-yr PFS of 83.1% for A+AVD vs 76.0% for ABVD; the 3-yr PFS for PET2- pts <60 yrs was 87.2% vs 81.0%, respectively. Trend toward benefit for PET2+ pts <60 yrs treated with A+AVD was also observed, with a 3-yr PFS of 69.2% vs 54.7% with ABVD. Data from prespecified subgroups and safety follow-up, including peripheral neuropathy, will be presented. Conclusions: Follow-up at 3-yrs demonstrates that frontline treatment of Stage 3/4 cHL with A+AVD provides a durable treatment benefit vs ABVD that is independent of PET2 status. While direct comparisons cannot be made, A+AVD compares favorably to PET-adapted strategies without requiring interim PET assessment, escalation of therapy, or bleomycin. Clinical trial information: NCT01712490. [Table: see text]