Background We previously demonstrated that brentuximab vedotin (BV) used as second-line therapy in patients with Hodgkin lymphoma is a tolerable and effective bridge to autologous hematopoietic cell transplantation (AHCT). Here, we report the post-AHCT outcomes of patients treated with second-line standard/fixed-dose BV and an additional cohort of patients where positron-emission tomography adapted dose-escalation of second-line BV was utilized. Patients and methods Patients on the dose-escalation cohort received 1.8 mg/kg of BV intravenously every 3 weeks for two cycles. Patients in complete remission (CR) after two cycles received two additional cycles of BV at 1.8 mg/kg, while patients with stable disease or partial response were escalated to 2.4 mg/kg for two cycles. All patients, regardless of treatment cohort, proceeded directly to AHCT or received additional pre-AHCT therapy at the discretion of the treating physician based on remission status after second-line BV. Results Of the 20 patients enrolled to the BV dose-escalation cohort, 8 patients underwent BV dose-escalation. BV escalation was well-tolerated, but no patients who were escalated converted to CR. Of 56 evaluable patients treated across cohorts, the overall response rate (ORR) to second-line BV was 75% with 43% CR. Twenty-eight (50%) patients proceeded directly to AHCT without post-BV chemotherapy, and a total of 50 patients proceeded to AHCT. Thirteen patients received consolidative post-AHCT therapy with either radiation, BV, or a PD-1 inhibitor. After AHCT, the 2-year progression-free survival (PFS) and overall survival were 67% and 93%, respectively. The 2-year PFS among patients in CR at the time of AHCT (n = 37) was 71% compared with 54% in patients not in CR (p = 0.12). The 2-year PFS in patients who proceeded to AHCT directly after receiving BV alone was 77%. Conclusions Second-line BV is an effective bridge to AHCT that produces responses of sufficient depth to provide durable remission in conjunction with AHCT (clinicaltrials.gov: NCT01393717).

中文翻译：

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二线brentuximab vedotin在复发性或难治性霍奇金淋巴瘤中进行自体干细胞移植。

背景我们先前证明，在霍奇金淋巴瘤患者中用作第二线治疗的brentuximab vedotin（BV）是自体造血细胞移植（AHCT）的可耐受且有效的桥梁。在这里，我们报告了接受二线标准/固定剂量BV治疗的患者的AHCT结局，以及另外一组使用正电子发射断层扫描适应二线BV剂量递增的患者。患者和方法剂量递增研究组的患者每3周静脉注射BV 1.8 mg / kg，持续两个周期。在两个周期后达到完全缓解（CR）的患者又接受了两个周期的BV，分别为1.8 mg / kg，而病情稳定或部分缓解的患者在两个周期中均升至2.4 mg / kg。所有患者，无论治疗人群如何，根据二线BV缓解后的状况，由治疗医师自行决定直接进行AHCT或接受额外的AHCT前治疗。结果参加BV剂量递增队列的20名患者中，有8例接受了BV剂量递增。BV升高的耐受性良好，但没有患者升级为CR。在所有队列中接受治疗的56名可评估患者中，对二线BV的总缓解率（ORR）为75％，CR为43％。28例（50％）患者直接接受AHCT，而未进行BV后化疗，总共50例患者进行了AHCT。13例接受放疗，BV或PD-1抑制剂的AHCT合并巩固治疗。AHCT后，2年无进展生存期（PFS）和总生存期分别为67％和93％。在AHCT时，CR患者中的2年PFS（n = 37）为71％，而非CR患者为2％（p = 0.12）。仅接受BV后直接进行AHCT的患者的2年PFS为77％。结论二线BV是通向AHCT的有效桥梁，与AHCT结合，可产生足够深度的反应以提供持久的缓解（clinicaltrials.gov：NCT01393717）。