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Horwitz S, O'Connor OA, Pro B, Trümper L, Iyer S, Advani R, Bartlett NL, Christensen JH, Morschhauser F, Domingo-Domenech E, Rossi G, Kim WS, Feldman T, Menne T, Belada D, Illés Á, Tobinai K, Tsukasaki K, Yeh SP, Shustov A, Hüttmann A, Savage KJ, Yuen S, Zinzani PL, Miao H, Bunn V, Fenton K, Fanale M, Puhlmann M, Illidge T. The ECHELON-2 Trial: 5-year results of a randomized, phase 3 study of brentuximab vedotin with chemotherapy for CD30-positive peripheral T-cell lymphoma. Ann Oncol 2021; 33:288-298. [PMID: 34921960 PMCID: PMC9447792 DOI: 10.1016/j.annonc.2021.12.002] [Citation(s) in RCA: 75] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 11/12/2021] [Accepted: 12/07/2021] [Indexed: 01/18/2023] Open
Abstract
Background: For patients with peripheral T-cell lymphoma (PTCL), outcomes using frontline treatment with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) or CHOP-like therapy are typically poor. The ECHELON-2 study demonstrated that brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone (A+CHP) exhibited statistically superior progression-free survival (PFS) per independent central review and improvements in overall survival versus CHOP for the frontline treatment of patients with systemic anaplastic large cell lymphoma or other CD30-positive PTCL. Patients and methods: ECHELON-2 is a double-blind, double-dummy, randomized, placebo-controlled, active-comparator phase III study. We present an exploratory update of the ECHELON-2 study, including an analysis of 5-year PFS per investigator in the intent-to-treat analysis group. Results: A total of 452 patients were randomized (1 : 1) to six or eight cycles of A+CHP (N = 226) or CHOP (N = 226). At median follow-up of 47.6 months, 5-year PFS rates were 51.4% [95% confidence interval (CI): 42.8% to 59.4%] with A+CHP versus 43.0% (95% CI: 35.8% to 50.0%) with CHOP (hazard ratio = 0.70; 95% CI: 0.53–0.91), and 5-year overall survival (OS) rates were 70.1% (95% CI: 63.3% to 75.9%) with A+CHP versus 61.0% (95% CI: 54.0% to 67.3%) with CHOP (hazard ratio = 0.72; 95% CI: 0.53–0.99). Both PFS and OS were generally consistent across key subgroups. Peripheral neuropathy was resolved or improved in 72% (84/117) of patients in the A+CHP arm and 78% (97/124) in the CHOP arm. Among patients who relapsed and subsequently received brentuximab vedotin, the objective response rate was 59% with brentuximab vedotin retreatment after A+CHP and 50% with subsequent brentuximab vedotin after CHOP. Conclusions: In this 5-year update of ECHELON-2, frontline treatment of patients with PTCL with A+CHP continues to provide clinically meaningful improvement in PFS and OS versus CHOP, with a manageable safety profile, including continued resolution or improvement of peripheral neuropathy.
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Affiliation(s)
- S Horwitz
- Memorial Sloan Kettering Cancer Center, New York, New York, USA.
| | - O A O'Connor
- University of Virginia Cancer Center, University of Virginia, Charlottesville, Virginia, USA
| | - B Pro
- Division of Hematology and Oncology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - L Trümper
- Universitätsmedizin Göttingen, Göttingen, Germany
| | - S Iyer
- MD Anderson Cancer Center/University of Texas, Houston, Texas, USA
| | - R Advani
- Stanford Cancer Center, Blood and Marrow Transplant Program, Stanford, California, USA
| | - N L Bartlett
- Washington University School of Medicine, St. Louis, Missouri, USA
| | | | | | - E Domingo-Domenech
- Institut Catala D'oncologia, L'Hospitalet de Llobregat, Barcelona, Spain
| | - G Rossi
- Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy
| | - W S Kim
- Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - T Feldman
- John Theurer Cancer Center, Hackensack Meridian Health School of Medicine, Hackensack NJ
| | - T Menne
- Freeman Hospital, Newcastle upon Tyne, England
| | - D Belada
- 4th Department of Internal Medicine - Hematology, University Hospital Hradec Králové, Czech Republic and Charles University in Prague, Faculty of Medicine in Hradec Kralove, Czech Republic
| | - Á Illés
- Debreceni Egyetem, Debrecen, Hajdu-Bihar, Hungary
| | - K Tobinai
- National Cancer Center Hospital, Tokyo, Japan
| | - K Tsukasaki
- Saitama Medical University International Medical Center, Saitama, Japan
| | - S-P Yeh
- China Medical University Hospital, Taichung, Taiwan
| | - A Shustov
- University of Washington Medical Center, Seattle, Washington, USA
| | - A Hüttmann
- Universitatsklinikum Essen, Essen, Nordrhein-Westfalen, Germany
| | - K J Savage
- Department of Medical Oncology and University of British Columbia, BC Cancer, Vancouver, British Columbia, Canada
| | - S Yuen
- Calvary Mater Newcastle Hospital, Australia
| | - P L Zinzani
- IRCCS Azienda Ospedaliero-Universitaria di Bologna, Istituto di Ematologia "Seràgnoli"; Dipartimento di Medicina Specialistica, Diagnostica e Sperimentale, Università di Bologna, Bologna, Italia
| | - H Miao
- Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, USA, a wholly owned subsidiary of Takeda Pharmaceuticals Limited
| | - V Bunn
- Millennium Pharmaceuticals, Inc., Cambridge, Massachusetts, USA, a wholly owned subsidiary of Takeda Pharmaceuticals Limited
| | - K Fenton
- Seagen Inc., Bothell, Washington, USA
| | - M Fanale
- Seagen Inc., Bothell, Washington, USA
| | | | - T Illidge
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, NIHR Biomedical Research Centre, Manchester Academic Health Sciences Centre, Christie Hospital NHS Foundation Trust, Manchester, UK
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Spira A, Ramalingam S, Neal J, Piotrowska Z, Mekhail T, Tsao A, Gentzler R, Riely G, Bazhenova L, Gadgeel S, Nguyen D, Johnson M, Vincent S, Jin S, Griffin C, Bunn V, Lin J, Churchill E, Mehta M, Janne P. OA15.01 Mobocertinib in EGFR Exon 20 Insertion–Positive Metastatic NSCLC Patients With Disease Control on Prior EGFR TKI Therapy. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.082] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Nguyen D, Ramalingam S, Spira A, Riely G, Kim T, Yang JH, Piotrowska Z, Campelo MG, Felip E, Bazhenova L, Jin S, Griffin C, Diderichsen P, Gupta N, Bunn V, Lin J, Churchill E, Mehta M, Zhou C, Janne P. 1218P Characterization of GI toxicities and their impact on efficacy in patients (pts) with EGFR exon 20 insertion+ (ex20ins+) non-small cell lung cancer (NSCLC) treated with mobocertinib (TAK-788) who previously received platinum chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Yang JH, Ramalingam S, Kim T, Kim SW, Riely G, Mekhail T, Nguyen D, Campelo MG, Felip E, Bazhenova L, Jin S, Griffin C, Bunn V, Lin J, Churchill E, Mehta M, Janne P, Zhou C. 1231P Characterization and management of mobocertinib (TAK-788) induced skin toxicity in patients with EGFR exon 20 insertion+ (ex20ins+) non-small cell lung cancer (NSCLC) who previously received platinum chemotherapy. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Horwitz S, Scarisbrick J, Prince H, Whittaker S, Duvic M, Kim Y, Quaglino P, Zinzani P, Bechter O, Eradat H, Pinter-Brown L, Akilov O, Geskin L, Sanches J, Ortiz-Romero P, Lisano J, Brown L, Palanca-Wessels M, Gautam A, Bunn V, Little M, Dummer R. FINAL DATA FROM THE PHASE 3 ALCANZA STUDY: BRENTUXIMAB VEDOTIN (BV) VS PHYSICIAN'S CHOICE (PC) IN PATIENTS (PTS) WITH CD30-POSITIVE (CD30+) CUTANEOUS T-CELL LYMPHOMA (CTCL). Hematol Oncol 2019. [DOI: 10.1002/hon.96_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S.M. Horwitz
- Department of Medicine; Memorial Sloan Kettering Cancer Center; New York United States
| | - J. Scarisbrick
- Department of Dermatology; University Hospital Birmingham; Birmingham United Kingdom
| | - H.M. Prince
- Division of Cancer Medicine; Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, The University of Melbourne; Melbourne Australia
| | - S. Whittaker
- St John's Institute of Dermatology; Guys and St Thomas NHS Foundation Trust; London United Kingdom
| | - M. Duvic
- Department of Dermatology; Division of Internal Medicine, The University of Texas MD Anderson Cancer Center; Houston United States
| | - Y.H. Kim
- Department of Dermatology; Stanford University School of Medicine and Stanford Cancer Institute; Stanford United States
| | - P. Quaglino
- Department of Medical Sciences; Dermatologic Clinic, University of Turin; Turin Italy
| | - P.L. Zinzani
- Institute of Haematology; University of Bologna; Bologna Italy
| | - O. Bechter
- Department of General Medical Oncology; University Hospitals Leuven; Leuven KU Belgium
| | - H. Eradat
- Division of Hematology-Oncology; David Geffen School of Medicine at UCLA; Los Angeles United States
| | - L. Pinter-Brown
- Division of Hematology Oncology; Chao Family Comprehensive Cancer Center, University of California; Irvine United States
| | - O. Akilov
- Department of Dermatology; University of Pittsburgh; Pittsburgh United States
| | - L. Geskin
- Department of Dermatology; Columbia University; New York United States
| | - J. Sanches
- Department of Dermatology; University of São Paulo Medical School; São Paulo Brazil
| | - P. Ortiz-Romero
- Department of Dermatology; University Hospital 12 de Octubre, Institute i+12 Medical School, University Complutense; Madrid Spain
| | - J. Lisano
- Medical Affairs; Seattle Genetics, Inc.; Bothell United States
| | - L. Brown
- Biostatistics; Seattle Genetics, Inc.; Bothell United States
| | | | - A. Gautam
- Global Medical Affairs; Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - V. Bunn
- Oncology Statistics; Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - M. Little
- Oncology Clinical Research; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - R. Dummer
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
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