Brentuximab vedotin plus chemo better than standard chemo for T-cell lymphoma

Results of the Echelon-2 trial have been published recently in the Lancet.

The trial aimed to find out if it is safe and effective to use brentuximab vedotin instead of vincristine in the CHOP chemotherapy regimen (combination of drugs) for people with peripheral T-cell lymphomas that have a protein called CD30 and who have not had any treatment before.

CHOP chemotherapy includes cyclophosphamide, doxorubicin (or hydroxydaunorubicin), vincristine (also known as Oncovin®) and prednisolone. Brentuximab vedotin is an antibody–drug conjugate: an anti-cancer drug joined to an antibody. The antibody targets a protein called CD30 on lymphoma cells and takes the anti-cancer drug directly to them.

People in the study were allocated to one of two treatment groups:

• One group received brentuximab vedotin in combination with CHP chemotherapy (cyclophosphamide, doxorubicin [or hydroxydaunorubicin] and prednisolone).
• The other group received standard treatment with CHOP chemotherapy.

Both groups had 6 to 8 cycles of treatment every 3 weeks.

The study looked at how long the response to treatment lasted in each group by measuring how long it was before the lymphoma got worse.

In the brentuximab vedotin + CHP group, it was an average of 48 months (4 years) after treatment before lymphoma got worse. In the CHOP group, lymphoma got worse after an average of 21 months (less than 2 years). A similar number of people in both groups experienced side effects.

This shows that first-line treatment with brentuximab vedotin + CHP is better than CHOP for people with CD30-positive T-cell lymphomas.

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