Among patients with CD30-expressing mycosis fungoides (MF) or primary cutaneous anaplastic large-cell lymphoma (C-ALCL), brentuximab vedotin (BV) appears to yield superior outcomes to physician’s choice therapy, according to research published in Blood Advances.
MF and C-ALCL, 2 subtypes of cutaneous T cell lymphoma (CTCL), share several phenotypic features, including CD30 expression, though the 2 malignancies show different variance in such expression. These diseases tend to have a high symptom burden and manifest chronically, with significant negative effects on patient quality of life (QoL).
While no standard therapies are known to improve survival rates among patients with CTCL, many therapies are used to improve QoL and reduce symptom burden. BV, which targets CD30-expressing cells, previously showed improvement over physician’s therapy choice in the phase 3 ALCANZA study (ClinicalTrials.gov Identifier: NCT01578499) in several endpoints, including progression-free survival and QoL, among patients with C-ALCL or CD30-expressing MF.
For this final analysis of ALCANZA, researchers aimed to confirm whether BV improved previously evaluated endpoints, as well as overall survival, compared with physician’s therapy choice among patients with CD30-expressing MF or C-ALCL.
Overall, 128 patients were randomly assigned to receive BV (64 patients) or physician’s choice (64 patients). After a median follow-up of 45.9 months, long-term efficacy and safety at the primary study endpoint (ORR4) was determined to be 54.7% in the BV group vs 12.5% in the physician’s choice group (P <.001); the complete response rates were 17.2% vs 1.6%, respectively (P =.002).
The median progression-free survival in the BV group was 16.7 months vs 3.5 months in the physician’s choice group (P <.001), and median time to next treatment was similarly improved with BV (14.2 vs 5.6 months, respectively; hazard ratio, 0.27; P <.001).
BV was not, however, associated with improved overall survival (3-year rate, 64.4% vs 61.9% with physician’s choice; P =.31). A total of 44 patients in the BV arm developed any-grade peripheral neuropathy, with 18 patients having an ongoing grade 1-2 event at the time of analysis.
Disclosure: The study author(s) declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Horwitz SM, Scarisbrick JJ, Dummer R, et al. Randomized phase 3 ALCANZA study of brentuximab vedotin vs physician’s choice in cutaneous T-cell lymphoma: final data. Blood Adv. 2021;5(23):5098-5106. doi:10.1182/bloodadvances.2021004710