Patients with CD30-positive peripheral T-cell lymphoma (PTCL) who reach a complete response (CR) after front-line brentuximab vedotin plus cyclophosphamide, doxorubicin, and prednisone (A+CHP) may benefit from consolidative stem cell transplant (SCT), according to research published in Blood Advances.
Over the past several decades, patients with PTCL have typically been treated with cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP), though this population has been in need of improved treatment options. SCT has, however, previously been suggested as a potentially beneficial consolidative option.
The randomized phase 3 ECHELON-2 trial (ClinicalTrials.gov Identifier: NCT01777152) previously showed that A+CHP may improve PTCL outcomes compared with CHOP, particularly among patients with CD30-positive disease, such as patients with systemic anaplastic large cell lymphoma. For this study, researchers evaluated whether consolidative SCT improves outcomes among patients who reached a CR after front-line A+CHP in ECHELON-2. Whether SCT improved outcomes in CHOP-treated patients was also investigated.
Overall, data from 177 patients with CD30-positive PTCL from the A+CHP arm of ECHELON-2 were included. Among these, 114 had a CR after treatment and 38 proceeded to consolidative SCT. The median follow-up for progression-free survival (PFS) was 47.57 months.
Analysis showed that patients who underwent SCT had a lower risk of a PFS event (hazard ratio, 0.36; risk reduction, 64%). The median PFS among patients who received SCT was not reached compared with 55.66 months among patients who did not receive SCT. These findings were noted regardless of PTCL subtype.
“Analyses of SCT use among patients who received A+CHP appears to support the benefit of consolidative SCT; however, the benefit appeared less pronounced in the CHOP arm,” the authors wrote in their report.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, or device companies. Please see the original reference for a full list of authors’ disclosures.
Savage KJ, Horwitz SM, Advani R, et al. Role of stem cell transplant in CD30+ PTCL following frontline brentuximab vedotin plus CHP or CHOP in ECHELON-2. Blood Adv. 2022;6(19):5550-5555. doi:10.1182/bloodadvances.2020003971