T ransplant in CR on B rentuximab V edotin Allo Transplant or Maintenance T herapy Anas Younes MD Memorial Sloan Kettering Cancer Center Overall Survival lt1990 median 19 yrs ID: 774800
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Slide1
Recurrent HL after Auto Transplant in CR on Brentuximab Vedotin: Allo Transplant or Maintenance Therapy?
Anas Younes, M.D.
Memorial Sloan Kettering Cancer Center
Slide2Overall Survival
<1990 median 1.9 yrs
1990-2000 median 2.6 yrs>2000* median 1.9 yrs
>2000 vs 1990-2000: P (Gehan) = .02, P (logrank) = .03
Relapse After ASCT: OS by Era of Transplant
Arai
S et al
, Leukemia and Lymphoma 2013
Slide3Gemcitabine, Vinorelbine, and Pegylated Liposomal Doxorubicin (GVD) Followed by Autologous Stem-Cell Transplant (solid line) or GVD after failing a prior transplant (dashed line).
Bartlett N et al. Ann
Oncol
2007;18:1071-1079
Slide4Brentuximab Vedotin: Pivotal Phase II TrialMaximum Tumour Reduction per IRF
Complete remission by PET
94% (96 of 102) of patients achieved
tumour
reduction
Individual patients (n=98*)
Tumour size (% change from baseline)
100
50
0
–50
–100
Younes et
al.
JCO 2012
Slide5Brentuximab Vedotin: Pivotal Phase II TrialPFS Results by Best Response
Phase II pivotal study of brentuximab vedotin in 102 patients with relapsed/refractory HL post ASCT: PFS by best response
Slide6Summary Results of Phase I/II Single Agents in Patients with Relapsed HL
Response rate (%)
Younes a, Hematology/Oncology Clinics of North America 2013
Slide7Single Agent Activity of New Agents in Post SCT Relapsed cHLComparison to multiagent chemotherapy GVD
% Response rate
Younes a et
al.
ASCO 2012
Slide8Brentuximab VedotinInitial treatment vs. Retreatment
HL
sALCL
N= 58 N=8
N=102 N=15
Bartlet
et
al.
ASCO 2012
Slide9Slide10Slide11Slide12Allogeneic stem cell transplantation after reduced intensity conditioning in patients with relapsed or refractory Hodgkin’s lymphoma. Results of the HDR-ALLO study – a prospective clinical trial by the Grupo Español de Linfomas/Trasplante de Médula Osea (GEL/TAMO) and the Lymphoma Working Party of the European Group for Blood and Marrow Transplantation
Sureda
A, et al:
Haematologica
. 2012 February; 97(2): 310–317.
Slide13Non Relapse Mortality
Relapse Incidence
Impact of disease
chemosensitivity on relapse incidence.
Sureda
A, et al: Haematologica. 2012 February; 97(2): 310–317.
RIC and
Allo
SCT for Relapsed/Refractory HL
Slide14RIC and
Allo SCT for Relapsed/Refractory HL
PFS
Slide15Integrated Genomic Analysis of Flow Sorted Hodgkin and Reed-Sternberg Cell in Primary Classical Hodgkin LymphomaJonathan Reichel (New York, USA)
70% of HRS cells have B2MG mutations
Slide16Allo
Transplant for Relapsed
cHL
?
Slide17Proposed Algorithm for Treating Patients Post ASCT