Brentuximab vedotin

(Adcetris®)

Adcetris®

Drug updated on 12/11/2024

Dosage FormInjection (intravenous; 50 mg)
Drug ClassCD30-directed antibody-drug conjugates (ADC)
Ongoing and
Completed Studies
ClinicalTrials.gov

Indication

  • Indicated for the treatment of adult patients with previously untreated Stage III or IV classical Hodgkin lymphoma (cHL), in combination with doxorubicin, vinblastine, and dacarbazine in adult patients
  • Indicated for the treatment of pediatric patients 2 years and older with previously untreated high risk classical Hodgkin lymphoma (cHL), in combination with doxorubicin, vincristine, etoposide, prednisone, and cyclophosphamide
  • Indicated for the treatment of adult patients with classical Hodgkin lymphoma (cHL) at high risk of relapse or progression as post-autologous hematopoietic stem cell transplantation (auto-HSCT) consolidation
  • Indicated for the treatment of adult patients with previously untreated systemic anaplastic large cell lymphoma (sALCL) or other CD30-expressing peripheral T-cell lymphomas (PTCL), including angioimmunoblastic T-cell lymphoma and PTCL not otherwise specified, in combination with cyclophosphamide, doxorubicin, and prednisone
  • Indicated for the treatment of adult patients with systemic anaplastic large cell lymphoma (sALCL) after failure of at least one prior multi-agent chemotherapy regimen
  • Indicated for the treatment of adult patients with primary cutaneous anaplastic large cell lymphoma (pcALCL) or CD30-expressing mycosis fungoides (MF) who have received prior systemic therapy.

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Summary
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  • This summary is based on the review of 12 systematic review(s)/meta-analysis(es). [1-12]
  • Brentuximab vedotin (BV) demonstrated a pooled overall response rate (ORR) of 62.6% and complete response (CR) rate of 32.9% in relapsed/refractory classical Hodgkin lymphoma (R/R cHL) after four cycles. BV improved ORR by 22% compared to salvage chemotherapy in R/R cHL patients post-autologous stem cell transplantation (ASCT).
  • For R/R cHL treated with BV, progression-free survival (PFS) rates were reported as 52.1% to 63.2% at 1 year, 45.2% to 56.2% at 2 years, and 31.9% to 33.0% at 5 years. Overall survival (OS) rates for BV were 68.2% to 82.7% at 1 year, 58.0% to 81.9% at 2 years, and 58.0% to 62.0% at 5 years. In post-ASCT cases, 5-year OS was 34%, and 5-year PFS was 31%.
  • BV combined with cyclophosphamide, doxorubicin, and prednisone (A+CHP) showed significant benefits over CHOP in peripheral T-cell lymphoma (PTCL). Additionally, BV with doxorubicin, vinblastine, and dacarbazine (A+AVD) was more effective than doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) in advanced-stage Hodgkin lymphoma (HL).
  • Pembrolizumab and other PD-1 inhibitors provided higher quality of life (QoL) scores than BV in R/R cHL cases, indicating a favorable comparison in terms of patient-reported outcomes.
  • Common adverse events (AEs) associated with BV included hematological toxicities, with neutropenia occurring in 13.3%-23% of patients, anemia in 8.8%-39.0%, thrombocytopenia in 4%-4.6%, and peripheral neuropathy in 3.3%-7.3% of patients. BV significantly increased the risk of both all-grade and high-grade AEs, particularly peripheral sensory neuropathy, pyrexia, nausea, vomiting, diarrhea, alopecia, and neutropenia.
  • High-grade sensory neuropathy (relative risk (RR) 4.79) and high-grade neutropenia (RR 1.48) were reported to be significantly elevated in patients treated with BV.
  • When compared to chemotherapy regimens such as ABVD and bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone (BEACOPP), BV was generally tolerable, though it showed an increased risk of peripheral neuropathy and other adverse events (AEs). In older adults with classical Hodgkin lymphoma (cHL), pulmonary toxicity was more common with more than two cycles of bleomycin, while cumulative BV doses were associated with peripheral neuropathy.
  • BV treatment in R/R cHL post-ASCT showed significant clinical response and survival benefits, with notable effectiveness in combination with A+CHP for PTCL. In older adults with cHL, BV was associated with increased toxicity, specifically pulmonary toxicity and peripheral neuropathy. Special dosing and timing considerations are advised for hemodialysis patients due to altered pharmacokinetics of BV. Pembrolizumab and similar inhibitors demonstrated superior QoL improvements in R/R cHL compared to BV.

Product Monograph / Prescribing Information

Document TitleYearSource
Adcetris (brentuximab vedotin) Prescribing Information.2023Seagen Inc., Bothell, WA

Systematic Reviews / Meta-Analyses

Document TitleYearSource
A systematic literature review of the epidemiology, quality of life, and economic burden, including disease pathways and treatment patterns of relapsed/refractory classical Hodgkin lymphoma2022Expert Review of Hematology
Efficacy of Brentuximab Vedotin and Nivolumab in Refractory or Relapsed Hodgkin Lymphoma: A Systematic Review2022 Cureus
The clinical and economic burden of peripheral T-cell lymphoma: a systematic literature review2022 Future Oncology (London
Effectiveness of brentuximab vedotin monotherapy in relapsed or refractory Hodgkin lymphoma: a systematic review and meta-analysis2021 Leukemia & Lymphoma
Chemotherapy for non-Hodgkin lymphoma in the hemodialysis patient: A comprehensive review2021 Cancer Science
Long-term survival outcomes of brentuximab vedotin in patients with relapsed or refractory Hodgkin lymphoma: a systematic review and meta-analysis2021 European Review for Medical and Pharmacological Sciences
Efficacy and safety of front-line treatments for advanced Hodgkin lymphoma: a systematic literature review2020 Expert Review of Hematology
Interventions for mycosis fungoides2020Cochrane Database of Systematic Reviews
A systematic review of therapeutic regimens for older patients with newly diagnosed Hodgkin lymphoma2020Leukemia & Lymphoma
The clinical and humanistic burden of cutaneous T-cell lymphomas and response to conventional and novel therapies: results of a systematic review2020 Expert Review of Hematology
Risk of adverse events in lymphoma patients treated with brentuximab vedotin: a systematic review and meta-analysis2020 Expert Opinion on Drug Safety
Brentuximab vedotin for the treatment of patients with relapsed or refractory Hodgkin lymphoma after autologous stem cell transplantation2020British Journal of Haematology

Clinical Practice Guidelines