First Targeted Therapy for Pediatric Hodgkin Lymphoma Achieves Reduced Radiation, Excellent Outcomes

The first frontline clinical trial using targeted therapy with brentuximab vedotin to treat high-risk pediatric Hodgkin lymphoma has achieved excellent outcomes, according to a new study published in the Journal of Clinical Oncology. The study shows that the drug allowed for reduced radiation exposures and resulted in fewer adverse effects for patients, according to its authors.

Brentuximab vedotin, an anti-CD30 antibody drug conjugate, is already approved to treat adults with Hodgkin lymphoma. The drug is specifically targeted to Hodgkin Reed Sternberg cells, delivering treatment directly to the cancer cells, according to the study authors.

“I think of brentuximab vedotin as a smart drug,” said Monika Metzger, MD, the study’s first author, in a press release. “Unlike conventional chemotherapy, which can have wide-ranging effects on all cells of the body, this drug knows to go directly to the Hodgkin lymphoma cells - maximizing its effect while minimizing side effects.”

The phase 2 clinical trial replaced the chemotherapy drug vincristine with brentuximab vedotin in the frontline treatment regimen, which included other chemotherapy agents and radiation when necessary. Vincristine is associated with neuropathy, a symptom that was reduced when it was removed from the treatment regimen, according to the researchers.

The study was conducted on 77 patients, 35% of whom were spared radiation. When radiation was necessary, it was precisely tailored, with reduced dosages applied when possible. The overall 3-year survival for the trial was 99%.

“We have already reduced the use of radiation for low-risk Hodgkin lymphoma patients,” said Matthew Krasin, MD, co-senior author of the study, in the release. “In this study we've shown that it is also possible to either omit or reduce the extent of radiation for high-risk patients, using highly focal methods such as proton beam radiation or intensity modulated radiation.”

The researchers concluded brentuximab vedotin is tolerable in the frontline treatment of pediatric high-risk Hodgkin lymphoma, resulting in reduced radiation exposure and producing excellent outcomes. The drug is currently being incorporated into other national trials for the care of pediatric patients with Hodgkin lymphoma.

REFERENCE

Excellent outcomes reported for first targeted therapy for pediatric Hodgkin lymphoma [news release]. EurekAlert; April 8, 2021. Accessed April 8, 2021. https://www.eurekalert.org/pub_releases/2021-04/sjcr-eor040721.php