2021CSCO report: The current status of Hodgkin's lymphoma treatment illustrates this problem

It is only for medical professionals to read and refer to.
Through research to see the treatment model and curative effect results of Hodgkin's lymphoma in East Asia
.

In September, the academic feast in the field of oncology in China-the 24th National Conference on Clinical Oncology and the 2021 CSCO Annual Conference will be held in the form of an online conference on September 25-29, 2021
.

The theme of the annual meeting is "Focus on Innovative Research, Leading the Future of Originality"
.

As always, this CSCO conference showcased many new advances in lymphoma diagnosis and treatment, one of which was the presentation of the final results of the East Asian subgroup of the B-HOLISTIC study [1]
.

We selected the content that doctors pay attention to to satisfy the readers
.

Let’s take a look at the treatment model and clinical results of Hodgkin’s lymphoma in East Asia.
[1] The B-HOLISTIC study evaluated classic Hodgkin’s lymphoma (cHL) and recurrence from countries in Latin America, Africa, the Middle East and Asia-Pacific regions.
The treatment model and outcome of patients with refractory cHL (RRHL)
.

The researchers included adult patients diagnosed with stage IIB-IV cHL or RRHL between January 2010 and December 2013, and collected patient data until their death or the last follow-up
.

The primary endpoint is progression-free survival (PFS) in RRHL patients
.

Secondary endpoints include overall survival (OS), response rate, and adverse events (AEs)
.

In the subgroup, a total of 426 eligible patients were included
.

Including 138 cases in Taiwan, China, 128 cases in South Korea, 100 cases in Mainland China, 44 cases in Singapore, and 16 cases in Hong Kong, China
.

402 cases were included in the cHL group and 98 cases were included in the RRHL group (74 patients initially diagnosed with cHL had disease progression to RRHL during the study period)
.

The median age (range) of patients in the cHL group and RRHL group at diagnosis was 33 years (18-90 years) and 32 years (18-92 years), respectively
.

1.
Treatment mode All cHL patients received first-line chemotherapy: 371 (92.
3%) patients received ABVD regimen (doxorubicin, bleomycin, vinblastine and dacarbazine)
.

Among 84 patients with initial salvage chemotherapy, 23 patients (27.
4%) received etoposide, methylprednisolone, cytarabine, and cisplatin regimens
.

Among 72 patients suitable for transplantation, 54 (75.
0%) patients underwent stem cell transplantation
.

2.
Clinical results The 5-year PFS rates of the cHL group and RRHL group were 69.
5% and 35.
3%, respectively (Table 1) The 5-year OS rates were 84.
7% and 60.
5%, respectively (Table 1) Table 1 Clinical results of cHL and RRHL patients* 74 patients with the initial diagnosis of cHL progressed to RRHL during the study period.
After cHL patients received first-line treatment with chemotherapy alone or combined with radiotherapy; after RRHL patients received the first salvage treatment; ORR=CR+PR‡after the diagnosis of RRHL, the study brought it What inspired us? On the whole, the treatment model of cHL and RRHL in East Asia is generally consistent with the recommendations of European guidelines [1]
.

According to ESMO guidelines, the first-line treatment for cHL patients usually includes a combination of radiotherapy and chemotherapy or chemotherapy alone (late stage); the treatment option for most RRHL patients is high-dose chemotherapy (HDCT) sequential autologous stem cell transplantation (ASCT) [2]
.

Let's take a look at the overall data of this study and other subgroups: the total population of the B-HOLISTIC study announced at the 2020 American Society of Hematology (ASH) annual meeting (covering East Asia, Latin America, the Middle East, South Africa, Australia and Russia) The data show that the 5-year PFS rates of cHL and RRHL patients are 65% and 33.
9%, respectively [3]; the Chinese subgroup of the B-HOLISTIC study announced at the European Society of Hematology (EHA) annual meeting in 2021 shows that cHL and RRHL patients The five-year PFS rates of 55.
1% and 29.
8% were respectively [4]
.

In addition, the PFS rate of cHL patients in this subgroup analysis is comparable to data from real-world studies conducted in Europe and North America, but slightly lower [1]
.

It can be seen that cHL and RRHL still have large unmet needs in treatment
.

The use of new drugs such as verbutuximab (BV) and immune checkpoint inhibitors based on conventional chemotherapy is expected to improve this situation
.

In 2020, an antibody-conjugated drug targeting CD30 will be launched on the market.
At present, it has four approved indications in China, including: CD30-positive relapsed or refractory systemic anaplastic large cells Adult patients with lymphoma (sALCL) and cHL, as well as adult patients with CD30-positive primary cutaneous anaplastic large cell lymphoma (pcALCL) and mycosis fungoides (MF) who have previously received systemic treatment
.

In key BV studies (SG035-0003 study [5] and C25007 study [6]), BV showed relapsed or refractory CD30-positive HL patients after autologous hematopoietic stem cell transplantation (ASCT), as well as non-stem cell transplant candidates The efficacy and safety of patients with relapsed or refractory cHL
.

At present, the "CSCO Lymphoma Diagnosis and Treatment Guidelines (2021 Edition)" has recommended BV as a single agent or in combination with nivolumab for relapsed and refractory CD30-positive HL patients, which also adds more confidence to the practice of oncologists
.

References: [1]Real-world treatment patterns and clinical outcomes of patients with hodgkin lymphoma in east asia:final results from a b-holistic subgroup.
CSCO 2021[2]Eichenauer DA,et al.
Hodgkin lymphoma:ESMO Clinical Practice Guidelines for diagnosis,treatment and follow-up.
Ann Oncol.
2018;29:iv19–29.
[3]https://ash.
confex.
com/ash/2020/webprogram/Paper134885.
html[4]https://library .
ehaweb.
org/eha/2021/eha2021-virtual-congress/324232/yuqin.
song.
retrospective.
study.
to.
describe.
treatment.
pathways.
outcomes.
and.
html?f=listing%3D0%2Abrowseby%3D8%2Asortby %3D1%2Asearch%3Dresults%2Bsubgroup+analysis%2Bpatients+from%E2%80%AFchina%E2%80%AF[5]Chen R,Gopal AK,Smith SE,et al.
Five-year Survival and Durability Results of Brentuximab Vedotin in Patients With Relapsed or Refractory Hodgkin Lymphoma[J].
Blood.
2016 Sep 22;128(12):1562-6.
[6]Walewski J,Hellmann A,Siritanaratkul N,et al.
Prospective study of brentuximab vedotin in relapsed/refractory Hodgkin lymphoma patients who are not suitable for stem cell transplant or multi-agent chemotherapy[J].
Br J Haematol.
2018 Nov;183(3):400-410 .
Material approval number: VV-MEDMAT-53369 Material approval date: 9/2021- End -*This information is designed to help medical and health professionals better understand the latest developments in the field of related diseases
.

The content of the information published by this site does not mean that it agrees with its description and opinions, but only provides more information
.

If copyright issues are involved, please contact us, and we will deal with it as soon as possible
.

Only for medical and health professionals to understand the information
.

Such information cannot replace professional medical guidance in any way, nor should it be regarded as diagnosis and treatment advice
.

If such information is used for purposes other than understanding the information, Takeda does not assume the related responsibilities
.

●How is the development of proton therapy for Hodgkin's lymphoma? Cancers reveals the "black technology" of nuclear medicine! ●What are the clinical features of elderly Hodgkin's lymphoma? How to choose the right treatment plan? ｜ASH study notes ●Follow the NCCN guidelines to get a thorough diagnosis and treatment of Hodgkin's lymphoma in children! ●Umbilical cord blood-derived NK cell therapy may become the "terminator" of non-Hodgkin's lymphoma? The latest research found.
.
.